Journal of Hospital Infection最新文献

{"title":"The burden of ESKAPE pathogen-related hospital-acquired infections: clinical and financial perspective from a systematic review","authors":"P.Y. Woh ,&nbsp;X. Zhang","doi":"10.1016/j.jhin.2025.06.006","DOIUrl":"10.1016/j.jhin.2025.06.006","url":null,"abstract":"<div><div>Antimicrobial resistance (AMR) poses a significant challenge in managing hospital-acquired infections (HAIs) caused by ESKAPE pathogens. We conducted a systematic literature search in Embase, Web of Science, and PubMed for articles published between 2000 and 2023, to assess the clinical and economic burden of ESKAPE infections. The evidence covered mortality rates, length of hospital stays (LOSs), and healthcare costs, with most studies focusing on HAIs caused by meticillin-resistant <em>Staphylococcus aureus</em> (MRSA). These impacts varied by region, ESKAPE pathogen strain, and type of resistance. Compared with non-resistant groups, resistant ESKAPE-related HAIs were associated with nearly double the risk of death (odds ratio = 1.96; 95% confidence interval = 1.56–2.46). Resistant ESKAPE-related HAIs also resulted in significantly longer hospital LOS (<em>P</em>&lt;0.001) and increased healthcare costs (<em>P</em>=0.047), particularly in the Asia-Pacific region. The study highlights the urgent need for comprehensive strategies and global collaboration to mitigate the impact of AMR, particularly in resource-constrained settings. Addressing these challenges can improve patient outcomes and reduce the financial burden on healthcare systems worldwide.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 377-385"},"PeriodicalIF":3.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509493","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":"Carbapenem-resistant Providencia spp.: the threat at the door","authors":"O. Ozalp ,&nbsp;B. Ortakci ,&nbsp;S. Komec ,&nbsp;O. Gokce ,&nbsp;E. Alp ,&nbsp;O.A. Aydin","doi":"10.1016/j.jhin.2025.06.007","DOIUrl":"10.1016/j.jhin.2025.06.007","url":null,"abstract":"<div><h3>Background</h3><div><em>Providencia</em> species are emerging opportunistic pathogens associated with nosocomial infections, particularly in immunocompromised patients and those with prolonged hospital stays. The increasing prevalence of carbapenem-resistant <em>Providencia</em> spp. poses a significant therapeutic challenge due to limited treatment options.</div></div><div><h3>Aim</h3><div>To evaluate the clinical characteristics, risk factors, and outcomes of patients with carbapenem-resistant and carbapenem-susceptible <em>Providencia</em> spp. infections.</div></div><div><h3>Methods</h3><div>A retrospective, observational study was conducted, including hospitalized patients with <em>Providencia</em> spp. isolates between January 1^st, 2020 and January 1^st, 2024. Patients were stratified based on carbapenem susceptibility. Clinical data, risk factors, and mortality rates were compared between carbapenem-resistant and carbapenem-susceptible cases. Statistical analyses were performed to identify independent risk factors for carbapenem resistance.</div></div><div><h3>Findings</h3><div>Among 118 <em>Providencia</em>-associated infections, 53 (44.9%) were carbapenem-resistant. <em>Providencia rettgeri</em> was the predominant species (67.8%), with a significantly higher carbapenem resistance rate than <em>P. stuartii</em> (<em>P</em> = 0.003). Carbapenem-resistant infections were most commonly urinary tract infections (58.5%), while carbapenem-susceptible infections were more frequently associated with skin and soft tissue infections (40.0%) (<em>P</em> &lt; 0.001). Carbapenem-resistant cases exhibited longer hospital stays, increased ICU admissions, and higher mortality rates (<em>P</em> &lt; 0.05). Risk factors for carbapenem resistance included prior ICU admission, mechanical ventilation, urinary catheterization, and prior carbapenem use.</div></div><div><h3>Conclusion</h3><div>Carbapenem-resistant <em>Providencia</em> infections are associated with increased morbidity and mortality. Given the limited therapeutic options, infection control measures and antimicrobial stewardship programmes should be strengthened. Further large-scale studies are needed to characterize resistance mechanisms and optimal treatment strategies.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"163 ","pages":"Pages 51-55"},"PeriodicalIF":3.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509487","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":"Investigation on hand hygiene in anaesthesiology departments in China","authors":"R. Chen ,&nbsp;Y. Du ,&nbsp;J. Zhang ,&nbsp;L. Wang ,&nbsp;H. Cheng ,&nbsp;L. Wu ,&nbsp;T. Yu ,&nbsp;Q. Chen ,&nbsp;G. Wang","doi":"10.1016/j.jhin.2025.06.003","DOIUrl":"10.1016/j.jhin.2025.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the current status of hand hygiene practices and knowledge among anaesthesiology personnel in China, providing a reference for improving hand hygiene standards among healthcare workers.</div></div><div><h3>Methods</h3><div>A cross-sectional nationwide online survey was conducted from 1^st November to 31^st December 2024, targeting anaesthesiology staff in Chinese hospitals. Developed by a multi-disciplinary team, the questionnaire covered sociodemographics, hand hygiene practices, proficiency and knowledge. Of 2580 responses, 2512 were valid after quality control. Descriptive statistics, Chi-squared tests and logistic regression were used to analyse the data and identify predictors of hand hygiene compliance.</div></div><div><h3>Results</h3><div>The study analysed 2512 valid responses, mostly from male anaesthesiologists (90.84% and 59.39% for males and females, respectively). Most participants were from Class IIIA hospitals (60.67%). A large majority of participants had formal hand hygiene training (94.43%) and regular access to hand sanitizers (90.61%), with over two-thirds reporting adequate disinfection and washing durations (66.44% and 67.27%, respectively) and high adherence to the seven-step technique (81.76%). Barriers to adherence included being ‘too busy’ (66.28%), insufficient hand towel availability (41.68%), the belief that ‘gloves substitute for handwashing’ (39.93%), and inadequate facilities (18.91%). The hand hygiene assessment showed a mean knowledge score of 61.02, a mean practice score of 80.36, and a mean proficiency score of 82.62. Higher knowledge and formal training were linked to better compliance with recommended practices.</div></div><div><h3>Conclusions</h3><div>This study highlights the need for improved hand hygiene practices among anaesthesiology personnel in China, emphasizing the roles of training, knowledge, and addressing barriers to compliance.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"163 ","pages":"Pages 42-50"},"PeriodicalIF":3.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509488","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":"Resolving a neonatal intensive care unit outbreak of meticillin-resistant Staphylococcus aureus to the single-nucleotide variant level using Oxford Nanopore simplex reads and HERRO error correction","authors":"M. Bloomfield ,&nbsp;S. Bakker ,&nbsp;M. Burton ,&nbsp;M.L. Castro ,&nbsp;K. Dyet ,&nbsp;A. Eustace ,&nbsp;S. Hutton ,&nbsp;D. Macartney-Coxson ,&nbsp;W. Taylor ,&nbsp;R.T. White","doi":"10.1016/j.jhin.2025.06.004","DOIUrl":"10.1016/j.jhin.2025.06.004","url":null,"abstract":"<div><div>Our laboratory began prospective genomic surveillance for healthcare-associated organisms in 2022 using Oxford Nanopore Technologies (ONT) as a standalone platform. While effective for early outbreak detection, the lower read accuracy compared to Illumina sequencing has limited single-nucleotide variant (SNV) analysis. This study aimed to determine whether Haplotype-aware ERRor cOrrection (HERRO) of ONT data could permit high-resolution comparison of outbreak isolates. ONT simplex reads were used from isolates involved in a recent outbreak of meticillin-resistant <em>Staphylococcus aureus</em> (MRSA) in our neonatal unit. Raw data were basecalled and adapter-trimmed using Dorado v0.7.0, followed by HERRO correction. Genome assemblies and phylogenies were compared with previous analyses (using Dorado v0.3.4 no HERRO correction, and data generated by Illumina sequencing). Five of nine outbreak isolates were analysed; four had insufficient read lengths (N50 values &lt;10,000 bp) and did not achieve complete chromosome coverage post-HERRO correction. The average chromosome sequencing depth for nanopore data was 147× (range: 44–220×) with an average read N50 of 12,215 bp (interquartile range: 11,439–12,711 bp). The median pairwise SNV distance between outbreak isolates from the original investigation was 51 SNVs (range: 40–68), which decreased to 3 SNVs (range: 1–15) with HERRO correction. Illumina sequencing generated a median SNV distance of 2 (range: 0–13). The HERRO-corrected ONT phylogeny closely matched the Illumina-generated phylogeny. HERRO correction enabled high-resolution analysis of MRSA outbreak isolates comparable to Illumina sequencing. ONT sequencing with HERRO correction represents a viable standalone option for detailed genomic analysis of hospital outbreaks, provided sufficient read lengths are achieved.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"163 ","pages":"Pages 72-77"},"PeriodicalIF":3.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509491","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 for surgical site infection in patients after hysterectomy: a systematic review and meta-analysis","authors":"Y. Zeng ,&nbsp;Y. Lei ,&nbsp;M. Li ,&nbsp;S. Yang ,&nbsp;S. Liu ,&nbsp;M. Liu ,&nbsp;W. Liu ,&nbsp;C. Peng ,&nbsp;J. Zhou ,&nbsp;C. Xiao ,&nbsp;X. Tan ,&nbsp;Q. Zhang","doi":"10.1016/j.jhin.2025.05.018","DOIUrl":"10.1016/j.jhin.2025.05.018","url":null,"abstract":"<div><h3>Background</h3><div>The reported incidence rates of surgical site infection (SSI) following hysterectomy range from 2% to 21%.</div></div><div><h3>Aim</h3><div>To conduct a meta-analysis to determine the risk of post-hysterectomy infection and to assess risk factors for post-hysterectomy SSI.</div></div><div><h3>Methods</h3><div>A systematic search was made in PubMed, Embase, and the Cochrane Library, and reference lists were manually searched from previous systematic reviews and meta-analyses. A random effects model was used to estimate the combined odds ratio values.</div></div><div><h3>Findings</h3><div>A total of 88,735 potential articles in the database search met the inclusion criteria. After the titles, abstracts, and full texts were reviewed, 23 articles were included in the final analysis. The 23 articles included 681,695 patients who underwent hysterectomy. High-quality (Class I) evidence showed that abdominal hysterectomy (odds ratio: 4.17; 95% confidence interval: 3.42–5.07), vaginal hysterectomy (1.22; 1.05–1.42), obesity (body mass index ≥30 kg/m²) (1.56; 1.40–1.75), gynaecological cancer (1.49; 1.30–1.72), operative time ≥160 min (1.58; 1.36–1.84), diabetes (1.57; 1.23–2.00), and smoking (1.41; 1.14–1.74) were associated with a greater risk of infection. The meta-analysis revealed no associations of age or intraoperative blood loss ≥500 mL with infection.</div></div><div><h3>Conclusion</h3><div>This meta-analysis identified seven significant risk factors for post-hysterectomy infection, including abdominal hysterectomy, vaginal hysterectomy, obesity, gynaecological cancer, operative time, diabetes, and smoking. These findings can help identify patients who have a higher risk of infection after hysterectomy so that appropriate measures can be implemented to improve the prognosis of these patients.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"163 ","pages":"Pages 30-41"},"PeriodicalIF":3.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327784","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":"Aquatic reservoir-associated outbreaks of multi-drug-resistant bacteria: a hospital outbreak report of Pseudomonas aeruginosa in perspective from the Dutch national surveillance databases","authors":"S.B. Debast ,&nbsp;M.I. van den Bos-Kromhout ,&nbsp;S.V. de Vries-van Rossum ,&nbsp;S.E.M. Abma-Blatter ,&nbsp;D.W. Notermans ,&nbsp;J.A.J.W. Kluytmans ,&nbsp;B. Immeker ,&nbsp;J.K. Zuur ,&nbsp;M.L. Hijmering ,&nbsp;A.A. Bergwerff ,&nbsp;M.J. Bruins ,&nbsp;Y.J.W.M. Bisselink ,&nbsp;A.P.A. Hendrickx ,&nbsp;J.W.A. Rossen","doi":"10.1016/j.jhin.2025.05.024","DOIUrl":"10.1016/j.jhin.2025.05.024","url":null,"abstract":"<div><h3>Background</h3><div>Water fixtures can be involved in hospital outbreaks with multi-resistant pathogens.</div></div><div><h3>Aim</h3><div>To document an outbreak of a Verona integron-encoded metallo-<em>β</em>-lactamase type 2-producing carbapenem-resistant <em>Pseudomonas aeruginosa</em> (CRPA-VIM) and evaluate infection control measures. Additionally, to overview waterborne outbreaks involving multi-resistant pathogens in Dutch healthcare institutions.</div></div><div><h3>Methods</h3><div>Epidemiologic analysis, selective culturing, PCR, and whole-genome sequencing (WGS) identified the outbreak sources. National surveillance databases were consulted.</div></div><div><h3>Findings</h3><div>In December 2023, three ICU patients tested positive for CRPA-VIM with multi-locus sequence type (MLST) ST111. Contaminated sinks were identified as the source. Despite interventions, a new cluster of five CRPA-VIM-positive patients emerged in March–April 2024. WGS linked this to a decommissioned sink (November 2021) and two patients (December 2021 and April 2023). Contact tracing and source investigations found no interpatient transmission; sinks were identified as the sole source. Measures, including contact precautions, intensified cleaning and hygiene procedures, retraining, installing and frequently replacing splash- and aerosol-reducing inlets, and faucet modifications failed to halt the transmission. No new cases occurred after the removal of all water fixtures in the ICU patient rooms. The outbreak strain was unique to the hospital and showed no genetic clustering in the national surveillance. Nationally, three to five waterborne outbreaks with highly resistant micro-organisms in hospitals are reported annually.</div></div><div><h3>Conclusions</h3><div>CRPA-VIM was transmitted from sinks to ICU patients without interpatient transmission. Infection control requires comprehensive surveillance of patients and the environment. A water-restricted and drain-free environment ended the outbreak. Future hospital design should minimize contamination from drains and sinks to reduce the nosocomial infection risk.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 310-318"},"PeriodicalIF":3.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327781","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":"Effect of air flow rate over time on SARS-CoV-2 viability during representative sampling using MD8 airport air sampler","authors":"I. Nicholls ,&nbsp;O. Onianwa ,&nbsp;S. Collins ,&nbsp;A. Spencer ,&nbsp;S. Parks ,&nbsp;B. Atkinson ,&nbsp;T. Pottage","doi":"10.1016/j.jhin.2025.06.002","DOIUrl":"10.1016/j.jhin.2025.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Studies involving air sampling for SARS-CoV-2 commonly return either negative data or non-viable virus.</div></div><div><h3>Aim</h3><div>This study assessed the desiccative impact of time parameters during air sampling.</div></div><div><h3>Methods</h3><div>The study aerosolised SARS-CoV-2 on to gelatine Sartorius MD8 AirPort gelatin filters which were then attached to a Sartorius MD8 AirPort and run at 50 L/min up to 40 min. These filters were then analysed by viral plaque assay and quantitative reverse transcription–polymerase chain reaction.</div></div><div><h3>Findings</h3><div>There was no significant difference in recovery of infectious virus or genomic copy numbers with increasing air sampled.</div></div><div><h3>Conclusion</h3><div>Sampling for ≤40 min with a Sartorius MD8 AirPort does not reduce the viability of SARS-CoV-2.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"163 ","pages":"Pages 78-81"},"PeriodicalIF":3.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327783","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":"Clostridioides difficile in Honduras: a genomic and phenotypic characterization of the persistent RT027 and emergent RT002 genotypes","authors":"M. Andino-Molina ,&nbsp;M. Abdel-Glil ,&nbsp;F. Hidalgo-Villeda ,&nbsp;E. Tzoc ,&nbsp;G. Schmoock ,&nbsp;M.W. Pletz ,&nbsp;H. Neubauer ,&nbsp;C. Seyboldt","doi":"10.1016/j.jhin.2025.06.001","DOIUrl":"10.1016/j.jhin.2025.06.001","url":null,"abstract":"<div><h3>Background</h3><div><em>Clostridioides difficile</em> is an anaerobic enteropathogen of clinical relevance in hospital and community settings. Its ubiquitous presence in pets, livestock, food and the environment, together with its ability to form spores, facilitates its survival and spread. Hypervirulent and multi-drug-resistant genotypes have been reported previously from Central America.</div></div><div><h3>Aim</h3><div>To characterize 31 isolates from patients of two major hospitals in Honduras.</div></div><div><h3>Methods</h3><div>Second- and third-generation whole-genome sequencing and phenotypic antimicrobial susceptibility testing.</div></div><div><h3>Findings</h3><div>Two toxigenic polymerase chain reaction ribotypes RT027 (ST1) and RT002 (ST8) were detected. All RT027/ST1 isolates (<em>N</em>=29) were resistant to moxifloxacin, tetracycline and linezolid, whereas RT002/ST8 isolates (<em>N</em>=2) were susceptible. In addition, a number of mobile genetic elements associated with antimicrobial resistance were found in all RT027 isolates. Notably, core genome multi-locus sequence typing and core genome single nucleotide polymorphism analysis demonstrated the close genetic relationship among RT027/ST1 isolates, their persistence since 2016, and an interhospital transfer event with unknown sanitary and economic consequences. In addition, RT002, a genotype with known implications for community-acquired <em>C. difficile</em> infection and possible zoonotic implications, is a remarkable finding in the national epidemiologic context.</div></div><div><h3>Conclusions</h3><div>Taken together, these findings highlight the presence of persistent and community-relevant <em>C. difficile</em> strains, and the consequent need to adopt and develop interventions to control and prevent CDI in the Honduran national health system within a One Health research approach.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 386-398"},"PeriodicalIF":3.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327782","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 gowns in preventing nosocomial transmission of respiratory viruses: a systematic review","authors":"L.M. Orsel ,&nbsp;J.A. Severin ,&nbsp;M. Knoester ,&nbsp;M. Lokate ,&nbsp;A. Voss ,&nbsp;C.P. Haanappel ,&nbsp;J.J.A. van Kampen ,&nbsp;B.L. Haagmans ,&nbsp;M.P.G. Koopmans ,&nbsp;K.E. Veldkamp ,&nbsp;R. van Mansfeld ,&nbsp;H.J. de Jager ,&nbsp;A.F. Voor in ‘t holt ,&nbsp;C. Bowles","doi":"10.1016/j.jhin.2025.05.023","DOIUrl":"10.1016/j.jhin.2025.05.023","url":null,"abstract":"<div><h3>Background</h3><div>During the COVID-19 pandemic, long-sleeved gowns were advocated as personal protective equipment for healthcare workers (HCWs). The purpose of gowns is preventing transmission of infectious agents via the uniform or arms during contact with patients and their surroundings. Gowns, however, entail a substantial burden; in costs, workload for HCWs, and generated waste.</div></div><div><h3>Aim</h3><div>To evaluate the current knowledge regarding the use of gowns during care of patients with COVID-19 and other respiratory viruses to prevent nosocomial transmission.</div></div><div><h3>Methods</h3><div>PRISMA guidelines were used to search five databases (Medline, Embase, Web of Science, Cochrane, Google Scholar) up to April 11^th, 2023.</div></div><div><h3>Findings</h3><div>The search identified 2667 potentially relevant studies, of which 30 were selected and divided into four categories. In 12 studies, contamination rates of gowns ranged from 0% to 77.5% (median: 1.43%). Three out of seven studies showed that virus remained infectious the longest on Tyvek coveralls and plastic gowns, and the shortest on cotton and polyester. Two out of seven studies found a protective effect between HCW protective clothing and infection of HCWs. Finally, three out of four studies concluded that short sleeves, cotton gowns, or no gowns provided the same level of protection as standard gowns.</div></div><div><h3>Conclusion</h3><div>Viral RNA can be found on clothing, but it is unclear whether viruses are transmitted to HCWs and/or patients. Evidence for the protective effect of long-sleeved gowns over alternatives is still insufficient. Therefore, well-controlled and adequately powered laboratory transmission experiments that simulate real-life conditions are necessary.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"163 ","pages":"Pages 57-71"},"PeriodicalIF":3.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327785","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":"Effect of an educational antimicrobial stewardship programme on antibiotic prescriptions' appropriateness in three medical units of a large university hospital: an interrupted time series analysis","authors":"F. Giovannenze ,&nbsp;P. Del Vecchio ,&nbsp;F. Frondizi ,&nbsp;E. Rando ,&nbsp;G.M. Leanza ,&nbsp;M.M. Gross ,&nbsp;A. Frater ,&nbsp;E. Magrini ,&nbsp;B. Liguoro ,&nbsp;F. Sangiorgi ,&nbsp;M. Fantoni ,&nbsp;C. Torti ,&nbsp;R. Murri","doi":"10.1016/j.jhin.2025.05.017","DOIUrl":"10.1016/j.jhin.2025.05.017","url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial stewardship (AMS) programmes aim to enhance antibiotic prescription quality, reduce antibiotic use, and combat multi-drug-resistant pathogens. However, the optimal AMS intervention for different clinical settings remains unclear, with previous studies predominantly focusing on antibiotic consumption rather than prescription appropriateness.</div></div><div><h3>Aim</h3><div>This study aimed to evaluate the impact of an education-based AMS intervention on antibiotic prescription appropriateness in three medical units of a 1500-bed university hospital.</div></div><div><h3>Methods</h3><div>We conducted a retrospective interventional, interrupted time series study, to test the effect of an educational programme in three medical units of our 1500-bed university hospital in Rome, from June 2018 to October 2019. The intervention comprised six educational meetings held over 3 months (December 2018 to February 2019). The primary outcome was the appropriateness of antibiotic prescriptions, with in-hospital survival as a secondary outcome.</div></div><div><h3>Findings</h3><div>Of 609 antibiotic prescriptions evaluated, the programme led to a significant and sustained reduction in inappropriate prescriptions in one unit (change in level: -18.15%, <em>P</em>&lt;0.01; change in trend: -3.21%, <em>P</em>=0.01), while it failed to demonstrate a significant reduction in the other two units and globally in the three units.</div></div><div><h3>Conclusion</h3><div>The same educational AMS programme led to variable results in terms of antibiotic appropriateness in three medical units with similar structural and organizational features. Larger and more tailored high-quality AMS interventional studies are needed to better understand the impact of educational programmes on the appropriateness of antibiotic prescriptions.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 127-135"},"PeriodicalIF":3.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259337","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}