Infection Control and Hospital Epidemiology最新文献

{"title":"Risk period for transmission of SARS-CoV-2 and seasonal influenza: a rapid review.","authors":"Erin C Stone, Devon L Okasako-Schmucker, Joanna Taliano, Melissa Schaefer, David T Kuhar","doi":"10.1017/ice.2025.11","DOIUrl":"10.1017/ice.2025.11","url":null,"abstract":"<p><strong>Background: </strong>Restricting infectious healthcare workers (HCWs) from the workplace is an important infection prevention strategy. The duration of viral shedding or symptoms are often used as proxies for the infectious period in adults but may not accurately estimate it.</p><p><strong>Objective: </strong>To determine the risk period for transmission among previously healthy adults infected with SARS-CoV-2 omicron variant (omicron) or influenza A (influenza) by examining the duration of shedding and symptoms, and day of symptom onset in secondary cases of transmission pairs.</p><p><strong>Design: </strong>Rapid review.</p><p><strong>Methods: </strong>This rapid review adhered to PRISMA-ScR; five databases were searched. The cumulative daily proportion of participants with an outcome of interest was calculated for each study and summarized.</p><p><strong>Results: </strong>Forty-three studies were included. Shedding resolved among ≥ 70% of participants by the end of day nine post symptom onset for omicron, and day seven for influenza; and for ≥ 90% of participants, by the end of day 10 for omicron and day nine for influenza. Two studies suggested shedding continues > 24 hours post-fever resolution for both viruses. Symptom onset occurred in ≥ 80% of secondary cases by the end of day seven post-primary case symptom onset for omicron and day six for influenza.</p><p><strong>Conclusions: </strong>Omicron shedding is consistent with previous recommendations to exclude infected HCWs from work for 10 days; and influenza follows a similar trend. Earlier symptom onset in most secondary cases for both pathogens indicates that, despite persistent viral shedding, most transmission occurs earlier; and the cumulative serial interval might better approximate the duration of infectiousness.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-9"},"PeriodicalIF":3.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483073","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":"Risk factors for the development of <i>Clostridioides difficile</i> infection in patients colonized with toxigenic <i>Clostridioides difficile</i>.","authors":"Josh Clement, Gauri Barlingay, Sindhu Addepalli, Heejung Bang, Monica A Donnelley, Stuart H Cohen, Scott Crabtree","doi":"10.1017/ice.2025.4","DOIUrl":"10.1017/ice.2025.4","url":null,"abstract":"<p><strong>Objective: </strong>Asymptomatic patients colonized with toxigenic <i>Clostridioides difficile</i> are at risk of progressing to <i>C. difficile</i> infection (CDI), but risk factors associated with progression are poorly understood. The objectives of this study were to estimate the incidence and identify risk factors to progression of hospital-onset CDI (HO-CDI) among colonized patients.</p><p><strong>Methods: </strong>This was a nested case-control study at an academic medical center including adult patients colonized with toxigenic <i>C. difficile</i>, detected via polymerase chain reaction (PCR) on a rectal swab collected on admission from 2017 to 2020. Patients with prior CDI or symptoms on admission, neutropenia, prior rectal surgery, or hospitalization less than 24 hours were excluded. Colonized patients that developed HO-CDI were matched 1:3 to colonized patients who did not based on PCR test date. Bivariate and multivariable-adjusted Cox regression analyses were used to identify risk factors.</p><p><strong>Results: </strong>Of 2,150 colonized patients, 109 developed HO-CDI, with an incidence of 5.1%. After exclusions, 321 patients (69 with HO-CDI) were included, with an estimated incidence of 4.2%. Risk factors included cirrhosis (aHR 1.94), ICU admission (aHR 1.76), malignancy (aHR 1.88), and hospitalization within six months (aHR 1.6). Prior antibiotic exposure in the past three months (aHR 2.14) and receipt of at-risk antibiotics were also identified as potential risk factors (aHR 2.17).</p><p><strong>Conclusions: </strong>Progression to HO-CDI among colonized patients was not uncommon. This study highlights key risk factors associated with progression, underscoring the importance of enhanced monitoring and prevention efforts tailored to high-risk populations to mitigate HO-CDI.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483072","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":"Failure of timely removal of central and peripheral venous catheters after antibiotic therapy in nursing homes.","authors":"Amarah Mauricio, Joshua B Hsi, Tom Tjoa, Raveena D Singh, Shereen Nourollahi, Raheeb Saavedra, Bardia Bahadori, Mohamad N Alsharif, Steven Tam, Justin Chang, Syma Rashid, Shruti K Gohil","doi":"10.1017/ice.2025.17","DOIUrl":"https://doi.org/10.1017/ice.2025.17","url":null,"abstract":"<p><p>Each day a venous catheter is retained poses unnecessary safety risks. In a retrospective evaluation of central/peripheral lines in nursing home residents receiving antibiotics, 80% were retained beyond antibiotic treatment end and nearly one third were retained longer than a week. Interventions for timely catheter removal are urgently needed.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":3.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483108","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":"Clinical outcomes and hospital-reported cost associated with surgical site infections and the co-occurrence of hospital-onset bacteremia and fungemia across US hospitals.","authors":"ChinEn Ai, Molly Jung, Samantha Bastow, Ghislene Adjaoute, David Bostick, Kalvin C Yu","doi":"10.1017/ice.2025.13","DOIUrl":"https://doi.org/10.1017/ice.2025.13","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the hospital-reported cost of care, clinical burden, and incidence of hospital-onset bacteremia and fungemia (HOB) for hospital admissions with surgical site infections (SSI).</p><p><strong>Methods: </strong>A cross-sectional study of 38 acute-care hospital admissions with a procedure under the National Healthcare Safety Network (NHSN) surveillance for SSI was conducted. SSI admissions were identified through NHSN reporting by the hospital. Clinical outcomes were estimated for SSI compared to no SSI controls using propensity matching and multivariable adjusted models that controlled for patient and hospital demographics; these endpoints were also compared for SSI admissions with and without HOB co-occurrence.</p><p><strong>Results: </strong>The rate of hospital-reported SSI was 0.15 per 100 admissions with a procedure under surveillance for SSI. Admissions with SSI compared to no SSI had significantly higher incremental hospital-reported cost of $30,689 and length of stay (LOS) was 11.6 days higher. The incidence of HOB was 6-fold higher in admissions with SSI compared to no SSI. For SSI admissions with HOB vs. no HOB, HOB added $28,049 to cost of care and 6.5 days to the LOS.</p><p><strong>Conclusions: </strong>Hospital-reported SSIs were associated with higher clinical and economic burden. Patients with SSI and HOB had even more deleterious outcomes. These data may inform programs to augment infection prevention bundles targeting SSIs and downstream complications or comorbidities like HOB.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448989","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":"A deeper look at serious superficial incisional surgical site infections (SSISSIs): prevalence, impact, and implications for hospital performance rankings.","authors":"Jessica Seidelman, Brittain Wood, Polly Padgette, Valerie Payne, Linda Crane, Linda Roach, Deverick J Anderson","doi":"10.1017/ice.2025.18","DOIUrl":"https://doi.org/10.1017/ice.2025.18","url":null,"abstract":"<p><p>Serious superficial incisional surgical site infections (SSISSIs) are a critical subset of SSIs that require surgical intervention or lead to hospital readmission. Analyzing 11,617 SSIs from 47 community hospitals, the inclusion of SSISSIs changed 30/47 hospital rankings (p = 0.02), highlighting the need for inclusion in standardized infection surveillance models.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-5"},"PeriodicalIF":3.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440718","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":"Racial and ethnic disparities in central line-associated bloodstream infections (CLABSI) in hospitalized patients: a risk-adjusted analysis.","authors":"Sandeep Tripathi, Taylor Walter, Jeremy McGarvey","doi":"10.1017/ice.2025.8","DOIUrl":"https://doi.org/10.1017/ice.2025.8","url":null,"abstract":"<p><strong>Objective: </strong>To compare the risk and exposure-adjusted central line-associated bloodstream infection (CLABSI) rates between racial and ethnic groups.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>15 network hospitals in Illinois and Michigan (Part of OSF HealthCare).</p><p><strong>Patients: </strong>Patients of all age groups who had a central line inserted and removed during the same hospitalization between 01/2018 and 06/2023.</p><p><strong>Methods: </strong>CLABSI rates/1000 Central line days of the four major racial and ethnic categories (Hispanic, non-Hispanic White [NHW], non-Hispanic Black [NHB], and non-Hispanic others) were analyzed by generalized Poisson regression. Confounding variables included in the regression model based on a directed acyclic graph and included age group, insurance class, language, ICU admission, diagnostic cohorts (obesity, diabetes, dialysis, cancer, neutropenia), and line usage (blood products, chemotherapy, total parenteral nutrition).</p><p><strong>Results: </strong>27,674 central lines (244,889 catheter days) on 23,133 unique patients (median age 64 years, 8% pediatric patients) were included in the analysis. Overall, the CLABSI rate was 1.070/1000 Central line days. 76% of the study population was NHW, 17% NHB, and 4% Hispanic. After adjusting for confounding variables, Hispanic patients had higher CLABSI rates than NHW (IRR 1.89, 95% CI 1.15-3.10, <i>P</i> = .013). No significant difference was observed in the CLABSI rates between NHW and NHB patients.</p><p><strong>Conclusion: </strong>Disparities in hospital-associated conditions persist even after controlling for patient-level risk factors and exposures, with Hispanic patients at the highest risk.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440735","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":"Mixed-methods multicenter assessment of healthcare workers' knowledge, perceptions, and practices related to blood culture utilization in hospitalized adults - CORRIGENDUM.","authors":"","doi":"10.1017/ice.2025.39","DOIUrl":"https://doi.org/10.1017/ice.2025.39","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440733","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":"Incidence of surgical infection in cefazolin 3 g versus 2 g for colorectal surgery in obese patients - CORRIGENDUM.","authors":"","doi":"10.1017/ice.2025.40","DOIUrl":"https://doi.org/10.1017/ice.2025.40","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440729","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":"Hospital-onset bacteremia in the neonatal intensive care unit: strategies for risk adjustment.","authors":"Erica C Prochaska, Shaoming Xiao, Elizabeth Colantuoni, Nora Elhaissouni, Reese H Clark, Julia Johnson, Sagori Mukhopadhyay, Ibukunoluwa C Kalu, Danielle M Zerr, Patrick J Reich, Jessica Roberts, Dustin D Flannery, Aaron M Milstone","doi":"10.1017/ice.2024.238","DOIUrl":"https://doi.org/10.1017/ice.2024.238","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the impact of patient- and unit-level risk adjustment on infant hospital-onset bacteremia (HOB) standardized infection ratio (SIR) ranking.</p><p><strong>Design: </strong>A retrospective, multicenter cohort study.</p><p><strong>Setting and participants: </strong>Infants admitted to 284 neonatal intensive care units (NICUs) in the United States between 2016 and 2021.</p><p><strong>Methods: </strong>Expected HOB rates and SIRs were calculated using four adjustment strategies: birthweight (model 1), birthweight and postnatal age (model 2), birthweight and NICU complexity (model 3), and birthweight, postnatal age, and NICU complexity (model 4). Sites were ranked according to the unadjusted HOB rate, and these rankings were compared to rankings based on the four adjusted SIR models.</p><p><strong>Results: </strong>Compared to unadjusted HOB rate ranking (smallest to largest), the number and proportion of NICUs that left the fourth quartile (worst-performing) following adjustments were as follows: adjusted for birthweight (16, 22.5%), birthweight and postnatal age (19, 26.8%), birthweight and NICU complexity (22, 31.0%), birthweight, postnatal age and NICU complexity (23, 32.4%). Comparing NICUs that moved into the better-performing quartiles after birthweight adjustment to those that remained in the better-performing quartiles regardless of adjustment, the median percentage of low birthweight infants was 17.1% (Interquartile Range (IQR): 15.8, 19.2) vs 8.7% (IQR: 4.8, 12.6); and the median percentage of infants who died was 2.2% (IQR: 1.8, 3.1) vs 0.5% (IQR: 0.01, 12.0), respectively.</p><p><strong>Conclusion: </strong>Adjusting for patient and unit-level complexity moved one-third of NICUs in the worst-performing quartile into a better-performing quartile. Risk adjustment may allow for a more accurate comparison across units with varying levels of patient acuity and complexity.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432991","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":"Benchmarking broad-spectrum antibiotic use in older adult pneumonia inpatients: a risk-adjusted smoothed observed-to-expected ratio approach.","authors":"Abbas Khatoun, Noriko Sasaki, Susumu Kunisawa, Kiyohide Fushimi, Yuichi Imanaka","doi":"10.1017/ice.2025.5","DOIUrl":"https://doi.org/10.1017/ice.2025.5","url":null,"abstract":"<p><strong>Objective: </strong>Antimicrobial resistance is increased by antibiotic overuse, so it's crucial for stewardship programs to monitor and control their use. Pneumonia, particularly prevalent among older adults in Japan, is requiring higher rates of medical treatment. This study aimed to develop an improved method for benchmarking broad-spectrum antibiotic use in the empiric treatment of pneumonia in older adult inpatients by applying the \"smoothed\" observed-to-expected (O/E) ratio which adjusts for hospital-level variations and minimizes the effect of extreme values.</p><p><strong>Methods: </strong>Using nationwide data from the Diagnosis Procedure Combination research group, pneumonia patients between April 1^st 2018 and March 31^st 2020 were analyzed. The primary outcome was the smoothed O/E ratio of the broad-spectrum antibiotic use for hospitals. It was calculated from the predicted values of broad-spectrum antibiotic use that were obtained through multilevel logistic regression using patient characteristics as predictors from data clustered by hospitals. The analysis investigated the risk-adjusted use of broad-spectrum antibiotics among hospitals.</p><p><strong>Results: </strong>A total of 244,747 patients from 958 hospitals were included, with a mean age of 81 (±8.30) years. The proportion of broad-spectrum antibiotic use was 35.3% (n = 86,316). The prediction model showed a C-statistic of 0.722. There was a noticeable variation in the O/E ratio among hospitals with values ranging from 0.13 (95% CI: 0.09-0.20) to 2.81 (95% CI: 2.64-2.97).</p><p><strong>Conclusions: </strong>Using a risk-adjusted smoothed O/E ratio, we assessed the use of broad-spectrum antibiotics across hospitals, identifying those with high O/E ratios that may indicate a need for improvement.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432986","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}