Infection Control and Hospital Epidemiology最新文献

{"title":"A discrete choice experiment to evaluate healthcare personnel preferences regarding risk-tailored policies for contact precautions for patients with methicillin-resistant <i>Staphylococcus aureus</i>.","authors":"Lyndsay M O'Hara, David P Calfee, Graham M Snyder, Elise M Martin, Nicholas F Angelino, Nathan N O'Hara, Anthony D Harris","doi":"10.1017/ice.2025.65","DOIUrl":"https://doi.org/10.1017/ice.2025.65","url":null,"abstract":"<p><strong>Background: </strong>An alternative to an \"all or none\" approach to contact precautions for patients with MRSA carriage may be a \"risk-tailored\" approach - using gloves and gowns only for certain high-risk activities, locations, or roles.</p><p><strong>Methods: </strong>We distributed a discrete choice experiment to healthcare personnel (HCPs) in three cities. Respondents were presented with eight choice sets, each consisting of two hypothetical policy options for glove and gown use to prevent MRSA transmission. In each comparison, respondents selected their preferred option. Using mixed logit modeling we calculated utility derived from each policy component, probability of uptake for the most favored policies, and heterogeneity in preferences based on HCP role.</p><p><strong>Results: </strong>In total, 326 HCPs completed the survey. 237 (54%) respondents reported wearing gloves and gowns 'all the time' when required. Respondents' preferred policy with the highest utility score was to use gloves and gown for all HCPs roles (utility, 0.17; 95% CI, 0.12 to 0.23), in high-risk settings (utility, 0.12; 95% CI 0.07-0.18), when touching the patient (utility, 0.11; 95% CI 0.06-0.17). Sixty-three percent (95% CI 60-66) would support a risk-tailored approach over an approach where contact precautions are used by all HCPs in all settings and for all activities. Support varied by HCP role (p < 0.02), with the strongest probability of support from physicians and advanced practice providers (77%, 95% CI 72%-82%) and the least support from environmental services personnel (45%, 95% CI 37%-53%).</p><p><strong>Conclusions: </strong>This discrete choice survey demonstrates that most HCPs prefer a risk-tailored approach to contact precautions when caring for patients with MRSA.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SHEA/APIC/IDSA/PIDS multisociety position paper: Raising the bar: necessary resources and structure for effective healthcare facility infection prevention and control programs.","authors":"Thomas R Talbot, Christopher Baliga, Rebecca Crapanzano-Sigafoos, Tania N Bubb, Mohamad Fakih, Thomas G Fraser, Ibukunoluwa C Kalu, Vidya Mony, Anupama Neelakanta, Ann-Christine Nyquist, Catherine O'Neal, Jan E Patterson, David K Warren, Sharon B Wright","doi":"10.1017/ice.2025.73","DOIUrl":"https://doi.org/10.1017/ice.2025.73","url":null,"abstract":"<p><p>The Society for Healthcare Epidemiology of America, the Association of Professionals in Infection Control and Epidemiology, the Infectious Diseases Society of America, and the Pediatric Infectious Diseases Society represent the core expertise regarding healthcare infection prevention and infectious diseases and have written multisociety statement for healthcare facility leaders, regulatory agencies, payors, and patients to strengthen requirements and expectations around facility infection prevention and control (IPC) programs. Based on a systematic literature search and formal consensus process, the authors advocate raising the expectations for facility IPC programs, moving to effective programs that are:• Foundational and influential parts of the facility's operational structure• Resourced with the correct expertise and leadership• Prioritized to address all potential infectious harmsThis document discusses the IPC program's leadership-a dyad model that includes both physician and infection preventionist leaders-its reporting structure, expertise, and competencies of its members, and the roles and accountability of partnering groups within the healthcare facility. The document outlines a process for identifying minimum IPC program medical director support. It applies to all types of healthcare settings except post-acute long-term care and focuses on resources for the IPC program. Long-term acute care hospital (LTACH) staffing and antimicrobial stewardship programs will be discussed in subsequent documents.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-19"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multisociety guidance for sterilization and high-level disinfection.","authors":"Erica S Shenoy, David J Weber, Kathleen McMullen, Zachary Rubin, Priya Sampathkumar, Joshua K Schaffzin, Emily Sickbert-Bennett, Laraine Washer, Deborah S Yokoe, Audrey H Calderwood, Raymond Chinn, Michelle Day, Sylvia Garcia-Houchins, Waleed Javaid, Susan Klacik, Erin Kyle, Rekha K Murthy, Amber Wood, William A Rutala","doi":"10.1017/ice.2025.41","DOIUrl":"https://doi.org/10.1017/ice.2025.41","url":null,"abstract":"<p><p>SHEA, in partnership with ASGE, APIC, AAMI, AORN, HSPA, IDSA, SGNA, and The Joint Commission, developed this multisociety infection prevention guidance document for individuals and organizations that engage in sterilization or high-level disinfection (HLD). This document follows the <i>CDC Guideline for Disinfection and Sterilization in Healthcare Facilities</i>. This guidance is based on a synthesis of published scientific evidence, theoretical rationale, current practices, practical considerations, writing group consensus, and consideration of potential harm when applicable. The supplementary material includes a summary of recommendations. The guidance provides an overview of the Spaulding Classification and considerations around manufacturers' instructions for use (MIFUs). Its recommendations address: point-of-use treatment prior to sterilization or HLD, preparation of reusable medical devices at the location of processing, sterilization, and immediate use steam sterilization (IUSS), HLD of lumened and non-lumened devices, processing of reusable medical devices used with lubricating or defoaming agents, monitoring for effectiveness of processing, handling of devices after HLD, augments and alternatives to HLD, processing of investigational devices, tracking of reusable medical devices, and approaches to implementation.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-23"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 prevention training with video-based feedback in nursing homes: impact on staff safety behaviors.","authors":"Victoria Ngai, Joshua B Hsi, Raveena D Singh, John E Mitchell, Raheeb Saavedra, Shruti K Gohil, Emily A Hsi, Robert Pedroza, Chase Berman, Kristine P Nguyen, Matthew Zahn, Emily Fonda, Susan S Huang, Gabrielle M Gussin","doi":"10.1017/ice.2025.77","DOIUrl":"https://doi.org/10.1017/ice.2025.77","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate impact of COVID-19 prevention training with video-based feedback on nursing home (NH) staff safety behaviors.</p><p><strong>Design: </strong>Public health intervention.</p><p><strong>Setting & participants: </strong>Twelve NHs in Orange County, California, 6/2020-4/2022.</p><p><strong>Methods: </strong>NHs received direct-to-staff COVID-19 prevention training and weekly feedback reports with video montages about hand hygiene, mask-wearing, and mask/face-touching. One-hour periods of recorded streaming video from common areas (breakroom, hallway, nursing station, entryway) were sampled randomly across days of the week and nursing shifts for safe behavior. Multivariable models assessed the intervention impact.</p><p><strong>Results: </strong>Video auditing encompassed 182,803 staff opportunities for safe behavior. Hand hygiene errors improved from first (67.0%) to last (35.7%) months of the intervention, decreasing 7.6% per month (OR = 0.92, 95% CI = 0.92-0.93, <i>P</i> < 0.001); masking errors improved from first (10.3 %) to last (6.6%) months of the intervention, decreasing 2.3% per month (OR = 0.98, 95% CI = 0.97-0.99, <i>P</i> < 0.001); face/mask touching improved from first (30.0%) to last (10.6%) months of the intervention, decreasing 2.5% per month (OR = 0.98, 95% CI = 0.97-0.98, <i>P</i> < 0.001). Hand hygiene errors were most common in entryways and on weekends, with similar rates across shifts. Masking errors and face/mask touching errors were most common in breakrooms, with the latter occurring most commonly during the day (7A.M.-3P.M.) shift, with similar rates across weekdays/weekends. Error reductions were seen across camera locations, days of the week, and nursing shifts, suggesting a widespread benefit within participating NHs.</p><p><strong>Conclusion: </strong>Direct-to-staff training with video-based feedback was temporally associated with improved hand hygiene, masking, and face/mask-touching behaviors among NH staff during the COVID-19 pandemic.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and perioperative factors contributing to postoperative pneumonia in patients undergoing isolated coronary artery bypass grafting: a retrospective Chinese study.","authors":"Yuxiao Zhan, Yang Yang, Jian Zhang, Rui Yang, Guojun Zhang","doi":"10.1017/ice.2025.19","DOIUrl":"https://doi.org/10.1017/ice.2025.19","url":null,"abstract":"<p><strong>Background: </strong>Despite the existent studies investigating the risk factors for postoperative pneumonia (POP) following coronary artery bypass grafting (CABG), the comprehensive understanding of POP is constrained by the scarcity of epidemiological data.</p><p><strong>Objective: </strong>To investigate the epidemiology and contributing factors of POP in patients undergoing isolated CABG, and establish a prediction model.</p><p><strong>Design: </strong>A single center, retrospective case-control study.</p><p><strong>Setting: </strong>Seven cardiovascular surgery wards across three campuses of a large general hospital in Henan Province, Mid-China.</p><p><strong>Participants: </strong>Patients aged ≥ 18 years who underwent isolated CABG between January 1, 2020 and November 30, 2023.</p><p><strong>Methods: </strong>Univariate and multivariate analyses with restricted cubic splines (RCS) were performed to identify factors that independently contributed to POP and explore the potential nonlinear relationships. The prediction model was evaluated via receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>POP occurred in 11.34% of patients (518/4569). A total of 416 pathogenic strains were isolated from 381 patients, predominantly Gram-negative bacteria (86.5%). Pathogen distribution varied annually and quarterly. Multivariate analyses indicated that age, diabetes mellitus, smoking, operative duration, red blood cell transfusion, and duration of mechanical ventilation were significantly associated with higher POP risk, whereas higher hemoglobin and total cholesterol levels indicated a reduced likelihood. RCS analysis revealed a nonlinear relationship between operative duration and POP. The prediction model demonstrated a high predictive value (C-statistic: 0.774, 95% CI: 0.735-0.813).</p><p><strong>Conclusions: </strong>This study identified eight independent factors that significantly influence the risk of POP following CABG, thereby clarifying the direction for optimizing perioperative prevention strategies for POP.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-dimensional chart for antimicrobial spectrums and costs: a tool for antimicrobial stewardship.","authors":"Yohei Manabe, Hideharu Hagiya","doi":"10.1017/ice.2025.74","DOIUrl":"https://doi.org/10.1017/ice.2025.74","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-2"},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High prevalence of multidrug-resistant bacteria on patient medical file surfaces at five critical care units in Kampala, Uganda: an explanatory sequential mixed-methods study - ERRATUM.","authors":"","doi":"10.1017/ice.2025.70","DOIUrl":"https://doi.org/10.1017/ice.2025.70","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outbreaks in hematopoietic stem cell transplant units: a systematic review.","authors":"Loukas Kakoullis, Georges Chedid, Bradley Walker, Vasiliki Xirou, Sufian Abdel Hafez, Sokratis N Zisis, Shreya Arora, Costas A Christophi, George Panos, Courtney E Harris, Robert Colgrove","doi":"10.1017/ice.2025.66","DOIUrl":"https://doi.org/10.1017/ice.2025.66","url":null,"abstract":"<p><strong>Objective: </strong>To identify and present the pathogens and sources of contamination linked to outbreaks within hematopoietic stem cell transplant (HSCT) units.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Setting: </strong>Inpatient HSCT units.</p><p><strong>Methods: </strong>The PubMed/Medline databases were systematically searched as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, employing the search terms \"stem cell\", \"bone marrow\", \"transplant\", \"transplantation\", \"outbreak\" and \"pseudo-outbreak\" from inception until July 31, 2024. Data on the type of event, pathogen involved, and source of contamination were extracted from eligible publications.</p><p><strong>Results: </strong>In total, 39 studies including 387 patients were included in this review. The overall mortality rate was 23%. Pathogens identified included adenovirus, RSV, <i>Pseudomonas aeruginosa</i>, <i>Aspergillus</i> spp., and non-tuberculous mycobacteria (NTM). <i>P. aeruginosa</i> outbreaks were associated with contaminated sanitary fixtures (<i>P</i> = .007) and water (<i>P</i> = .039), outbreaks caused by NTM were associated with water (<i>P</i> = .009), while <i>Aspergillus</i> spp. outbreaks were associated with construction (<i>P</i> < .001). An index case was identified in 36.8% of viral outbreaks (<i>P</i> = .016). Other sources included inadequate disinfection and transmission from visitors.</p><p><strong>Conclusions: </strong>Our study highlights several associations between pathogens involved in HSCT unit outbreaks and their respective sources. Establishing standardized guidelines for unit construction - particularly for ventilation and water safety - could further reduce the risk of pathogen transmission and enhance infection prevention in these high-risk settings.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sampling methods for flexible endoscopes without a working channel: a scoping review.","authors":"Yana Halmans, David Wellenstein, Joost Hopman, Robert Takes, Guido van den Broek","doi":"10.1017/ice.2025.56","DOIUrl":"10.1017/ice.2025.56","url":null,"abstract":"<p><strong>Background: </strong>A diagnostic flexible laryngoscopy using a flexible endoscope (FE) without a working channel can become contaminated when inserted through the nose to inspect the throat. Microbiological surveillance is necessary to ensure adequate reprocessing. A lack of knowledge exists about the most accurate way to assess microbiological contamination on the surface of FEs without a working channel. A scoping review of research on sampling techniques for FEs without a working channel was done to identify frequently used sampling techniques and to determine the best way to assess microbiological contamination.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, and CINAHL databases were searched. Data related to the sampling technique and bacterial contamination were extracted.</p><p><strong>Results: </strong>Twelve of the 378 studies met the inclusion criteria. None compared sampling techniques, most studies investigated the efficacy of several disinfection methods. Retrieved sampling techniques were immersion, swabbing, and wiping. Immersion and wiping could detect bacterial contamination on contaminated FEs without a working channel. Two out of six studies using a swabbing method found bacterial contamination on contaminated FEs without a working channel. Three studies using the swabbing method detected bacterial contamination after disinfection. One study did not retrieve microorganisms after disinfection using the swabbing method.</p><p><strong>Conclusions: </strong>Three different sampling techniques were extracted: immersion, wiping, and swabbing, which could all detect microbiological contamination on contaminated FEs without a working channel. However, this scoping review identified significant gaps in literature. Additional research is needed to determine the best sampling technique(s) for FEs without a working channel to detect microbiological contamination.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testing for methicillin-resistant <i>Staphylococcus aureus</i> in the anterior nares for antibiotic de-escalation in patients presenting with acute skin and soft tissue infections: systematic review and meta-analysis.","authors":"Sara Bohjanen, Connor Goldstick, Maria Hordinsky","doi":"10.1017/ice.2025.58","DOIUrl":"https://doi.org/10.1017/ice.2025.58","url":null,"abstract":"<p><strong>Objective: </strong>To improve the understanding of appropriate antibiotic de-escalation and stewardship by consolidating the evidence on screening for methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) colonization of the nares to predict MRSA in acute skin and soft tissue infections (SSTIs).</p><p><strong>Methods: </strong>This meta-analysis was performed according to PRISMA guidelines. Six databases were searched by two reviewers for articles on MRSA detection in the nares and acute SSTIs. The quality and risk of bias of the articles were then assessed. The primary outcomes of interest were pooled sensitivity and specificity. Sub-analyses were also performed to test for heterogeneity.</p><p><strong>Results: </strong>After screening 1040 records, 15 articles (n = 1,970) were included in the meta-analysis. Using MRSA nares screening to predict MRSA in acute SSTIs had an overall specificity of 0.949 and sensitivity of 0.474. With a prevalence of 29.1%, the calculated NPV was 0.815. There were sub-analyses on various study variables, such as study location, participant age, and detection by polymerase chain reaction versus culture. The only significant finding was an increased sensitivity for adults (0.543) compared to pediatric participants (0.285).</p><p><strong>Discussion: </strong>To our knowledge, this is the first meta-analysis that focuses on the performance of MRSA nares screening for predicting MRSA infection in patients presenting with acute SSTIs. The baseline prevalence of MRSA SSTIs is important for interpreting the screening results, and the prevalence is influenced by geography and patient factors. This clinical context must be considered before utilizing MRSA nares screening for acute SSTIs.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-5"},"PeriodicalIF":3.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}