Journal of Hospital Infection最新文献

{"title":"Biofilms and Antimicrobial Resistance in Healthcare: Evaluating Chlorine Dioxide as a Candidate to Protect Patient Safety.","authors":"P Norville, S Dangleben, S Hardy","doi":"10.1016/j.jhin.2025.04.034","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.04.034","url":null,"abstract":"<p><p>Healthcare-associated infections (HAIs) caused by the transmission of multi drug resistant organisms (MDROs) from contaminated surfaces are a major challenge for healthcare organisations. The presence of biofilm on surfaces makes effective environmental decontamination difficult to achieve and exacerbates antimicrobial resistance (AMR). In this study the performance of various chlorine dioxide-based disinfectants against a panel of MDROs, and biofilms formed by Pseudomonas aeruginosa and Staphylococcus aureus, was evaluated. All chlorine dioxide-based disinfectants tested demonstrated sufficient activity against MDROs meeting the relevant test standards and exhibited similar log reductions against organisms within the biofilm model. Sufficient log reductions when tested to the appropriate test standards in realistic contact times against planktonic MDROs, and comparable reductions against biofilms suggest chlorine dioxide is an attractive candidate for environmental decontamination strategies.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144506","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":"Integrating Infection Prevention into Antimicrobial Stewardship: A Dual Strategy for NICU Stewardship.","authors":"Kübra Aykaç, İrem İyigün, Tolga Çelik, Yasemin Ozsurekci","doi":"10.1016/j.jhin.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.005","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144507","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":"Evaluation of Disinfection Methods for Autonomous Mobile Robots Used in Hospital Logistics in Emergency Departments.","authors":"Przemysław Kardas, Filip Bielec, Małgorzata Brauncajs, Paweł Lewek, Dariusz Timler, Ewelina Łojewska, Marcello Chiurazzi, Neri Niccolò Dei, Gastone Ciuti, Raquel Juliá Ros, Víctor Solaz Estevan, Alessia Maccaro, Leandro Pecchia, Beatriz Merino, Alejandro Medrano, Thomas Penzel, Giuseppe Fico","doi":"10.1016/j.jhin.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.006","url":null,"abstract":"<p><strong>Background: </strong>Autonomous Mobile Robots (AMRs) have been increasingly used in hospital logistics, particularly in high-risk areas, such as Emergency Departments (EDs), to streamline operations, reduce staff fatigue, and minimize infection risks. However, their effective disinfection remains a critical concern, especially when it comes to solutions aimed at preventing spread of multi-drug-resistant organisms.</p><p><strong>Objective: </strong>This study evaluated the microbiological cleanliness and effectiveness of various disinfection methods for AMRs in real-life hospital logistics settings, with a particular focus on their application in EDs.</p><p><strong>Methods: </strong>The HOSBOT, an AMR designed for hospital logistics, was deployed in a tertiary hospital for two weeks and validated for transport of biological samples. Microbiological contamination was assessed at multiple robot sites before and after disinfection, using two methods, i.e. manual wiping with a standard disinfectant and non-contact fumigation with low temperature vaporized hydrogen peroxide. Contamination levels were evaluated using quantitative and qualitative microbiological techniques, and a threshold of <2.5 colony-forming units/cm² for critical environments, recommended by the Centers for Disease Control and Prevention (CDC), was considered as proof of success.</p><p><strong>Results: </strong>Bacterial contamination exceeded thresholds at all sites. Both disinfection methods significantly decreased contamination. Manual wiping reduced bacterial counts below thresholds and eradicated fungal growth, while fumigation was effective for bacterial but not fungal contamination. Fumigation also failed to meet CDC cleanliness standards in hard-to-reach areas.</p><p><strong>Conclusions: </strong>Both manual wiping and fumigation effectively reduced bacterial contamination, however, wiping showed better results in fungal eradication. Improvements to fumigation methods are necessary, such as application of higher disinfectant concentrations or alternative chemicals. The aforementioned findings not only support the use of AMRs in clinical settings but also emphasize the importance of effective disinfection for safety and efficacy.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133154","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":"Clinical prediction models to guide treatment of periprosthetic joint infections: A systematic review and meta-analysis.","authors":"Elise Naufal, Cade Shadbolt, Marjan Wouthuyzen-Bakker, Siddharth Rele, Srujana Sahebjada, Sharmala Thuraisingam, Sina Babazadeh, Peter F Choong, Michelle M Dowsey","doi":"10.1016/j.jhin.2025.04.035","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.04.035","url":null,"abstract":"<p><strong>Background: </strong>Several clinical prediction models that aim to guide decisions about the management of periprosthetic joint infections (PJI) have been developed. While some models have been recommended for use in clinical settings, their suitability remains uncertain.</p><p><strong>Methods: </strong>We systematically reviewed and critically appraised all multivariable prediction models for the treatment of PJI. We searched MEDLINE, EMBASE, Web of Science, and Google Scholar from inception until March 1st, 2024 and included studies that developed or validated models that predict the outcome of PJI. We used PROBAST (Prediction model Risk Of Bias ASsessment Tool) to assess the risk of bias and applicability. Model performance estimates were pooled via random effect meta-analysis.</p><p><strong>Results: </strong>Thirteen predictive models and seven external validations were identified. Methodological issues were identified in all studies. Pooled estimates indicated that the KLIC (Kidney, Liver, Index surgery, Cemented prosthesis, C-reactive protein) score had fair discriminative performance (pooled c-statistic 0.62, 95% CI 0.55 to 0.69). Both the τ2 (0.02) and I2 (33.4) estimates indicated that between study heterogeneity was minimal. Meta-analysis indicated Shohat et al's model had good discriminative performance (pooled c-statistic 0.74, 95% CI 0.57 to 0.85). Both the τ2 (0.0) and I2 (0.0) indicated that between study heterogeneity was minimal.</p><p><strong>Conclusions: </strong>Clinicians should be aware of limitations in the methods used to develop available models to predict outcomes of PJI. As no models have consistently demonstrated adequate performance across external validation studies, it remains unclear if any available models would provide reliable information if used to guide clinical decision-making.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121336","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":"Characterization of a nosocomial outbreak caused by VIM-1 Klebsiella michiganensis using Fourier-Transform Infrared (FT-IR) Spectroscopy.","authors":"David Rodriguez-Temporal, María Sánchez-Cueto, Sergio Buenestado-Serrano, Mario Blázquez-Sánchez, Emilia Cercenado, Mark Gutiérrez-Pareja, Andrea Molero-Salinas, Elena López-Camacho, Patricia Muñoz, Darío García de Viedma, Laura Pérez-Lago, Belén Rodríguez-Sánchez","doi":"10.1016/j.jhin.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.003","url":null,"abstract":"<p><p>Fourier-transform Infrared (FT-IR) spectroscopy has emerged as a rapid and reliable method for bacterial typing. In this study, we evaluated FT-IR spectroscopy for characterizing a nosocomial outbreak caused by VIM-1-producing Klebsiella michiganensis (K. oxytoca complex). All K. oxytoca complex isolates collected during the outbreak period (N=27) and control isolates (N=8) were obtained from Hospital Universitario Gregorio Marañón, Spain. Among the 27 isolates, 22 were obtained from paediatric patients, 4 from adults and one was an environmental isolate. FT-IR spectroscopy was employed for bacterial typing, while whole-genome sequencing (WGS) was used as the reference typing method for comparison. Analysis of the FT-IR spectra revealed distinct clusters, one of which corresponded to 19 outbreak isolates (18 from paediatric patients and the environmental isolate), suggesting a common origin. Other minor clusters did not exhibit any epidemiological relationship among the isolates. Subsequent WGS analysis identified Klebsiella michiganensis as the causative agent of the outbreak. FT-IR showed a high concordance with WGS in outbreak classification, supporting its reliability in this setting (Adjusted Rand Index=0.882; Adjusted Wallace Coefficient=0.937). Moreover, FT-IR spectra visualization highlighted discriminative features between outbreak and non-outbreak isolates, facilitating rapid screening when an outbreak is suspected. In conclusion, FT-IR spectroscopy represents a rapid and cost-effective method that enables timely intervention and effective management of nosocomial outbreaks. Its integration with WGS enhances the accuracy of outbreak investigations, demonstrating its utility in clinical microbiology and infection control practices.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121331","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":"Clinical decision support system to guide antimicrobial selection: a narrative review from 2019 to 2023.","authors":"Anne-Lise Bienvenu, Jean-Michel Ducrocq, Marie-Josée Augé-Caumon, Eric Baseilhac","doi":"10.1016/j.jhin.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.001","url":null,"abstract":"<p><strong>Background: </strong>Clinical decision support systems (CDSS) are increasingly developed to improve healthcare delivery.</p><p><strong>Objectives: </strong>To update the last review on this topic, we conducted a narrative review aimed at describing all CDSS identified through searches of MEDLINE dedicated to antimicrobials prescribing from 2019 to 2023.</p><p><strong>Materials and methods: </strong>All original research describing a CDSS dedicated to antimicrobials selection, including antibiotics, antivirals, antifungals, and antiparasitic drugs, were eligible. CDSS goals and their potential clinical impacts, as well as characteristics of studies for CDSS evaluation (type of study, population, setting, objectives, and main findings) were extracted.</p><p><strong>Results: </strong>Among the 28 studies included, most (n=24) were dedicated to antibiotics and 15 were embedded in an electronic health record. Only one CDSS was developed in low and middle-income countries (LMIC). The main goal of the included CDSS was to assist clinicians in the selection of antimicrobials. Ten studies included more than 1 000 patients or prescriptions, and most of them were implemented in hospitals. Only six studies reported no impact of CDSS on antibiotic use or compliance with guidelines.</p><p><strong>Conclusions: </strong>CDSS dedicated to antimicrobial prescribing is an area of increasing activity, with solutions offering the potential to optimise antimicrobial use. Although there is an urgent need to develop CDSS, CDSS clinical evaluation appears to be an important requirement before implementation. Special efforts are needed to ensure transferability of CDSS and high adoption, especially in LMIC, while improving awareness through education and training.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121333","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":"Conditions for air cleanliness in a unidirectional airflow ventilation, during orthopaedic joint replacement procedures.","authors":"Ida-Linnea Böregård, Sven Bringman, Christine Leo Swenne, Ann-Christin Von Vogelsang","doi":"10.1016/j.jhin.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.004","url":null,"abstract":"<p><strong>Background: </strong>Microbiological air contamination in the operating room (OR) is associated with the risk of surgical site infections (SSIs) after joint replacement procedures. Recommendations define the level of microbiological air cleanliness by the number of colony-forming units (cfu) in an OR. Airborne microorganisms originate from the staff and unidirectional airflow (UDAF) ventilation is effective in the OR, providing filtered air to create ultraclean zones.</p><p><strong>Aim: </strong>To evaluate the air cleanliness in the demarcation zone during joint replacement procedures and describe the limitations for optimal air cleanliness in an UDAF ventilation.</p><p><strong>Methods: </strong>In a cross-sectional design, cfu were measured using active air sampling in an OR with UDAF. Comparative measures were taken between demarcation and outer zone, supplemented by observations of staff numbers, traffic flow and movements.</p><p><strong>Findings: </strong>A total of 166 samples were collected during 20 arthroplasty procedures. There were significantly more cfus in the outer zone than in the demarcation zone (P < 0.001). The only significantly predictor associated for higher cfu counts were the numbers of persons in the outer zone (odds ratio: 2.566; 95% confidence interval: 1.306-5.044; P = 0.006). Observations associated with higher cfu counts were method or organisational related.</p><p><strong>Conclusions: </strong>Air cleanliness in UDAF ventilation was better in the demarcation zone compared to the outer zone, and the number of persons in the outer zone was associated with decreased air cleanliness. Intraoperative movements could cause higher cfu counts in demarcation zone, but further studies are needed to evaluate the consequences of staff movements.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121338","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":"A hospital-wide outbreak of ESBL-producing Klebsiella oxytoca associated with contaminated sinks and associated plumbing: outbreak report, risk factor analysis and plasmid mapping.","authors":"Jon Edman-Wallér, Jenny Andersson, Maria Nelson, Linda Hallberg, Lisa Berglund, Henrik Mellström Dahlgren, Oskar Lindsjö, Vilhelm Müller, Joacim Stalfors","doi":"10.1016/j.jhin.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.002","url":null,"abstract":"<p><strong>Objectives: </strong>To describe a sink-related outbreak of Klebsiella oxytoca and determine risk factors for acquiring the outbreak strain.</p><p><strong>Methods: </strong>Case-control analysis, environmental sampling from sinks, short-read whole genome sequencing and long-read whole genome sequencing of selected isolates.</p><p><strong>Results: </strong>Whole genome sequencing revealed genetic clustering of 47 patient cases over 26 months. The outbreak strain (Klebsiella oxytoca, sequence type 2, with or without blaCTX-M containing plasmid) was also identified in sinks or adjacent plumbing in four rooms in two wards. After adjustment for age, sex, and length of stay, four significant risk factors for infection or colonization of the outbreak strain were found: age (OR per additional year: 1.03 (95% CI: 1.00-1.07); length of stay (OR per additional day: 1.04 (95% CI: 1.02-1.08); urinary catheter (OR: 7.65 (95% CI: 2.10-27.8; OR per additional day: 1.06 (95% CI: 1.01-1.12); and diarrhoea (OR: 3.10 (1.03-9.35). Long-read plasmid sequencing revealed strong indications of plasmid transmission from the outbreak strain to other sequence types of Klebsiella oxytoca. Multifaceted interventions were employed, including exchange of sinks strainers, traps, and piping, behavioural interventions, and reinforced cleaning and disinfection. Outbreak control has so far not been achieved despite interventions.</p><p><strong>Conclusions: </strong>Klebsiella oxytoca established in sink plumbing biofilm was associated with a prolonged outbreak difficult to control. Age, length of stay, urinary catheter and diarrhoea were risk factors for acquiring the outbreak strain. Both clonal and horizontal transmission occurred.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112877","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":"Defining water safety in healthcare premises.","authors":"M Weinbren, M Meda, J Hopman, G Fucini, W Sunder","doi":"10.1016/j.jhin.2025.04.017","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.04.017","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095914","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":"Comparison of Brushing Efficacy for Gastroscopes Using Different Brush Types Under Simulated Contamination Conditions.","authors":"Jinying Li, Wenqian Hu, Chenying Zhou, Yuxin Ge, Qing Gu","doi":"10.1016/j.jhin.2025.04.029","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.04.029","url":null,"abstract":"<p><strong>Background: </strong>Channel-cleaning brushes are an important tool in the reprocessing of endoscopes.</p><p><strong>Aim: </strong>To investigate the efficacy of cleaning brushes composed of various materials in removing organic matter from the biopsy channels of flexible endoscopes.</p><p><strong>Methods: </strong>A total of 168 cleaned gastroscopes were randomly divided into six groups (A, B, C1, C2, C3, and D) based on the specific characteristics of four different types of cleaning brushes. A suspension containing 12% bovine serum and 10ˆ6 units of Escherichia coli was injected into the biopsy channels of each endoscope to ensure sufficient contamination. After a 5-minute incubation period, brushing and sampling were performed according to the experimental protocol. The effectiveness of the cleaning process was evaluated using a protein detection test (PDT) and an adenosine triphosphate test (ATP).</p><p><strong>Results: </strong>Cleaning brushes constructed from metal demonstrated superior performance in removing organic matter from flexible endoscopes compared to those made of plastic (p < 0.05). Similarly, brushes with bristles made of cylindrical DuPont fibres exhibited superior cleaning efficacy compared with those made of strip microfibres or caterpillar polyolefin (p < 0.05). The brush was passed through the biopsy channel four times and achieved better results than passing it once or twice (100%).</p><p><strong>Conclusion: </strong>From the perspective of cleaning outcomes and economic benefits, the use of cylindrical DuPont fibre bristles and metal shaft cleaning brushes during the reprocessing of flexible endoscopes, combined with a cleaning technique involving four brushing passes through the biopsy channel, can more effectively remove organic matter.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082150","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}