Journal of Hospital Infection最新文献

{"title":"Impact of COVID-19 pandemic on the implementation of transmission-based precautions.","authors":"Kihan Yap, Kyaw Zaw Linn, Allie Yin Lim, Xiaowei Huan, Nicholas Bao Han Hang, Louisa Sun, Si Huei Tan, Koh Cheng Thoon, Brenda Sze Peng Ang, Moi Lin Ling, Surinder Kaur Pada, Albert Ty, Dale Fisher, Kalisvar Marimuthu","doi":"10.1016/j.jhin.2025.03.010","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.03.010","url":null,"abstract":"<p><strong>Background: </strong>Multidrug-resistant organisms (MDROs) and hospital-acquired infections (HAIs) threaten patient safety. Transmission-based precautions (TBPs) are critical infection prevention and control (IPC) measures but resource-intensive. The COVID-19 pandemic disrupted routine IPC practices due to resource diversion for pandemic response, straining systems and compromising TBPs for pathogens of interest (POIs). This study analysed IPC practices in five Singapore acute hospitals before and during the COVID-19 pandemic from August 2020 to August 2021.</p><p><strong>Aim: </strong>This study investigated the impact of the COVID-19 pandemic on the implementation of pathogen-specific TBP.</p><p><strong>Methods: </strong>The primary outcome measure was the proportion of patients on appropriate pathogen-specific transmission-based precautions (TBP). We compared the variables between the two cycles to assess the impact of COVID-19 on the implementation of pathogen-specific IPC measures.</p><p><strong>Findings: </strong>A total of 8601 patient records were reviewed (4132 in Cycle 1 and 4469 in Cycle 2). Appropriate TBP implementation decreased by 39% during Cycle 2 compared to Cycle 1 (OR, 0.61; 95% CI, 0.50-0.73; p<0.01). Staff unawareness of pathogens of interest (POIs) emerged as the most common factor contributing to inappropriate TBP placement across both cycles. Notably, patients with MRSA only experienced a significant decrease in appropriate TBP during Cycle 2 (OR, 0.56; 95%CI, 0.44-0.71; p<0.01). Interestingly, hospitals with higher pre-pandemic TBP adherence rates maintained better compliance during the pandemic.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic adversely affected the implementation of appropriate TBPs in Singapore acute care hospitals. This study highlights the need to act proactively to maintain appropriate TBPs during public health emergencies.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804882","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 Healthcare Workforce Management: The Economic Impact of In-House Molecular Testing During the COVID-19 Pandemic.","authors":"Pâmela T Coutinho, Édison J Manchesski, Pedro D Batista, Vinicius U Palma, João P F Fortti, Gabriela M Faleiro, Lidiane da S Almeida, Marluci Reche, Alessandro C Pasqualotto","doi":"10.1016/j.jhin.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.04.001","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804883","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":"Why is the pathogen positivity rate so high even after chlorhexidine-alcohol disinfection?","authors":"Yuanyuan Xiao, Caixia Tan, Ju Zou, Siyao Chen, Biyue Tian, Anhua Wu, Chunhui Li","doi":"10.1016/j.jhin.2025.01.018","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.01.018","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797145","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":"Are particle counts better than microbiological sampling to assess air supply cleanliness in operating theatres?","authors":"A Bak, P Hoffman, C Mackintosh, H Humphreys","doi":"10.1016/j.jhin.2025.03.012","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.03.012","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797098","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":"Long-term within household sharing of ESBL-producing E. coli carrying bla_CTX-M-147 that converted to bla_CTX-M-14.","authors":"Heleen H Aardema, Sigrid S Rosema, Monika M A Fliss, Lilli L Gard, Mariëtte A J M Lokate, Carin C L E Hazenberg, Andreas A Voss, Erik E Bathoorn","doi":"10.1016/j.jhin.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.03.008","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797101","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":"Health economic burden of refractory and recurrent Clostridioides difficile infection in the inpatient setting of the German health care system - the IBIS Study.","authors":"S M Wingen-Heimann, A Ullah, M R Cruz Aguilar, S K Gräfe, J Conrad, K Giesbrecht, K-P Hunfeld, C Lübbert, S Pützfeld, P A Reuken, M Schmitz-Rode, E Schalk, T Schmidt-Wilcke, S Schmiedel, P Solbach, M J G T Vehreschild","doi":"10.1016/j.jhin.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.03.011","url":null,"abstract":"<p><strong>Background: </strong>Clostridioides difficile infections (CDI) remain a prevalent and costly healthcare challenge, particularly affecting elderly, comorbid patients. Evidence on the health economic burden of CDI in Germany, particularly in refractory and recurrent patients is limited.</p><p><strong>Methods: </strong>The IBIS study was a non-interventional retrospective and prospective study conducted from 08/2017 to 09/2020 in 10 German hospitals to assess the health economic burden of inpatient CDI treatment. It categorized CDI episodes into initial, refractory and recurrent, following the current ESCMID guidelines. A micro-costing approach from the societal perspective was applied, considering personnel, material, and infrastructure costs for treatment on different types of hospital wards, targeted antibiotic CDI therapies, and productivity losses due to illness related disability.</p><p><strong>Results: </strong>Mean total costs per patient were €13,607 (95% CI: €12,124-€15,171) for the initial, €19,953 (95% CI: €16,839-€23,377) refractory and €22,671 (95% CI: €16,088-€30,474; P<0.001) for the recurrence group. Treatment on a general ward was the most important cost driver. Mean hospital length of stay in the initial, refractory group and recurrence group was 30 (95% CI: 27-33,) vs. 41 (95% CI: 35-46) vs. 47 days (95% CI: 37-57; P<0.001), respectively. Patients with initial, refractory and recurrent CDI required 11 (95% CI: 10-11), 15 (95% CI: 13-16), and 24 days (95% CI: 22-27; P<0.001) of targeted antibiotic therapy for CDI.</p><p><strong>Conclusion: </strong>The IBIS study contributes valuable insights to the health economic burden of refractory and recurrent CDI in the German inpatient setting and underlines the importance of effective first-line treatment to improve treatment outcomes and reduce overall costs related with CDI.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797099","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":"Quality indicators for appropriate inpatient antibiotic use: results from two national surveys in Italy, 2016-2022.","authors":"Costanza Vicentini, Antonino Russotto, Roberta Bussolino, Marta Castagnotto, Claudia Gastaldo, Stefano Bazzolo, Dario Gamba, Silvia Corcione, Francesco Giuseppe De Rosa, Fortunato D'Ancona, Carla Maria Zotti","doi":"10.1016/j.jhin.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.03.007","url":null,"abstract":"<p><strong>Background: </strong>To address its high antimicrobial resistance (AMR) and antibiotic consumption rates, Italy introduced a national action plan to contrast AMR (PNCAR) in 2017.</p><p><strong>Aim: </strong>To investigate trends in antibiotic use, prescribing practices, and AMR rates in Italy through indicators of appropriate antibiotic use.</p><p><strong>Methods: </strong>Two point prevalence surveys (PPSs), according to ECDC methods and definitions, were conducted in 2016 and 2022. Indicators of appropriate antibiotic use were defined and measured. Antibiotic use prevalence and AMR rates for specific pathogen-drug combinations were calculated. To account for potential confounding factors, a propensity score matching approach was applied to compare the results of the two PPS editions using prevalence rate ratio (PRR).</p><p><strong>Results: </strong>Overall, 28,991 patients from 140 hospitals and 60,403 patients from 325 hospitals were included in 2016 and 2022 respectively. Patient characteristics remained stable, but patients were increasingly exposed to invasive procedures. The overall prevalence of antibiotic use decreased from 43.51 to 41.52 (PRR 0.95, 95% confidence interval, CI 0.94 - 0.97, p <0.001). Improvements in some prescribing practices were identified: the proportion of surgical prophylaxis lasting >1 day decreased from 55.99% to 52.15%, (PRR 0.94, 95% CI 0.90 - 0.98, p <0.001) and the proportion of culture-guided hospital infection treatments increased from 33.68% to 48.57% (PRR 1.30, 95% CI 1.22 - 1.38, p<0.05). Conversely, a significant rise in the proportion of last line/broad spectrum agents was recorded for most indications.</p><p><strong>Conclusion: </strong>This study provided a mapping of prescribing activity at national level, and defined measurable quality indicators, through which strengths and areas for improvement in prescribing practices were identified.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782089","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":"Surgery and sustainability: time for multi-disciplinary collaboration to reduce the carbon footprint while not compromising infection prevention","authors":"H. Humphreys ,&nbsp;A.D.K. Hill","doi":"10.1016/j.jhin.2025.01.001","DOIUrl":"10.1016/j.jhin.2025.01.001","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"158 ","pages":"Pages 69-70"},"PeriodicalIF":3.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973385","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":"Nosocomial Bloodstream Infection in Critically Ill Patients: Is Extracorporeal Membrane Oxygenation a Relevant Factor?","authors":"Almudena Martínez, María Marín-Cerezuela, Carmen Carrasco, Juan Frasquet, Ricardo Gimeno, Francisca Perez-Esteban, Faustino Álvarez, Javier Pemán, Álvaro Castellanos, Paula Ramirez","doi":"10.1016/j.jhin.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.03.004","url":null,"abstract":"<p><strong>Background: </strong>Nosocomial bloodstream infections (BSIs) in critically ill patients can cause clinical deterioration, extend intensive care unit (ICU) stays, and increase mortality risk. Extracorporeal membrane oxygenation support (ECMO) is a known risk factor for BSI, and infections in these patients are assumed to have a worse prognosis. However, no comparative studies exist between ECMO and non-ECMO patients.</p><p><strong>Methods: </strong>A three-year prospective observational study was conducted in a 24-bed medical ICU. Consecutive nosocomial BSIs episodes were recorded, and BSIs in mechanically ventilated patients were analyzed based on ECMO treatment status.</p><p><strong>Findings: </strong>A total of 98 BSI episodes were included: 30 (30.6%) in ECMO and 68 (69.3%) in non-ECMO patients. The total number of ECMO patients during the study period was 110, with a bacteraemia rate of 27.7% (20.26 episodes per 1000 treatment-days). In non-ECMO patients, the BSI rate was 7.9% (p<0.001). ECMO patients were younger and had fewer co-morbidities. BSI type and aetiology were similar between groups, but severity was higher in ECMO patients. Although multidrug-resistant microorganisms were more frequent in ECMO patients, the appropriate treatment rate was similar. ICU-mortality was 66.6% in ECMO patients and 30.8% in non-ECMO patients (p <0.001). However, CRRT (OR 3.67), SOFA score (OR 1.54) and COVID-19 diagnosis (OR 1.54) were the only independent risk factors associated with mortality in BSI patients.</p><p><strong>Conclusion: </strong>Although BSI was more frequent and severe in ECMO patients, ECMO support was not independently related to mortality in patients with healthcare-associated BSI.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756021","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 considerations for integrated face and respiratory protection: a qualitative study.","authors":"Luciana Cordeiro, Amy Price, Naila Albertina de Oliveira, Caroline Lopes Ciofi-Silva, Giorgia Girelli, Ying Ling Lin, Anna S Levin, Fabio Tumietto, Maria Clara Padoveze","doi":"10.1016/j.jhin.2025.02.022","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.02.022","url":null,"abstract":"<p><strong>Background: </strong>The implementation of an innovative form of personal protective equipment (PPE) as an infection and prevention control measure for respiratory transmissible diseases is complex, with several elements to be addressed.</p><p><strong>Aim: </strong>To make considerations for integrated face and respiratory protection implementation in clinical settings.</p><p><strong>Methods: </strong>Multisite qualitative study with 87 health workers that compared traditional PPE or powered air purifying (PAPR) respirators with lightweight PAPR (L-PAPR). Semi-structured interviews were performed based on the Consolidated Framework for Implementation Research (CFIR).</p><p><strong>Findings: </strong>Insights into L-PAPR implementation were found. The advantages consist of: enhanced sense of protection, pleasant ventilation, good visibility for both health worker and patient, no fogging of the visor interior, no movement restriction, and easy disinfection process. To enhance usability some barriers should be tackled: reduction of facial pressure; better accommodation for glasses and corrective lenses; reduction of number of steps for assembling the device; infrastructure provision for storage, charging and disinfection of the device; training of health workers for assembling, donning and doffing; and the cost benefit of implementation.</p><p><strong>Conclusion: </strong>L-PAPR was overall perceived with advantages by many participants, and can be considered a potential option of PPE to be implemented to protect health workers during outbreaks of respiratory transmissible diseases.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702344","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}