Infection Control and Hospital Epidemiology最新文献

{"title":"Is the BLADDER score the \"boost\" we need?","authors":"Lindsay N Taylor, Christopher J Crnich, Robin L P Jump","doi":"10.1017/ice.2024.149","DOIUrl":"https://doi.org/10.1017/ice.2024.149","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-2"},"PeriodicalIF":3.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464406","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":"To see, or not to see… pathogens in virtual reality hand hygiene training.","authors":"Aline Wolfensberger, Juliette C Désiron, Beatrice Domenech-Jakob, Dominik Petko, Walter Zingg","doi":"10.1017/ice.2024.135","DOIUrl":"10.1017/ice.2024.135","url":null,"abstract":"<p><strong>Background: </strong>ViRTUE, a virtual reality (VR) hand hygiene trainer, offers users the option of visualizing pathogen transfers during virtual patient care either in \"real-time\" or at the end of a level as a \"summary\" visualization. In this study, we aimed to evaluate the effect of different timings of pathogen visualization (\"real-time\" vs \"summary\") on in-trainer performance and user's immersion.</p><p><strong>Methods: </strong>The study included first-year medical students undergoing hand hygiene training with ViRTUE, randomized to one of three visualization set-ups: set-up 1 (\"on-off-off\", with \"real-time\" visualization at the first level only, and \"summary\" visualization at level 2 and 3), set-up 2 (\"off-on-off\"), and set-up 3 (\"off-off-off\"). In-trainer performance was defined by number of pathogen transmission events (=contaminations) in level 3. The virtual experience of user's (among others: immersion) was assessed with a questionnaire.</p><p><strong>Results: </strong>173 medical students participated in the study, with 58, 54, and 61 assigned to set-up 1, set-up 2, and set-up 3, respectively. Users assigned to set-up 3 with \"summary\" visualization at all levels, performed best with 1.02 (standard deviation (SD) +/- 1.86) contaminations, compared to 2.34 (SD +/- 3.09) and 2.07 (SD +/- 2.52) contaminations of users assigned to the other set-ups. \"Summary\" visualization at all levels also resulted in higher immersion of users.</p><p><strong>Conclusions: </strong>\"Real-time\" visualization of pathogen transmission during VR hand hygiene training with ViRTUE may negatively affect in-trainer performance and user immersion. This emphasizes the importance of pilot testing the effect of VR-based trainings in order to understand their impact on users.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464354","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":"Impacts of indoor masks wearing on air contamination during 10-minute speaking in patients with SARS-CoV-2 omicron variant infection.","authors":"Se Yoon Park, Min-Chul Kim, Ji Yeun Kim, Joung Ha Park, Seongman Bae, Jin-Won Chung, Saerom Yun, Minki Sung, Sung-Han Kim","doi":"10.1017/ice.2024.139","DOIUrl":"https://doi.org/10.1017/ice.2024.139","url":null,"abstract":"<p><p>In 10-minute speaking, N95 respirators significantly decreased SARS-CoV-2 emissions compared with no-mask wearing. However, SARS-CoV-2 was detected in the air even when wearing N95 and surgical masks in patients with high viral loads. Therefore, universal masking of infected and uninfected persons is important for preventing COVID-19 transmission via the air.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":3.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464405","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":"Postoperative wound care protocol prevents surgical site infection after craniotomy.","authors":"Mariya Kovryga Kornick, Eunjung Lee, Lisa Wilhelm, Janice White, Oh-Hyun Cho, Michelle Paff, Frank P K Hsu, Jefferson Chen, Linda Dickey, Susan S Huang","doi":"10.1017/ice.2024.134","DOIUrl":"10.1017/ice.2024.134","url":null,"abstract":"<p><strong>Background: </strong>Postoperative wound care after craniotomy is not standardized.</p><p><strong>Objective: </strong>Evaluate the impact of a standardized post-craniotomy wound care protocol on surgical site infection (SSI).</p><p><strong>Design and setting: </strong>Prospective quasi-experimental single-center intervention cohort study involving adult patients undergoing craniotomy at a 461-bed academic medical center in Orange County, California from January 2019-March 2023 (intervention) compared to January 2017-December 2018 (baseline).</p><p><strong>Methods: </strong>A postoperative neurosurgical wound care protocol was developed involving chlorhexidine cloths to remove incisional clots and to clean the surgical incision and adjacent hair after craniotomy surgery. Protocol adherence was monitored by routine inpatient surveillance of wounds and photo-documentation for real-time feedback to surgeons and nursing staff. Impact of the intervention was assessed using multivariable regression models.</p><p><strong>Results: </strong>There were 3560 craniotomy surgeries and 62 (1.7%) SSIs; 1251 surgeries and 30 (2.4%) SSIs during baseline, and 2309 surgeries and 32 (1.4%) SSIs during intervention. Process evaluation after implementation found significant decreases in incisional clots, erythema, drainage, and unclean hair. In multivariable analysis, the intervention was associated with fewer SSI (odds ratio (OR): 0.5 (0.3, 0.9), <i>P</i> = 0.02).</p><p><strong>Conclusions: </strong>A standardized post-craniotomy wound care protocol involving cleaning of the incision and adjacent hair, including removal of incisional clots with chlorhexidine cloths was effective in reducing the risk of SSI.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464349","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 of invasive MDRO infection in MDRO-colonized patients.","authors":"Ali M Alshubaily, Aeshah S Alosaimi, Bushra I Alhothli, Sahar I Althawadi, Salem M Alghamdi","doi":"10.1017/ice.2024.156","DOIUrl":"https://doi.org/10.1017/ice.2024.156","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we aim to estimate the risk of developing clinical multidrug-resistant organism (MDRO) infection with carbapenem-resistant <i>Enterobacterales</i> (CRE), methicillin-resistant <i>Staphylococcus aureus</i> (MRSA), or vancomycin-resistant enterococci (VRE) in colonized patients compared with non-colonized admitted to high-risk areas with a main focus on CRE colonization/infection.</p><p><strong>Design and setting: </strong>Retrospective cohort study conducted at a tertiary care facility.</p><p><strong>Methods: </strong>This study included patients enrolled in active surveillance testing (AST) for CRE, MRSA, or VRE during the year 2021. Development of relevant invasive infection within 365 days of the AST result was collected as the primary outcome. The association between MDRO colonization and infection was calculated using the risk ratio. The prevalence of CRE organisms and carbapenemase genes is presented.</p><p><strong>Results: </strong>A total of 19,134 ASTs were included in the analysis (4,919 CRE AST, 8,303 MRSA AST, and 5,912 VRE AST). Patient demographics were similar between colonized and non-colonized groups. Colonization was associated with an increased risk of infection in the 3 cohorts (CRE, MRSA, and VRE), with risk ratios reported as 4.6, 8.2, and 22, respectively. Most patients (88%) develop CRE infection with the same colonizing carbapenemase gene. Oxa-48/NDM <i>Klebsiella pneumoniae</i> was the most common organism detected in CRE infection.</p><p><strong>Conclusions: </strong>The study demonstrated that colonization with CRE, MRSA, or VRE is a risk factor for developing infections caused by the respective bacteria. The high percentage of match between carbapenemase genes detected in colonization and infection indicates that screening results might be used to inform infection management and treatment.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-5"},"PeriodicalIF":3.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464352","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":"Comparing rates of recurrent infection for first occurrence of <i>Clostridioides difficile</i> between tapered oral vancomycin and standard vancomycin: a retrospective, propensity matched cohort study.","authors":"Sarah E Moore, Matthew Song, Elena A Swingler, Stephen Furmanek, Thomas Chandler, Dakota Smith, Martin T Brenneman, Ashley M Wilde","doi":"10.1017/ice.2024.117","DOIUrl":"https://doi.org/10.1017/ice.2024.117","url":null,"abstract":"<p><strong>Objective: </strong>To compare rates of <i>Clostridioides difficile</i> infection (CDI) recurrence following initial occurrence treated with tapered enteral vancomycin compared to standard vancomycin.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Community health system.</p><p><strong>Patients: </strong>Adults ≥18 years of age hospitalized with positive <i>C. difficile</i> polymerase chain reaction or toxin enzyme immunoassay who were prescribed either standard 10-14 days of enteral vancomycin four times daily or a 12-week tapered vancomycin regimen.</p><p><strong>Methods: </strong>Retrospective propensity score pair matched cohort study. Groups were matched based on age < or ≥ 65 years and receipt of non-<i>C. difficile</i> antibiotics during hospitalization or within 6 months post-discharge. Recurrence rates were analyzed via logistic regression conditioned on matched pairs and reported as conditional odds ratios. The primary outcome was recurrence rates compared between standard vancomycin versus tapered vancomycin for treatment of initial CDI.</p><p><strong>Results: </strong>The CDI recurrence rate at 6 months was 5.3% (4/75) in the taper cohort versus 28% (21/75) in the standard vancomycin cohort. The median time to CDI recurrence was 115 days versus 20 days in the taper and standard vancomycin cohorts, respectively. When adjusted for matching, patients in the taper arm were less likely to experience CDI recurrence at 6 months when compared to standard vancomycin (cOR = 0.19, 95% CI 0.07-0.56, <i>p</i> < 0.002).</p><p><strong>Conclusions: </strong>Larger prospective trials are needed to elucidate the clinical utility of tapered oral vancomycin as a treatment option to achieve sustained clinical cure in first occurrences of CDI.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464400","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":"Assessing for race, ethnicity, and socioeconomic disparities in central line-associated bloodstream infection risk in a large academic health system.","authors":"Lindsey B Gottlieb, Radhika Prakash-Asrani, William Dube, Zanthia Wiley, Giancarlo Licitra, Scott K Fridkin","doi":"10.1017/ice.2024.133","DOIUrl":"10.1017/ice.2024.133","url":null,"abstract":"<p><strong>Objective: </strong>To examine the relationship between race and ethnicity and central line-associated bloodstream infections (CLABSI) while accounting for inherent differences in CLABSI risk related to central venous catheter (CVC) type.</p><p><strong>Design: </strong>Retrospective cohort analysis.</p><p><strong>Setting: </strong>Acute care facilities within an academic healthcare system.</p><p><strong>Patients: </strong>Adult inpatients from January 2012 through December 2017 with CVC present for ≥2 contiguous days.</p><p><strong>Methods: </strong>We describe variability in demographics, comorbidities, CVC type/configuration, and CLABSI rate by patient's race and ethnicity. We estimated the unadjusted risk of CLABSI for each demographic and clinical characteristic and then modelled the effect of race on time to CLABSI, adjusting for total parenteral nutrition use and CVC type. We also performed exploratory analysis replacing race and ethnicity with social vulnerability index (SVI) metrics.</p><p><strong>Results: </strong>32,925 patients with 57,642 CVC episodes met inclusion criteria, most of which (51,348, 89%) were among non-Hispanic White or non-Hispanic Black patients. CVC types differed between race/ethnicity groups. However, after adjusting for CVC type, configuration, and indication in an adjusted cox regression, the risk of CLABSI among non-Hispanic Black patients did not significantly differ from non-Hispanic White patients (adjusted hazard ratio [aHR] 1.19; 95% confidence interval [CI]: 0.94, 1.51). The odds of having a CLABSI among the most vulnerable SVI subset compared to the less vulnerable was no different (odds ratio [OR] 0.95; 95% CI: 0.75-1.2).</p><p><strong>Conclusions: </strong>We did not find a difference in CLABSI risk between non-Hispanic White and non-Hispanic Black patients when adjusting for CLABSI risk inherent in type and configuration of CVC.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464399","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":"Enabling laboratory readiness and preparedness for the evaluation of suspected viral hemorrhagic fevers: development of a laboratory toolkit.","authors":"Sarah E Turbett, Jacob E Lazarus, Mia A Nardini, Joseph E Braidt, Stefanie A Lane, Eileen F Searle, Paul D Biddinger, Erica S Shenoy","doi":"10.1017/ice.2024.143","DOIUrl":"10.1017/ice.2024.143","url":null,"abstract":"<p><strong>Purpose: </strong>Viral hemorrhagic fevers (VHFs), such as Ebola virus disease, Marburg virus disease, and Lassa fever, are associated with significant morbidity and mortality and the potential for person-to-person transmission. While most individuals in whom VHF is suspected will ultimately be diagnosed with a non-VHF illness, such patients may present to any United States healthcare facility (HCF) for initial evaluation; therefore, all HCFs must be prepared to evaluate and initiate care for suspect VHF patients, especially if they are acutely ill. Included within this evaluation is the ability to perform basic routine laboratory testing before VHF-specific diagnostic test results are available, as well as rapid malaria testing to assess for a common, dangerous \"VHF mimic.\"</p><p><strong>Objective: </strong>To improve laboratory preparedness and readiness in the initial care of suspect VHF patients who may present to acute care hospitals.</p><p><strong>Design: </strong>Plan-Do-Study-Act quality improvement model.</p><p><strong>Setting: </strong>Frontline healthcare facilities and their clinical laboratories.</p><p><strong>Methods: </strong>We describe the development of a laboratory testing toolkit for a suspect VHF patient that can assist frontline HCFs in providing basic laboratory testing required for the care of these patients.</p><p><strong>Results: </strong>The toolkit provides guidance on infection prevention and control, waste management, occupational health, laboratory test collection, processing, and resulting, in the context of suspect VHF patient evaluation.</p><p><strong>Conclusions: </strong>The toolkit is designed to be readily adapted by any frontline HCF in the US. With the guidance provided, facilities will be able to support safer initial evaluation of VHF suspects and ensure high-quality patient care.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400188","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":"Antibiotic spectrum coverage scoring as a potential metric for evaluating the antimicrobial stewardship team activity: a single-center study.","authors":"Kazutaka Oda, Hideyuki Hayashi, Keiichi Yamamoto, Shoji Kondo, Tomomi Katanoda, Shinichiro Okamoto, Toshikazu Miyakawa, Eisaku Iwanaga, Kisato Nosaka, Tatsuya Kawaguchi, Hirotomo Nakata","doi":"10.1017/ice.2024.137","DOIUrl":"10.1017/ice.2024.137","url":null,"abstract":"<p><strong>Objective: </strong>Days of antibiotic spectrum coverage (days of ASC: DASC) is a metric for antibiotic usage calculated by ASC scores for spectrum and addresses limitations of days of therapy (DOT), which does not include spectrum. This study aims to investigate whether ASC-related metrics offer different aspects compared to aggregated DOT for all antibiotics (DOT_total) and to assess their correlation in evaluating the impact of antimicrobial stewardship team (AST) programs.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Setting: </strong>A single center within an 845-bed hospital.</p><p><strong>Methods: </strong>Trends in DOT_total, DASC, and the DASC/DOT ratio, representing the average spectrum coverage per therapy day, were analyzed pre- and post-AST programs (April 2018) from January 2015 to December 2023, using interrupted time series analysis. Independent of the DASC/DOT, we also advocated ASC-stratified DOT (ASDOT), which facilitates comprehensive evaluation of DOT across ASC scores of <6, 6-10, and >10, representing narrow-, intermediate-, and broad-spectrum antibiotics.</p><p><strong>Results: </strong>Among inpatients, AST programs significantly moderated the increasing trends of these metrics. Specifically, although the rates of increase in DOT_total and DASC were slowed or plateaued, the DASC/DOT ratio decreased (<i>P</i> < 0.001). ASDOT metrics revealed a decrease and subsequent plateau in DOT_total for the broad- and intermediate-spectrum antibiotics, with an increase observed for the narrow-spectrum antibiotics (<i>P</i> < 0.001 for each). DASC did not provide additional insights in the outpatient's population.</p><p><strong>Conclusions: </strong>The study demonstrates that ASC-related metrics may yield different and useful conclusions about the effectiveness of AST programs for inpatients.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-9"},"PeriodicalIF":3.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464398","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":"Factors influencing the use of highly bioavailable oral antibiotic therapy for the treatment of prosthetic joint infections.","authors":"Marie-Félixe Granger, Jerome A Leis, Amanda Hempel, Daniel Pincus, Bheeshma Ravi, Nick Daneman, Philip W Lam","doi":"10.1017/ice.2024.159","DOIUrl":"10.1017/ice.2024.159","url":null,"abstract":"<p><p>We conducted a retrospective cohort study to identify factors influencing intravenous (IV) versus oral antibiotic therapy in first-episode prosthetic joint infections. Of the 34/78 (44%) cases treated intravenously, negative cultures (26%), concomitant infections necessitating IV antibiotics (21%), and delays in susceptibility testing (15%) were the most common reasons for IV therapy.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":3.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390336","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}