Journal of Hospital Infection最新文献

{"title":"Ultrasound endoscopes and routine microbiological surveillance - another critical device in reprocessing.","authors":"Anna Mueller, Bhavya Chakrakodi, Marie-Theres Meier, Frank Bieger, Christoph Schlag, Branko Duvnjak, Silvio D Brugger, Walter Zingg, Peter W Schreiber","doi":"10.1016/j.jhin.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.09.015","url":null,"abstract":"<p><strong>Background: </strong>Periodic routine microbiological surveillance of gastrointestinal endoscopes is recommended to ensure adequacy of reprocessing. We aimed to investigate whether there were differences in contamination depending on the type of endoscope.</p><p><strong>Methods: </strong>We analyzed 437 microbiological surveillance samples obtained from gastrointestinal endoscopes at a tertiary-care center in Switzerland. Sampling was carried out after reprocessing in washer-disinfectors according to Standard SN EN ISO 15883-4:2018. For microbiological analysis, endoscope irrigation solution was filtered and transferred to sheep blood agar. These plates were incubated at 37°C. If bacterial growth was detected, the species was identified using MALDI or other microbiological identification techniques, and colony forming units (CFUs) were counted. Contamination was defined as detection of any microorganism with ≥20 CFUs/20 mL or detection of Enterobacterales, Enterococcus spp., Pseudomonas aeruginosa and other non-fermenters, Streptococcus viridans and Staphylococcus aureus, independent of CFU count.</p><p><strong>Results: </strong>Totally, 204 samples were gathered from 28 gastroscopes, 146 samples from 23 colonoscopes, 45 samples from 5 ultrasound endoscopes, 27 from 4 duodenoscopes and 15 from 3 enteroscopes, respectively. Eleven (2.5%) samples, gathered from 5 endoscopes, indicated contamination. The proportion of samples indicating contamination varied largely by endoscope type: 20.0% (9/45) of ultrasound endoscopes-derived, 1.4% (2/146) of colonoscope-derived, 0.5% (1/204) of gastroscope-derived, 0% (0/27) of duodenoscope-derived and 0% (0/15) enteroscope-derived samples were contaminated (P<0.001).</p><p><strong>Conclusions: </strong>Overall, a small proportion of endoscopes were contaminated. Significant differences were observed based on the type of endoscope, with ultrasound endoscopes performing worst.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors and Colistin Resistance in Multidrug-Resistant Pseudomonas aeruginosa: Insights from a Urology and Kidney Transplant Ward.","authors":"Mariana Duarte Almeida, Belmiro Parada, Sarah M Johansson, Pedro Valada, João Pereira, Rita Leal, Catarina Chaves, João Frade, Ana Rita Rebelo, Teresa Gonçalves, Gabriela J Da Silva, Rene S Hendriksen, Célia Nogueira","doi":"10.1016/j.jhin.2025.09.017","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.09.017","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operating theaters are not all the same: can downflow ultra clean air really make a difference? A correlation study between HVAC systems and surgical site infections.","authors":"Jacopo Dolcini, Agnese Lucesoli, Giorgio Firmani, Roberto Allegrezza Giulietti, Roberto Bruschi, Enrica Martini, Maria Grazia Gioia, Marcello Mario D'Errico, Pamela Barbadoro","doi":"10.1016/j.jhin.2025.08.016","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.08.016","url":null,"abstract":"<p><strong>Background: </strong>Air quality in operating theaters (OTs) is crucial for preventing surgical site infections (SSIs). HVAC systems should ensure high air quality, minimizing microbial contamination. Recently, the effectiveness of downflow ultra-clean air (UCA) systems in preventing SSIs has been debated.</p><p><strong>Aim: </strong>This study analyzes the correlation between OT HVAC systems and SSI incidence using data from 12 hospitals in the Marche Region (2018-2019).</p><p><strong>Methods: </strong>The data were correlated with the incidence of SSIs following 899 surgical procedures. A logistic regression analysis showed that UCA systems were associated with a reduced risk of SSI (OR=0.37; C.I. 0.15-0.92).</p><p><strong>Findings: </strong>We observed 38 SSIs, resulting in a total incidence of 4.2% (95% C.I. 3.0-5.8). Of these, 29 occurred under non-UCA systems (5.17%, 95% C.I. 3.5-7.4), and 9 occurred in UCA environments (2.66%, 95% C.I. 1.2-5.0). Technical data were collected from validation tests in each OT, focusing on UCA HVAC systems with unidirectional airflow meeting ISO 5 class standards.</p><p><strong>Conclusions: </strong>These data suggest the potential effectiveness of UCA in reducing microbial air contamination, thus improving air quality and decreasing the risk of SSIs compared to non-UCA ventilation systems.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Antibiotic Stewardship in United Arab Emirates Hospitals: An Assessment of Programme Structure in Emirates Health Services.","authors":"Fatma Al Hamidh, Md Hafizur Rahman, Esmita Charani","doi":"10.1016/j.jhin.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.09.002","url":null,"abstract":"<p><strong>Background: </strong>Optimal implementation of Antibiotic Stewardship Programmes (ASPs) is crucial to combat antibiotic resistance in gulf countries including the United Arab Emirates (UAE). This study evaluates ASP structure in UAE hospitals for seven core elements defined by Centres for Disease Control and Prevention (CDC) and World Health Organisation (WHO).</p><p><strong>Methods: </strong>A mixed-methods approach across 12 Emirates Health Services (EHS) hospitals, included document reviews, surveys, and expert interviews. Document evaluation was performed on a 3-point Likert scale. Online surveys distributed to a random sample of 385 employees, evaluated ASP dissemination using a 5-point Likert scale, analysed descriptively and through Mann-Whitney and Kruskal-Wallis tests (P<0.05) using SPSS. Interviews with programme experts were thematically analysed using NVIVO.</p><p><strong>Results: </strong>Document analysis showed 6 of 7 ASP core elements fully met, with accountability partially met in all hospitals. The survey (83% response rate) revealed partial ASP dissemination (median = 4, IQR=2) across all elements, with significant differences between employee groups and hospitals (P=0.032). Interviews with 12 ASP experts identified key programme facilitators to be leadership, active interventions, pharmacist engagement, and tailored education. Barriers were inconsistent antibiotic tracking, physician resistance, lack of rapid diagnostics, competency framework and cadre training.</p><p><strong>Conclusion: </strong>EHS ASP demonstrates adequate structure but inconsistent dissemination across hospitals. This first UAE mixed-methods study benchmarks local ASP against CDC and WHO standards, aligning with high-income countries but diverging from practices in Middle East and North African countries. ASP implementation and adoption optimisation needs to be explored with process and outcome indicator data focusing on prescribing, cost-effectiveness and clinical outcomes.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation Impact of Methicillin-resistant Staphylococcus aureus (MRSA) Rapid Molecular Testing on Hospital-Related Quality and Cost of Care.","authors":"Amy Pinsent, Kerry Winter, Jordan Chase, Christophe Martinaud, David P Nicolau, Henri Folse","doi":"10.1016/j.jhin.2025.09.013","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.09.013","url":null,"abstract":"<p><strong>Background: </strong>The implementation of proactive screening has reduced methicillin-resistant Staphylococcus aureus (MRSA) infections in hospital settings. This study evaluated the health and cost implications of the utilization of a rapid PCR-based testing strategy compared to conventional strategies for MRSA control.</p><p><strong>Methods: </strong>A cost-consequence analysis incorporating conventional interventional and infection-related expenditures was developed to estimate the health and economic impact of rapid PCR-based screening compared to no screening, universal decolonization, and culture-based screening from a U.S. hospital perspective. The analysis included patients hospitalized in general wards at risk of MRSA infection over a 30-day time horizon. The model inputs were informed by the published literature. Sensitivity and scenario analyses were conducted to examine the impact of key parameters and assumptions.</p><p><strong>Results: </strong>In a 1,000-patient cohort, compared to culture-based screening with and without pre-emptive isolation, the rapid PCR-based screening saved $11,842,498 and $5,625,278, respectively, in total costs and reduced health outcomes while resulting in fewer infections, deaths, and onward transmissions compared to conventional culture screening without pre-emptive isolation. Compared to universal decolonization, the rapid PCR-based strategy saved $12,353,893 in total costs. Although the total costs increased for molecular screening due to higher bed day costs compared to no active screening, the rapid PCR-based strategy averted infections, subsequent deaths, and onward transmissions. Sensitivity and scenario analyses confirmed the robustness of these findings.</p><p><strong>Conclusions: </strong>Compared to other interventional strategies to reduce MRSA-related sequelae in the hospital setting routine testing with rapid PCR-based screening shows potential for improved health outcomes and cost savings.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central line infections in a haematology-oncology patient associated with Bacillus containing cleaning spray.","authors":"Julie Messiaen, Veroniek Saegeman, Melissa Depypere, Veerle Cossey, Marleen Renard, Annette Schuermans","doi":"10.1016/j.jhin.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.09.007","url":null,"abstract":"<p><p>Haemato-oncological patients are susceptible to infections due to aplasia. We describe an adolescent with a history of a relapse precursor B-cell acute lymphoblastic leukaemia, who experienced a second leukaemia after CAR-T-cell therapy with a lineage switch to acute myeloid leukaemia. He experienced events of central-line associated bloodstream infections with Bacillus species, requiring long-term broad spectrum antibiotics, central venous line replacements and removal of a port catheter. We identified a commercially available 'synbiotic spray', containing Bacillus strains as the likely source of contamination. We advocate for public health warnings regarding using household probiotic cleaning products in environments with immunocompromized individuals.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact on peripheral catheter failure with the use of an extension set with integrated needless connector compared to a straight hub: a prospective quasi-experimental study.","authors":"Marta Piriz-Marabajan, Alexander Rombauts, Nerea Roch-Villaverde, Ana Pilar Cortes-Palacios, Engracia Fernandez-Piqueras, Susana Serrano-Condal, Marta Taltavull-Menendez, Sara Grillo, Antonella Francesca Simonetti, Pol Duch, Virginia Pomar-Solchaga, Laura Escolà-Vergé, Joaquin Lopez-Contreras","doi":"10.1016/j.jhin.2025.09.009","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.09.009","url":null,"abstract":"<p><strong>Background: </strong>Peripheral intravenous catheter (PIVC) failure is a significant clinical issue. Evidence is needed on the impact of different PIVC systems on outcomes.</p><p><strong>Aim: </strong>To analyze the effect of add-on extension sets with integrated connectors on PIVC outcomes in real-world practice.</p><p><strong>Methods: </strong>A prospective, open-label, quasi-experimental study with blinded analyst was conducted at a tertiary hospital in Barcelona, Spain, comparing two PIVC systems. The control system (standard winged PIVC with add-on needleless connector) was evaluated from March 1 to April 6, 2022, and the study system (with add-on extension set and integrated needleless connector) from September 9 to December 14, 2023. The primary endpoint was overall PIVC failure per 1000 catheter-days, analyzed as relative rate.</p><p><strong>Findings: </strong>A total of 1019 PIVCs (607 patients) in the control group and 1028 PIVCs (634 patients) in the study group were followed. Groups had similar hospital stay, dwell times, and mortality. Patients in the study group were more likely to have heart disease, COPD, and be physically restrained. Overall, 795 (39.7%) PIVCs failed, a rate of 86.0 per 1000 catheter-days. The most common reasons for unplanned removal were extravasation (10.6%), occlusion (8.1%), accidental removal (7.7%), phlebitis (7.4%), and discomfort (5.5%). PIVC failure was significantly lower in the study group compared with control (37.2% vs. 42.1%, p = 0.025). Failure per 1000 catheter-days showed a non-significant reduction (RR = 0.89; 95% CI 0.77-1.03).</p><p><strong>Conclusion: </strong>PIVC failure remains high. A PIVC with add-on extension and integrated needleless connector did not show a statistically significant reduction in failure rate.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laboratory-Acquired Infections in the MENA Region: A Systematic Review of Reported Cases and Biosafety Gaps.","authors":"Maha M Ayoub, Faizah D Retnowati, Asma Maliha, Rafia Anjum, Marawan Abu-Madi, Atiyeh M Abdallah","doi":"10.1016/j.jhin.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.09.010","url":null,"abstract":"<p><strong>Background: </strong>Laboratory-acquired infections (LAIs) are a significant occupational health hazard to laboratory workers. Laboratory personnel can become infected by various pathogens handled as part of their work, including bacteria, fungi, viruses, and parasites. Despite their importance, data on LAI in the Middle East and North Africa (MENA) regions are limited. The aim of this study was to systematically review the reported LAIs in the MENA region to identify gaps in biosafety practices and identify the most common infectious agents contributing to them.</p><p><strong>Methods: </strong>The PubMed, Scopus, LAI, and Belgian Biosafety Server (BBS) databases were searched from conception to October 2024 for any reports and cases of LAIs in the MENA region, following PRISMA guidelines. Using a systematic strategy, inclusion criteria were relevant studies reporting cases involving MENA laboratory workers. Non-laboratory cases or studies with insufficient data were excluded. Quality was assessed using a specific quality assessment tool for case reports and case series. Reported cases were analyzed by infection type, risk factors, and laboratory practices.</p><p><strong>Results: </strong>Of 2,062 studies, 12 articles (24 cases) from Egypt, Saudi Arabia, Turkey, and UAE were considered eligible for inclusion. Twenty-four LAI cases were reported in the MENA region between 1968 and 2016. Brucella melitensis was the most frequently reported pathogen, reported in 66.7% of cases, highlighting a specific occupational risk in microbiology laboratories in the region. The review also identified gaps in data reporting, variability in laboratory biosafety practices, and a tendency towards underreporting.</p><p><strong>Conclusions: </strong>This review highlights the occupational health risks posed by LAIs in the MENA region, with Brucella spp. identified as the predominant pathogens in reported cases, and it also identifies gaps in biosafety practices. Limitations include underreporting and English-only searches. No funding was received.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of spatial distance in SARS-CoV-2 nosocomial transmission.","authors":"C J R Illingworth, G Yahiaoui, M Butler, R C Brock, C Peters, R Thaxter, S Evans, T Gouliouris, A Conway Morris, C B Beggs, E Vanoli, C Crawford, V L Keevil, R J B Goudie","doi":"10.1016/j.jhin.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.09.011","url":null,"abstract":"<p><strong>Background: </strong>The nosocomial transmission of respiratory viruses causes significant disruption to hospital care, but the spatial dynamics of transmission on hospital wards are poorly understood.</p><p><strong>Methods: </strong>We developed a model integrating computational fluid dynamics (CFD) simulations into an epidemiological reconstruction of virus transmission to quantify the relationship between SARS-CoV-2 transmission and the location of beds in medicine for the elderly wards.</p><p><strong>Findings: </strong>Data from CFD simulations described a pattern in which exposure to an infected host decreased by approximately 40% for each additional metre of distance, with a further four-fold reduction when patients were in separate rooms. However, statistical inference suggested that only 72% (95% C. I. 45% to 96%) of the transmission events identified on wards could be explained by this model. Other cases of transmission occurred at distances too great to be consistent with the simulation model, suggesting that distance-independent mechanisms such as shared facilities or staff-mediated transmission had an important role in nosocomial transmission.</p><p><strong>Interpretation: </strong>Our results suggest that while spatial separation reduces transmission risk, infection prevention and control strategies such as the use of single-bed rooms may be insufficient to prevent outbreaks. Comprehensive approaches to preventing nosocomial transmission, addressing multiple potential viral transmission pathways, are necessary.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial resistance and the invisible casualties of conflict.","authors":"Jennifer Broom, Alex Broom","doi":"10.1016/j.jhin.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.09.003","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}