Infection Control and Hospital Epidemiology最新文献

{"title":"Candidemia rates and census tract social vulnerability index-Colorado, 2021-2022.","authors":"Christopher A Czaja, Alyssa Beck, Kelsey T Orten, Alison G Abraham, Rebecca Conway, Johnna Bakalar, Helen Johnston","doi":"10.1017/ice.2025.10219","DOIUrl":"https://doi.org/10.1017/ice.2025.10219","url":null,"abstract":"<p><p>In Colorado census tracts from 2021 to 2022, there was a 15% increase in the rate of candidemia for every 0.1 unit increase in social vulnerability index (SVI) (RR 1.15, 95% CI, 1.10, 1.20). Geographic social determinants of health included in SVI may be risk factors for candidemia.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":2.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953058","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":"Impact of routine chlorhexidine bathing and nasal iodophor on MDRO colonization and environmental contamination in nursing homes.","authors":"Evelyn Adriana Flores, Raveena Singh, James A McKinnell, Thomas T Tjoa, Gabrielle M Gussin, Bryn Launer, Michael Bolaris, Kaye Evans, Ellena Peterson, Loren G Miller, Susan S Huang","doi":"10.1017/ice.2025.10234","DOIUrl":"https://doi.org/10.1017/ice.2025.10234","url":null,"abstract":"<p><strong>Background: </strong>Nursing homes residents have a high prevalence of multidrug-resistant organism (MDRO) colonization. Recent trials demonstrated that decolonizing residents reduces infection. However, decolonization's impact on environmental MDRO contamination is not well understood.</p><p><strong>Methods: </strong>We performed a 9-month pilot (3-month baseline, 3-month phase-in and 3-month intervention) in 3 nursing homes implementing routine chlorhexidine bathing/showering and nasal iodophor. We repeatedly tested for colonization via skin and nasal swabs for methicillin-resistant <i>Staphylococcus aureus</i> (MRSA), vancomycin-resistant <i>Enterococcus</i> (VRE), extended-spectrum beta-lactamase producers (ESBLs), and carbapenem-resistant Enterobacterales (CRE). We also swabbed high-touch surfaces in rooms of MDRO carriers for MDRO fomite contamination.</p><p><strong>Results: </strong>Decolonization decreased the odds of MDRO colonization in nursing home residents by 55% (OR 0.45, <i>P</i> < 0.001, raw reduction from 46% (411/900) to intervention: 29% (262/900); colonization with MRSA, VRE, and ESBL all significantly decreased (<i>P</i> < 0.001). Among residents who remained colonized with any MDRO, 288/330 (87%) of high-touch bedroom objects were colonized with ≥1 MDRO. In a multivariable analysis, MDRO fomite contamination in rooms of MDRO carriers was associated with antibiotic use (OR = 1.54 [95% CI: 1.19-1.98], wound presence (OR = 1.34 (95% CI: 1.02-1.77), and specific fomites such as bedside table/bedrails (OR = 12.7 (95% CI: 9.37-17.25), but not the intervention period (OR = 1.02 [0.81-1.27]).</p><p><strong>Conclusion: </strong>Routine chlorhexidine bathing and nasal iodophor significantly reduced MDRO body colonization among nursing home residents. However, in rooms of residents who remained MDRO carriers, environmental contamination was unchanged during the decolonization intervention. Efforts to ensure fomite surface clearance in rooms of MDRO carriers may be key to reducing environmental MDRO spread.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952943","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":"Enhanced barrier precautions to prevent transmission of <i>Staphylococcus aureus</i> and Carbapenem-resistant organisms in nursing home chronic ventilator units.","authors":"Lyndsay M O'Hara, Michelle Newman, Alison D Lydecker, Gwen L Robinson, Aaron Hong, Christina Boucher, Patience Osei, Erin K Molloy, J Kristie Johnson, Ayse P Gurses, Heather Jones, Kara Jacobs Slifka, Mary-Claire Roghmann","doi":"10.1017/ice.2025.10237","DOIUrl":"https://doi.org/10.1017/ice.2025.10237","url":null,"abstract":"<p><strong>Objective: </strong>Assess the feasibility and effect of Enhanced Barrier Precautions (EBP) on the transmission of <i>Staphylococcus aureus</i> (SA) and carbapenem-resistant organisms (CRO) among residents in nursing home chronic ventilator units (NH-CVU).</p><p><strong>Design: </strong>Pre-post interventional study.</p><p><strong>Setting: </strong>Two community-based nursing homes with CVUs in Maryland. A total of 56 residents were enrolled in the baseline period and 64 residents were enrolled in the intervention period.</p><p><strong>Methods: </strong>During a 3-month baseline and intervention period, residents were swabbed monthly to estimate SA and CRO acquisition. During a 2-month training period, EBP was implemented for residents with chronic wounds, medical devices, or history of multidrug-resistant organism (MDRO) colonization. During the subsequent 3-month intervention period, healthcare personnel (HCP) wore gowns and gloves for high-contact care activities when residents were on EBP. Whole genome sequencing assessed resident-to-resident transmission.</p><p><strong>Results: </strong>At baseline, NH-CVU1 used gowns and gloves for all direct contact, while NH-CVU2 used EBP only for residents with a history of MDRO colonization. After training, the proportion of NH-CVU2 residents on EBP increased from 65% in the baseline period to 87% in the intervention period. Glove use was high (93-98%) in both NH-CVUs. Gown use increased from 39% to 77% in NH-CVU1 and from 26% to 72% in NH-CVU2. Resident-to-resident transmission of SA or CRO decreased by 25% in NH-CVU1 (<i>p</i> = 0.60) and by 67% in NH-CVU2 (<i>p</i> = 0.05). CRO transmission decreased by 33% in NH-CVU1 (<i>p</i> = 0.54) and by 83% in NH-CVU2 (<i>p</i> = 0.02).</p><p><strong>Conclusions: </strong>EBP is feasible and potentially decreases overall and CRO transmission in nursing home CVUs.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952991","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":"Implementation of a diagnostic algorithm to reduce CAUTI surveillance events.","authors":"Daniel A Caroff, James M Dargin, Lindsey Rieder, Rabin Dhungana, Yixin Kong, Damini Saxena, Arlene Stoller, Susan B Stempek, Robert A Duncan","doi":"10.1017/ice.2025.10236","DOIUrl":"https://doi.org/10.1017/ice.2025.10236","url":null,"abstract":"<p><p>Diagnostic stewardship of urine cultures is a recognized tool for CAUTI prevention, yet few diagnostic algorithms have been validated. This study of a novel diagnostic CAUTI algorithm showed a significant and durable improvement in urine culturing, catheter exchange, and CAUTI rate, supporting this algorithm as an effective diagnostic stewardship tool.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952889","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":"Low diagnostic yield of repeat urine cultures in hospitalized patients at a tertiary center in Northern California, 2023-2024.","authors":"Eugenia Miranti, Mindy M Sampson, John Shepard, Guillermo Rodriguez-Nava, Karen McIntyre, Erika Paola Viana Cardenas, Barbara W Trautner, Jorge L Salinas","doi":"10.1017/ice.2025.10248","DOIUrl":"https://doi.org/10.1017/ice.2025.10248","url":null,"abstract":"<p><p>We analyzed the diagnostic yield of repeat urine cultures in a retrospective study of adult inpatients. Most urine cultures repeated at less than 6 days provided redundant information. This was true whether the index culture was positive or negative, and whether the threshold for positivity was 10,000 or 100,000 CFU/mL.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952968","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":"Bias and discrimination perceived by antimicrobial stewards: a mixed-methods study.","authors":"Jessica Tischendorf, Allison Giuffre, Katherine Cinnamon, Michael Howe, Fauzia Hollnagel, Lindsay Taylor","doi":"10.1017/ice.2025.10224","DOIUrl":"10.1017/ice.2025.10224","url":null,"abstract":"<p><strong>Background: </strong>Bias and discrimination influence the experience of many in health care, including antimicrobial stewardship providers. In this mixed-methods study, we explore the perceptions of bias and discrimination among antimicrobial stewards.</p><p><strong>Methods: </strong>We conducted a nationwide survey of stewardship providers including physicians, pharmacists, advanced practice providers, and trainees. Participants were recruited via convenience sampling using X and professional listservs during May and June 2023. We solicited steward and program demographics and responses to statements exploring bias and discrimination through a 67-item electronic survey (Qualtrics). We further explored these experiences through semi-structured interviews.</p><p><strong>Results: </strong>Of 211 responses, 204 participants were included. Approximately half had been practicing for 5 years or less, 65% identified as female, and 24% identified as nonwhite or multiracial. Half of female stewards (50%) reported experiencing bias or discrimination in their role as an antimicrobial steward compared to 26% of male stewards. When controlling for race and ethnicity, seniority, and credentials, females were 2.8 times more likely (95% CI, 1.5-5.4; <i>P</i> < 0.01) to have experienced bias or discrimination when performing stewardship duties. Themes from our 16 interviews illuminated sources of perceived bias against stewards, the impact they had, and strategies to mitigate the influence of these biases.</p><p><strong>Conclusions: </strong>Bias and discrimination are felt disproportionately by women and junior antimicrobial stewards and can lead to poor job satisfaction and a lack of perceived effectiveness. Acknowledging these experiences and equipping stewards with strategies to mitigate their effects should be a priority of institutions and professional societies.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-10"},"PeriodicalIF":2.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873050","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":"Applying principles to practice: cleaning and disinfection of extended reality equipment used in healthcare settings.","authors":"Thomas S Murray, Erica S Shenoy, Scott C Roberts, Richard Martinello, Asher Marks, Kimberly Hieftje, Chloe V Green, Joseph T Rothschild, Morgan Shradar, Tess McKinney, Lindsey Jo Hand, Shannon Novosad, Janet Glowicz","doi":"10.1017/ice.2025.10249","DOIUrl":"10.1017/ice.2025.10249","url":null,"abstract":"<p><p>The use of extended reality (XR) for education of healthcare personnel (HCP) is increasing. XR equipment is reusable and often shared between HCP in clinical areas; however, it may not include manufacturer's instructions for use (MIFU) in healthcare settings. Considerations for the selection of equipment and development of cleaning and disinfection protocols are described.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873048","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":"Comparison of metrics of neonatal intensive care unit antibiotic use.","authors":"Alvaro Zevallos Barboza, Sagori Mukhopadhyay, Karen Marie Puopolo, Di Shu, Jeffrey S Gerber, Dustin Daniel Flannery","doi":"10.1017/ice.2025.10233","DOIUrl":"10.1017/ice.2025.10233","url":null,"abstract":"<p><strong>Objective: </strong>To compare temporal trends, variation, and correlations between antibiotic use metrics across U.S. neonatal intensive care units (NICUs) and assess associations with mortality.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 438,156 infants admitted to 272 NICUs from 2017 to 2021 using the Premier Health Database. Antibiotic use rate (AUR), days of therapy (DOT), and antibiotic spectrum index (ASI) per 1,000 patient or therapy days were calculated both cumulatively by year and at the center level. Mixed-effects models adjusted for center-level characteristics were used for all analyses.</p><p><strong>Results: </strong>All three metrics declined over time: AUR by 16.8%, DOT by 19.0%, and ASI by 2.5%. AUR and DOT were highly correlated (<i>r</i> = 0.989, <i>P</i> < 0.001), while ASI showed weaker correlations with AUR (<i>r</i> = 0.247, <i>P</i> < 0.001) and DOT (<i>r</i> = 0.338, <i>P</i> < 0.001). None were significantly associated with center-level mortality. ASI had the least variability, indicating more uniform antibiotic selection and lower center-level discriminatory value.</p><p><strong>Conclusions: </strong>DOT and AUR were comparable measures of antibiotic consumption, both showing significant declines. ASI exhibited the least variability, reflecting more consistency in antibiotic selection. The similarity in dispersion and decline between AUR and DOT suggests that neonatal antibiotic exposure is primarily influenced by initiation and discontinuation decisions rather than regimen complexity. Given its ease of calculation, AUR may be the most practical metric for evaluating the impact of antibiotic stewardship interventions at the center level.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873051","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":"The unintended burden of transmission-based precautions for suspected COVID-19 in the ambulatory setting.","authors":"Rebecca A Stern, Katherine Bashaw, Claude E Shackelford, Thomas R Talbot","doi":"10.1017/ice.2025.10229","DOIUrl":"10.1017/ice.2025.10229","url":null,"abstract":"<p><p>An observational pilot in walk-in clinics assessed workflow impacts of personal protective equipment (PPE) use for COVID-19 cases. PPE added time, waste, and cost despite a low incidence period of illness. Limited supporting data for contact transmission and operational barriers suggest ambulatory PPE guidance for COVID-19 warrants modification.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873052","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":"Behind closed doors: a look into hospital-at-home antimicrobial use.","authors":"Drew T Dickinson, Dan Ilges, Michael J Maniaci","doi":"10.1017/ice.2025.10244","DOIUrl":"10.1017/ice.2025.10244","url":null,"abstract":"<p><p>Antimicrobial use among hospital-at-home (HaH) patients across three Mayo Clinic sites was evaluated from 2023 to 2024. Nearly three-quarters of patients were administered an antibiotic during HaH admission. Ceftriaxone was the most commonly used antibiotic and respiratory infections were the most common antimicrobial indication. Further investigation into stewardship opportunities is warranted.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873049","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}