Infection Control and Hospital Epidemiology最新文献

{"title":"Are SEP-1 and blood culture stewardship at odds? Retrospective review of SEP-1 failures pre- and during a blood culture bottle shortage - ADDENDUM.","authors":"Jonathan H Ryder, Kelly A Cawcutt, Cynthia Japp, Trevor C Van Schooneveld","doi":"10.1017/ice.2026.10496","DOIUrl":"https://doi.org/10.1017/ice.2026.10496","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1"},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887498","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":"Evaluation of operating room high-touch surface cleaning effectiveness and process optimization based on dual-color fluorescent tracing technology.","authors":"Zhiqing Liu, Huimei Ge, Haixia Lan, Yan Zeng, Li Zhong, Yunxia Cai, Dejun Xiao","doi":"10.1017/ice.2026.10518","DOIUrl":"https://doi.org/10.1017/ice.2026.10518","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-2"},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880111","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 impact on airborne isolation duration utilizing GeneXpert versus acid-fast bacilli smears to guide discontinuation among individuals with suspected pulmonary tuberculosis: a systematic review and meta-analysis.","authors":"David Campbell, Chanhee Seo, Alexander A Leung, Paul E Ronksley, Rachel K Lim","doi":"10.1017/ice.2026.10486","DOIUrl":"10.1017/ice.2026.10486","url":null,"abstract":"<p><strong>Objective: </strong>The GeneXpert® MTB/RIF nucleic acid amplification test has been proposed as an alternative method to smear microscopy in guiding de-isolation for patients with suspected pulmonary tuberculosis, given its convenience and higher diagnostic accuracy. Currently, there is no comprehensive review summarizing the evidence on the isolation duration using GeneXpert. This systematic review and meta-analysis addressed the length of airborne infection isolation in hospitalized patients initially suspected of having pulmonary tuberculosis where de-isolation decisions were guided by GeneXpert nucleic acid amplification test compared to traditional smear microscopy.</p><p><strong>Methods: </strong>We conducted a comprehensive search in databases (Medline, Embase, and Scopus) from January 1, 2001, to April 1, 2026, and applied median-based quantile estimation methods to determine the pooled difference in median times of isolation. We also assessed diagnostic accuracy as well as hospital length of stay as secondary outcomes.</p><p><strong>Results: </strong>We screened 746 titles and abstracts, of which 7 were eligible for inclusion. Five studies included in the meta-analysis involved 1,409 patients, all within low-incidence tuberculosis settings. The meta-analysis demonstrated that use of a single unconcentrated GeneXpert versus serial acid-fast bacilli smear microscopy resulted in a pooled reduction in median isolation duration by 38.8 hours (95% confidence interval 20.2-57.3 hours).</p><p><strong>Conclusion: </strong>Compared to serial microscopy, GeneXpert done on a single unconcentrated respiratory specimen reduces airborne infection isolation duration by over 1.5 days, on average, making it an attractive strategy for optimizing healthcare facility resources while evaluating persons for pulmonary tuberculosis.Protocol Registration (PROSPERO, CRD42024538644).</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"885-893"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430329","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":"Updating CMV protocols in lung transplant patients: a single-center case study modeling use of generative AI for antimicrobial stewardship protocol development and economic impact analysis.","authors":"Kyle T Enriquez, Augusto Dulanto Chiang, Casey Smiley, Milner Staub","doi":"10.1017/ice.2026.10480","DOIUrl":"10.1017/ice.2026.10480","url":null,"abstract":"<p><strong>Objective: </strong>Antimicrobial Stewardship Programs (ASPs) need healthcare economic analyses to support and inform ASP strategies. This work aimed to determine whether widely available artificial intelligence (AI) platforms like Microsoft Copilot^TM could facilitate healthcare economics analyses for ASP programs without dedicated healthcare economic supports.</p><p><strong>Design: </strong>AI (Microsoft Copilot^TM) was prompted to develop a cytomegalovirus prophylaxis protocol for lung transplant recipients using only PubMed-indexed articles. Copilot^TM was then prompted to produce probabilistic samples of simulated patients from aggregate statistics of a 165-patient cohort from Vanderbilt University Medical Center and to analyze cost-effectiveness across four distinct cytomegalovirus prophylaxis protocols, including its own.</p><p><strong>Setting: </strong>Tertiary care academic medical center, including outpatient and inpatient environments.</p><p><strong>Patients or participants: </strong>Simulated patient data was developed via random, single-blind, probabilistic selection from pre-defined aggregate cohort statistics.</p><p><strong>Results: </strong>The AI-generated prophylaxis protocol was evidence-based without hallucination, but this conservative protocol relied on outdated evidence and was associated with significant increases in expected per-patient cost (mean +$4740, <i>P</i> < .01) compared to recent guideline-based and institutional protocols. AI independently identified and executed sensitivity analyses, which revealed that in this simplified model, letermovir use had a large impact on expected per-patient cost.</p><p><strong>Conclusions: </strong>The AI-proposed protocol was less cost-effective, but data suggest that careful prompting can provide appropriate PubMed-indexed literature to support ASP protocol development. Additionally, CoPilot^TM provided a thorough cost-effectiveness analysis comparing all potential and existing protocols. With appropriate oversight, AI and Microsoft Copilot^TM can conduct healthcare economic analyses suitable for ASP strategic planning and implementation.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"915-922"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198860","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":"The SCANNED rule: derivation and validation of a two-step rule for blood culture stewardship in patients presenting with suspected infection.","authors":"Zhenghong Liu, Maehanyi Frances Rajendram, Li Yan Julia Jaffar, Xiang Yin Tan, Myriam Hamtiaux, Siew Yee Thien, Frank Scheuermeyer, Robert Stenstrom","doi":"10.1017/ice.2026.10507","DOIUrl":"10.1017/ice.2026.10507","url":null,"abstract":"<p><strong>Background: </strong>Blood culture over-ordering is a recognized diagnostic stewardship challenge, contributing to contamination, inappropriate antimicrobial escalation, and laboratory burden. Validated tools to guide culture ordering at initial patient assessment are lacking.</p><p><strong>Objective: </strong>We aim to derive and externally validate a two-step diagnostic stewardship rule for blood culture ordering in the emergency department (ED) patients with suspected infection.</p><p><strong>Methods: </strong>We derived the Stepwise Culture Assessment with NEWS and NLR in ED (SCANNED) rule using consecutive blood cultures from a Singapore ED (April-July 2025) and validated it in Vancouver, Canada (2016-2019). The rule uses age-stratified National Early Warning Score (NEWS) thresholds (Step 1), followed by neutrophil-lymphocyte ratio (NLR) ≥5 for remaining patients (Step 2). Thresholds were selected via exhaustive grid search, optimizing culture reduction while constraining the false-negative rate to <5%.</p><p><strong>Results: </strong>We included 1,224 derivation and 808 validation encounters. Blood culture positivity was 9.6% (117/1,224) and 13.8% (112/808), respectively. The optimal rule (NEWS ≥5 if age <75 or NEWS ≥3 if age ≥75; NLR ≥5 for remainder) reduced cultures by 18.8% (95% CI 16.6-20.9%) in derivation and 15.1% (95% CI 12.8-17.6%) in validation, missing <5% of bacteremia cases in both cohorts. Performance was consistent across infection sources, including unclear/occult infections (17.5% reduction, 3.7% false-negative rate).</p><p><strong>Conclusion: </strong>The SCANNED rule represents a practical diagnostic stewardship intervention that can reduce unnecessary blood cultures by 15-19% while maintaining >95% sensitivity for bacteremia. It requires no electronic health record integration and can be applied at triage. Prospective validation is needed before clinical implementation.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"908-914"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436672","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":"Does AI know how to choose wisely? Do not trust and definitely verify when using generative AI in stewardship operations.","authors":"Amy V Dora, Lawrence N Benjamin, Christopher J Graber, Westyn Branch-Elliman","doi":"10.1017/ice.2026.10511","DOIUrl":"10.1017/ice.2026.10511","url":null,"abstract":"<p><p>Antimicrobial stewardship programs (ASP) serve as a valuable resource to healthcare institutions. This commentary explores a real world demonstration of the potential advantages and pitfalls of using artificial intelligence (AI) in ASP, both in supporting the development of institutional guidelines and in providing a cost-effectiveness analysis of these protocols, as well as the caution that should be exercised when involving AI in stewardship.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"863-865"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470354","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":"Complications in patients with midlines compared to peripherally inserted central catheters for outpatient parenteral antimicrobial therapy.","authors":"Justin J Kim, Guadalupe Ordaz-Nielsen, James B Vu, Kim L Tran, Ho D Kim, Michael Schoeny, Michael Y Lin","doi":"10.1017/ice.2026.10512","DOIUrl":"10.1017/ice.2026.10512","url":null,"abstract":"<p><p>In this single-center, retrospective cohort study of 1169 patients requiring outpatient parenteral antimicrobial therapy, complications (i.e., bloodstream infections or venous thrombosis) occurred more frequently in patients with midlines (6.4 per 1,000 line-days) than peripherally inserted central catheters (1.1 per 1,000 line-days), adjusted hazard ratio 3.60 (95% confidence interval 1.66-7.81).</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"956-958"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470381","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":"Evaluating a nurse-led, audit-based antimicrobial stewardship in the medical emergency unit of a tertiary level hospital.","authors":"Rupamdeep Kaur, Soumya Vij, Kamini Walia, Sonam Vijay, Asheema Khosla, Simranjit Kaur, Pawan Kumar, Priya, Naveen Kumar, Priya Choudhary, Mahesh Kumar Balasundaram, Navneet Sharma, Ritin Mohindra, Manisha Biswal, Pankaj Arora, Ashok Pannu, Neelam Taneja, Nusrat Shafiq","doi":"10.1017/ice.2026.10501","DOIUrl":"10.1017/ice.2026.10501","url":null,"abstract":"<p><strong>Background: </strong>Emergency departments in tertiary care are critical areas for decision-making regarding antimicrobial use,however, they are often underrepresented in antimicrobial stewardship (AMS) interventions. This study evaluates the impact of a nurse-driven antimicrobial stewardship intervention in a medical emergency unit of a tertiary care facility.</p><p><strong>Methods: </strong>A quasi experimental pre-post study was conducted in the Emergency Medical Outpatient department in a tertiary care center. Following a baseline assessment of antimicrobial use patterns conducted by a team of trained stewardship nurses, salient intervention targets were identified and implemented. AMS nurses actively reviewed antimicrobial prescriptions, reinforced adherence to institutional guidelines, monitored device- related practices and diagnostic utilization, and participated in audit and feedback with clinical teams. Data on patient characteristics, infection type, culture practices, antibiotic use, and guideline adherence were collected and compared between pre-intervention and intervention phases.</p><p><strong>Results: </strong>Following the intervention, compliance with hospital antibiotic guidelines improved from 82.4% to 91.0%. The proportion of cultures collected before initiating antibiotics increased from 23% to 40.3%, with a corresponding rise in culture positivity from 8% to 22%. An increase in antibiotic de-escalation practices was also noted.</p><p><strong>Conclusions: </strong>This nurse-driven antimicrobial stewardship intervention was associated with more rational antimicrobial use, improved diagnostic utilization, and strengthened infection control practices. Integrating stewardship activities into nursing workflows represents a feasible approach to strengthening AMS in high-volume acute care settings.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"931-937"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420800","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":"PATHogen PREValence on paper-packaged supplies in PICU bedside supply carts: the PATH-PREV study.","authors":"Shellie Severson, Cathy Sheppard, Angela Bates, Christine MacDonald, Kimberley Dang, Ari R Joffe","doi":"10.1017/ice.2026.10505","DOIUrl":"10.1017/ice.2026.10505","url":null,"abstract":"<p><strong>Objective: </strong>Single-use supplies stored in bedside supply carts with paper packaging cannot be wiped with disinfectants. We aimed to determine the prevalence of pathogens on these unused supplies.</p><p><strong>Design: </strong>Prospective study over 7 weeks in 2025.</p><p><strong>Setting: </strong>Two pediatric ICUs at a university affiliated children's hospital.</p><p><strong>Patients: </strong>The unit of analysis was the bedside supply cart from each discharged ICU patient.</p><p><strong>Interventions: </strong>One swab was used to swab three supply items contained in a single drawer in a room's bedside cart. Carts had two drawers sampled, each with a swab for bacterial culture and respiratory viral nucleic acid amplification testing (NAAT).</p><p><strong>Results: </strong>Paper-packaged supply items (n = 840) from 70 consecutive bedside carts were swabbed after patient discharge. All bacterial swabs had no growth of pathogen [0/140 (0%), 95% CI 0%, 2.3%)]. A non-pathogen was cultured from 8/140 (5.7%) swabs [7/70 (10.0%) carts], most with scant growth [7/8 (87.5%) only one colony]. Non-pathogens (common commensal skin and oral flora) included coagulase-negative staphylococci (n = 5), <i>Actinomyces oris</i> (n = 1), aerobic spore-forming <i>Bacillus</i> (n = 1), and viridans group streptococcus [non-anginosus] (n = 1). Of viral swabs, 3/140 (2.1%, 95% CI 0.5%, 6.4%) were NAAT positive (3/70 (4.3%) carts). Room isolation status, length of stay, and ICU were not associated with a positive bacterial or viral swab.</p><p><strong>Conclusions: </strong>Bacterial pathogen detection on supplies, a necessary step in transmission, was extremely low. Viral NAAT detection on supplies was low and likely exaggerated the risk of fomite transmission, as whether there was viable virus at sufficient concentration to transmit infection is unknown.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"901-907"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436608","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":"Parent and caregiver preferences toward antibiotic allergy delabeling in children.","authors":"Alistair Thorpe, Rachael A Lee, William B Petty, Adam L Hersh, Angela Fagerlin, Valerie M Vaughn, Julia E Szymczak","doi":"10.1017/ice.2026.10510","DOIUrl":"10.1017/ice.2026.10510","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"966-969"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455501","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}