Journal of Hospital Infection最新文献

{"title":"Compulsory screening for Legionella pneumophila and Legionella spp. in tap water: is it time for a revision of the guidelines?","authors":"L. Brouwer , T.K. Teoh , A. Carroll","doi":"10.1016/j.jhin.2024.07.001","DOIUrl":"10.1016/j.jhin.2024.07.001","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735692","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":"Admission screening testing of patients and staff N95 respirators are cost-effective in reducing COVID-19 hospital-acquired infections","authors":"F. McAndrew ,&nbsp;R.G. Abeysuriya ,&nbsp;R. Sacks-Davis ,&nbsp;M. Sammann ,&nbsp;D.M. Lister ,&nbsp;D. West ,&nbsp;S.S. Majumdar ,&nbsp;N. Scott","doi":"10.1016/j.jhin.2024.06.015","DOIUrl":"10.1016/j.jhin.2024.06.015","url":null,"abstract":"<div><h3>Background</h3><p>Coronavirus disease 2019 (COVID-19) outbreaks in acute care settings can have severe consequences for patients due to their underlying vulnerabilities, and can be costly due to additional patient bed-days and the need to replace isolating staff. This study assessed the cost-effectiveness of clinical staff N95 respirators and admission screening testing of patients to reduce COVID-19 hospital-acquired infections.</p></div><div><h3>Methods</h3><p>An agent-based model was calibrated to data on 178 outbreaks in acute care settings in Victoria, Australia between October 2021 and July 2023. Outbreaks were simulated under different combinations of staff masking (surgical, N95) and patient admission screening testing [none, rapid antigen test (RAT), polymerase chain reaction]. For each scenario, average diagnoses, COVID-19 deaths, quality-adjusted life years from discharged patients, and costs (masks, testing, patient COVID-19 bed-days, staff replacement costs while isolating) from acute COVID-19 were estimated over a 12-month period.</p></div><div><h3>Findings</h3><p>Compared with no admission screening testing and staff surgical masks, all scenarios were cost saving with health gains. Staff N95 respirators + RAT admission screening of patients was the cheapest scenario, saving A$78.4M [95% uncertainty interval (UI) 44.4M–135.3M] and preventing 1543 (95% UI 1070–2146) deaths state-wide per annum. Both interventions were individually beneficial: staff N95 respirators saved A$54.7M and 854 deaths state-wide per annum, while RAT admission screening of patients saved A$57.6M and 1176 deaths state-wide per annum.</p></div><div><h3>Interpretation</h3><p>In acute care settings, staff N95 respirators and admission screening testing of patients can reduce hospital-acquired COVID-19 and COVID-19 deaths, and are cost saving because of reduced patient bed-days and staff replacement needs.</p></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0195670124002366/pdfft?md5=3f810e9dba8fb0a3c2c42bd71a3e2d03&pid=1-s2.0-S0195670124002366-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The CATERPILLAR study: an assessor-blinded randomized controlled trial comparing a taurolidine–citrate–heparin lock solution to a heparin-only lock solution for the prevention of central-line-associated bloodstream infections in paediatric oncology patients","authors":"C.H. van den Bosch ,&nbsp;Y.G.T. Loeffen ,&nbsp;A.F.W. van der Steeg ,&nbsp;J.T. van der Bruggen ,&nbsp;F.N.J. Frakking ,&nbsp;M. Fiocco ,&nbsp;C.P. van de Ven ,&nbsp;M.H.W.A. Wijnen ,&nbsp;M.D. van de Wetering","doi":"10.1016/j.jhin.2024.06.009","DOIUrl":"10.1016/j.jhin.2024.06.009","url":null,"abstract":"<div><h3>Background</h3><p>Taurolidine–citrate(–heparin) lock solutions (TCHL) are suggested as a promising and safe method for the prevention of central-line-associated bloodstream infections (CLABSI).</p></div><div><h3>Aim</h3><p>To investigate the efficacy of TCHL for the prevention of CLABSI in paediatric oncology patients.</p></div><div><h3>Methods</h3><p>An assessor-blinded randomized controlled trial at the Princess Máxima Centre for paediatric oncology, the Netherlands, was performed from 2020 to 2023. Paediatric oncology patients receiving a tunnelled central venous access device (CVAD) were eligible. A total of 462 patients were required to compare the TCHL to the heparin-only lock (HL). Patients were followed-up for the first 90 days after CVAD insertion. The primary outcome was the incidence of the first CLABSI from CVAD insertion until the end of follow-up. Intention-to-treat and per-protocol analyses were performed.</p></div><div><h3>Findings</h3><p>In total, 232 were randomized in the HL and 231 in the TCHL group. A total of 47 CLABSIs were observed. The intention-to-treat analysis showed that a CLABSI was observed in 26 (11.2%) of the HL group patients versus 21 (9.1%) of the TCHL group patients; incidence rate ratio (IRR) of 0.81 (95% confidence interval (CI): 0.46–1.45) in favour of the TCHL group. The per-protocol analysis showed that a CLABSI was observed in 10 (7.9%) of the HL group patients versus 6 (4.8%) of the TCHL group patients; IRR of 0.59 (95% CI: 0.21–1.62) in favour of the TCHL group. Adverse events were more common in the TCHL group but rarely reported.</p></div><div><h3>Conclusion</h3><p>No difference was detected between the TCHL and HL in the incidence of CLABSI in paediatric oncology patients.</p></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0195670124002287/pdfft?md5=ea1161093e087c424a0fd9e57878159d&pid=1-s2.0-S0195670124002287-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal evolution of bacterial species and their antimicrobial resistance characteristics in wound infections of war-related injuries in Ukraine from 2014 to 2023","authors":"","doi":"10.1016/j.jhin.2024.06.011","DOIUrl":"10.1016/j.jhin.2024.06.011","url":null,"abstract":"<div><h3>Background</h3><p>This study continues surveillance of antimicrobial resistance associated with combat injuries in Ukraine.</p></div><div><h3>Aim</h3><p>To compare species composition, antibiotic resistance profiles, and emergence of new resistance genes between 2014–2020 and 2022–2023.</p></div><div><h3>Methods</h3><p>This was a retrospective multi-centre microbiological survey in Ukrainian hospitals. Antibiotic susceptibility, whole-genome sequencing and multi-locus sequence typing were conducted on 154 organisms obtained from 125 casualties between 2022 and 2023.</p></div><div><h3>Findings</h3><p>The data revealed a predominance of Gram-negative bacteria, particularly <em>Acinetobacter baumannii</em> (35.7%), <em>Pseudomonas aeruginosa</em> (14.9%) and <em>Klebsiella pneumoniae</em> (20.7%). High levels of carbapenem resistance were observed among <em>A. baumannii</em> {meropenem 72.2% [39/54, 95% confidence interval (CI) 58.4–83.5]; imipenem 66.7% (36/54, 95% CI 52.5–78.9)}, <em>K. pneumoniae</em> [meropenem 90.6% (29/32, 95% CI 75.0–98.0); imipenem 81.2% (26/32, 95% CI 63.6–92.8)] and <em>P. aeruginosa</em> [meropenem 47.8% (11/23, 95% CI 26.8–69.4); imipenem 60.8% (14/23, 95% CI 38.5–80.3)] strains. <em>A. baumannii</em> sequence type (ST)-78 and ST-400 were prevalent from 2014 to 2020, while five strains of ST-1077 were newly identified in 2022–2023. <em>P</em>. <em>aeruginosa</em> strains showed diversity across 16 STs, with ST-773 increasing in frequency and new STs emerging, but lacking carbapenemase genes. <em>K. pneumoniae</em> exhibited increased genetic diversity over time, with three STs from 2014 to 2020 and six new STs, including <em>bla</em>_NDM-1, <em>bla</em>_OXA-48 and <em>bla</em>_KPC2 carriers, in 2022–2023.</p></div><div><h3>Conclusion</h3><p>The prevalence of multi-drug-resistant isolates with STs associated with a high risk of global dissemination is increasing.</p></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602195","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 microbiological survey approach to understanding the virulence factors of Pseudomonas species in healthcare sinks","authors":"","doi":"10.1016/j.jhin.2024.06.012","DOIUrl":"10.1016/j.jhin.2024.06.012","url":null,"abstract":"<div><h3>Background</h3><p>Hospital water is involved in both the prevention and spread of healthcare-associated infections (HCAIs). Handwashing is key to reducing the transmission of pathogens, yet numerous outbreaks have been found to be caused by organisms within sinks, taps and showers. <em>Pseudomonas aeruginosa</em> and increasingly non-<em>aeruginosa Pseudomonas</em> cause waterborne HCAI, however, little is known about the virulence potential of <em>Pseudomonas</em> species found within hospital environments.</p></div><div><h3>Methods</h3><p>Swabs were taken from 62 sinks within two newly opened wards at Great Ormond Street Hospital, samples were taken before and after the wards opened to understand the impact of patient occupancy on sink micro-organisms. Culturable bacteria were identified by MALDI-TOF and virulence factors assessed through phenotypic methods.</p></div><div><h3>Results</h3><p>A total of 106 bacterial isolates were recovered including 24 <em>Pseudomonas</em> isolates. Of these 25% were identified as <em>P. oleovorans</em>, 21% <em>P. aeruginosa</em>, 17% <em>P. composti</em>, 13% <em>P. alicalipha</em>, 8% <em>P. monteilii</em>, 4% <em>P. putida</em>, 4% <em>P. stutzeri</em> and 8% could only be identified to genus level by MALDI-TOF. Differences were seen in both the number of <em>Pseudomonas</em> isolates and virulence production between the two wards, overall 25% of the <em>Pseudomonas</em> isolates produced pigment, 58% were capable of haemolysis, 87.5% were able to swim, 83.3% were capable of twitching motility, 33.3% produced alkaline protease and 8.3% produced gelatinase.</p></div><div><h3>Conclusions</h3><p>Results suggest that patients may be back-contaminating sinks with colonizing organisms which has ongoing implications for infection prevention and control. Additionally, this work highlights the ability of non-<em>aeruginosa Pseudomonas</em> to produce virulence factors traditionally associated with <em>P. aeruginosa</em>.</p></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0195670124002330/pdfft?md5=f52f0056b481939d85ad8446bfa1374e&pid=1-s2.0-S0195670124002330-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of methods for sampling and detection of carbapenemase-producing organisms in clinical handwash basin drains in health care","authors":"","doi":"10.1016/j.jhin.2024.06.008","DOIUrl":"10.1016/j.jhin.2024.06.008","url":null,"abstract":"<div><p>There are currently no standardized methods for the sampling and testing of clinical handwash basin (HWB) samples for the detection of carbapenemase-producing organisms (CPOs). Methods used for sampling (drain aspirate vs swab from top of drain) and detection of CPOs in clinical HWB drains in two different healthcare settings, one which was dealing with a hospital-wide CPO outbreak (Hospital A) and another with no reported outbreaks (Hospital B), were compared. Drain aspirates and swabs from HWB drains were tested using multiplex polymerase chain reaction (PCR) together with culture-based methods. No significant difference in detection of CPOs was found between drain aspirate or swab methods of sampling. Direct PCR on samples detected significantly more carbapenemase genes than culture on CARBA agar (<em>P</em>&lt;0.0001 and 0.0045, respectively). A higher percentage of HWB drains were positive in Hospital A both by culture and by direct PCR, and a significantly higher number of carbapenemase genes were detected in HWB drain aspirates at Hospital A, both by PCR and by culture (<em>P</em>=0.014 and 0.0071, respectively). There was high correlation between drain swab positivity by PCR and culture in Hospital A (91%) compared with Hospital B (33%). No difference in drain contamination rates was found when HWBs with a rear drain were compared with HWBs with the drain directly below the tap. Colonization of HWBs at the top of the drain may be related to risk of cross-transmission of CPOs from the healthcare environment to patients.</p></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592087","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 novel disinfection methods for the remediation of heavily contaminated thermostatic mixing valves and water systems with Pseudomonas aeruginosa biofilm: considerations for new and existing healthcare water systems","authors":"","doi":"10.1016/j.jhin.2024.05.024","DOIUrl":"10.1016/j.jhin.2024.05.024","url":null,"abstract":"<div><h3>Background</h3><p><em>Pseudomonas aeruginosa</em> is a leading cause of nosocomial Gram-negative bacteraemia. Water systems are a well-documented source of <em>P. aeruginosa</em> and established biofilms are difficult to remove.</p></div><div><h3>Aim</h3><p>To evaluate the efficacy of regular flushing, peracetic acid disinfection, in-tap thermal disinfection, and in-line thermal disinfection to eradicate <em>P. aeruginosa</em> biofilm in a colonized tap model.</p></div><div><h3>Methods</h3><p>A simulated tap system was constructed and inoculated with a reference and an environmental strain of <em>P. aeruginosa</em> to form biofilm. Water samples were collected from the taps and <em>P. aeruginosa</em> levels enumerated following disinfection methods. To simulate regular flushing, taps were flushed for 5 min, five times per day with water tested daily. Peracetic acid (4000 ppm) was manually injected into the system and flushed through the system with a pump. Thermal flushing at 60 °C was performed in-line and with an in-tap bypass valve. Tests were conducted with cross-linked polyethylene (PEX) piping and repeated with copper piping.</p></div><div><h3>Findings</h3><p>Regular flushing and peracetic acid applied with a pump did not reduce <em>P. aeruginosa</em> levels. A limited reduction was observed when manually injecting peracetic acid. In-tap thermal flushing eradicated <em>P. aeruginosa</em> in copper piping but not PEX. In-line thermal flushing was the most effective at reducing <em>P. aeruginosa</em> levels; however, it did not eradicate the biofilm.</p></div><div><h3>Conclusion</h3><p>In-line thermal flushing was the most effective method to remove <em>P. aeruginosa</em> biofilm. Results vary significantly with the strain of bacteria and the composition of the plumbing. Several methods used in combination may be necessary to remove established biofilm.</p></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592114","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":"Infection control in conflict zones: practical insights from recent medical missions to Gaza","authors":"","doi":"10.1016/j.jhin.2024.06.014","DOIUrl":"10.1016/j.jhin.2024.06.014","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592115","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 infection in patients undergoing knee arthroscopy: A Systematic Review and Meta-analysis.","authors":"Yuanhu Lei, Yuhuan Zeng, Zhengyu Li, Zhihong Xiao, Guojun Tang, Yi Liu, Changming Xiao, Mingjiang Luo, Huyong Yan, Hao Chen, Xiaoxu Wang","doi":"10.1016/j.jhin.2024.06.013","DOIUrl":"https://doi.org/10.1016/j.jhin.2024.06.013","url":null,"abstract":"<p><strong>Purpose: </strong>The primary aim was to determine the risk of infection after knee arthroscopy and to evaluate the risk factors for surgical site infection (SSI).</p><p><strong>Methods: </strong>The PubMed/Medline, Embase and Cochrane Library databases were systematically searched, as were the reference lists of previous systematic reviews and meta-analysis manual studies. A random-effects model was used to calculate the estimated pooled odds ratio (OR).</p><p><strong>Results: </strong>A total of 38,321 potential articles met the initial inclusion criteria. After a review of the titles, abstracts and full texts, the remaining 41 articles were included in the final analysis. We identified 9,089,578 patients who underwent knee arthroscopy in 41 articles. High-quality (class I) evidence showed that autografts (cruciate ligament reconstruction) (OR, 2.66% CI, 1.84-3.86) or high procedure complexity (OR, 2.02;95% CI, 1.69-2.43) had a higher risk of infection, while medium-quality (class II or class III) evidence showed that obesity (BMI ≥ 30 kg/m²) (OR, 1.27; 95% CI, 1.08-1.49) or male (OR, 1.52; 95% CI, 1.32-1.75) or diabetes (OR, 1.71; 95% CI, 1.36-2.14) or tobacco use (OR, 1.65; 95% CI, 1.38-1.97) or preoperative steroid use (OR, 3.41; 95% CI, 2.10-5.54) had a higher risk of infection. The meta-analysis showed that there was no association between age or antibiotic prophylaxis and infection incidence.</p><p><strong>Conclusions: </strong>The meta-analysis showed that significant risk factors for infection after knee arthroscopy included obesity, male sex, diabetes, tobacco use, high procedure complexity, graft type, and preoperative steroid use.</p><p><strong>Level of evidence: </strong>Level IV, systematic review of Level III and Level IV studies.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592116","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 effects of chlorhexidine, povidone-iodine and vancomycin on growth and biofilms of pathogens that cause prosthetic joint infections: an in-vitro model","authors":"","doi":"10.1016/j.jhin.2024.06.010","DOIUrl":"10.1016/j.jhin.2024.06.010","url":null,"abstract":"<div><h3>Background</h3><p>Chlorhexidine gluconate (CHG) and povidone-iodine (PI) are commonly used to prevent prosthetic joint infection (PJI) during total joint replacement; however, their effective concentrations and impact on biofilms are not well defined.</p></div><div><h3>Aim</h3><p>To determine: (1) the in-vitro minimum inhibitory concentration of CHG and PI against model PJI-causing organisms and clinical isolates; (2) their impact on biofilm formation; (3) whether there is a synergistic benefit to combining the two solutions; and (4) whether adding the antibiotic vancomycin impacts antiseptic activity.</p></div><div><h3>Methods</h3><p>We measured in-vitro growth and biofilm formation of <em>Staphylococcus epidermidis</em>, meticillin-sensitive and meticillin-resistant <em>Staphylococcus aureus</em>, <em>Escherichia coli</em>, <em>Pseudomonas aeruginosa</em> and <em>Candida albicans</em>, as well as recent clinical isolates, in the presence of increasing concentrations of CHG and/or PI. Checkerboard assays were used to measure potential synergy of the solutions together and with vancomycin.</p></div><div><h3>Findings</h3><p>CHG and PI inhibited growth and biofilm formation of all model organisms tested at concentrations of 0.0004% and 0.33% or lower, respectively; highly dilute concentrations paradoxically increased biofilm formation. The solutions did not synergize with one another and acted independently of vancomycin.</p></div><div><h3>Conclusion</h3><p>CHG and PI are effective at lower concentrations than typically used, establishing baselines to support further clinical trials aimed at optimizing wound disinfection. There is no synergistic advantage to using both in combination. Vancomycin is effective at inhibiting the growth of <em>S. epidermidis</em> and <em>S. aureus</em>; however, it stimulates <em>P. aeruginosa</em> biofilm production, suggesting in the rare case of <em>P. aeruginosa</em> PJI, it could exacerbate infection.</p></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0195670124002305/pdfft?md5=5542356cda3ead233d61b918b3165481&pid=1-s2.0-S0195670124002305-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}