Journal of Hospital Infection最新文献

{"title":"Risk factors associated with surgical glove perforation in minimally invasive procedures: a prospective study","authors":"W. Wang , J. Tang , Z. Cao , J. Xue , Y. Lu , N. Wang","doi":"10.1016/j.jhin.2025.03.002","DOIUrl":"10.1016/j.jhin.2025.03.002","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"160 ","pages":"Pages 125-127"},"PeriodicalIF":3.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639878","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":"Survey of current national and international guidance to reduce risk of aspergillosis in hospitals","authors":"S. Bamber ,&nbsp;D. Haiduven ,&nbsp;D.W. Denning","doi":"10.1016/j.jhin.2025.02.015","DOIUrl":"10.1016/j.jhin.2025.02.015","url":null,"abstract":"<div><div><em>Aspergillus</em> spp. are most commonly associated with disease in the severely immunocompromised host and those with chronic chest disease. The scope of patients at risk is expanding, including intensive care (inclusive of severe viral pneumonia), trauma, burns and major surgery. As exposure or colonization is a prerequisite to <em>Aspergillus-</em>related disease, this has prompted a global review of preventative measures recommended in healthcare establishments. This global review includes 75 documents from 24 countries, categorized into clinical, infection prevention and control, and building-related guidance for prevention of invasive aspergillosis (IA). We overview the IA incubation period and different acceptable levels of airborne <em>Aspergilli</em> in protected environments (PEs), including critical care and operating rooms. Few documents cover all aspects of prevention, prophylaxis, avoidance, preventative measures and monitoring (environmental and clinical). A multi-disciplinary approach is required to identify and minimize the multiple risks and ensure adequate preventative measures. Most building-related guidance addresses construction and internal hospital alterations, but we also review the importance of good management of the healthcare environment (including ventilation systems) and uncertainties of environmental monitoring. We highlight the differences in standards recommended for protective patient environments including the critical care environment. The large capital investment required for PEs is often limited to patient groups most at risk. Single document comprehensive guidance is lacking, and many countries provide no guidance. Reduction in healthcare-associated acquisition of invasive aspergillosis during vulnerable inpatient episodes requires heightened awareness of patients at risk, careful risk assessment and attentive maintenance of the general hospital environment.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"159 ","pages":"Pages 124-139"},"PeriodicalIF":3.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598418","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":"Drinking water plumbing systems are a hot spot for antimicrobial-resistant pathogens","authors":"C. Hayward ,&nbsp;K.E. Ross ,&nbsp;M.H. Brown ,&nbsp;R. Bentham ,&nbsp;J. Hinds ,&nbsp;H. Whiley","doi":"10.1016/j.jhin.2025.02.018","DOIUrl":"10.1016/j.jhin.2025.02.018","url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial-resistant (AMR) pathogens in drinking water plumbing systems represent a significant yet underestimated public health threat.</div></div><div><h3>Methods</h3><div>This is the first study to use qPCR and culture-based methods to investigate the prevalence of key AMR threats, meticillin resistant <em>Staphylococcus aureus</em> (MRSA) and carbapenem resistant <em>Pseudomonas aeruginosa</em> and <em>Acinetobacter baumannii,</em> in Australian hospital and residential drinking water and biofilm samples.</div></div><div><h3>Findings</h3><div>Seventy-three per cent of residential water and biofilm samples were qPCR positive for at least one target pathogen compared with 38% of hospital samples, and 45% of residential plumbing fixtures harboured at least two target pathogens. Thirty-seven per cent of water and biofilm samples were qPCR positive for <em>P. aeruginosa</em>, 22.3% for <em>A. baumannii</em> and 21.7% for <em>S. aureus</em>. Using culture, 10% of samples were positive for <em>P. aeruginosa</em>, 8% for <em>A. baumannii</em> and 7% for <em>S. aureus</em>. Of these, 29% of <em>P. aeruginosa</em> and 28% of <em>A. baumannii</em> culture isolates were carbapenem resistant, and 54% of <em>S. aureus</em> isolates were identified as MRSA. Drain biofilms were the most common reservoir for AMR <em>A. baumannii, S. aureus</em> and <em>P. aeruginosa</em>. Carbapenem resistance genes including <em>bla</em>_NDM-1, <em>bla</em>_OXA-48, <em>bla</em>_KPC-2 and <em>bla</em>_VIM were found in biofilm samples otherwise negative for <em>P. aeruginosa</em>, indicating plumbing biofilms may act as eDNA reservoirs.</div></div><div><h3>Conclusions</h3><div>These findings underscore the critical role of plumbing biofilms as hotspots for diverse AMR pathogens, amplifying risks for vulnerable populations, particularly in home healthcare settings. This study highlights an urgent need for enhanced surveillance and targeted interventions to mitigate AMR risks in drinking water plumbing systems.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"159 ","pages":"Pages 62-70"},"PeriodicalIF":3.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598386","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":"What factors are associated with surgical site infections after intracranial neurosurgical procedures? An exploratory register study","authors":"I-L. Böregård ,&nbsp;L. Arvidsson ,&nbsp;S. Bringman ,&nbsp;C. Leo Swenne ,&nbsp;A-C. von Vogelsang","doi":"10.1016/j.jhin.2025.02.013","DOIUrl":"10.1016/j.jhin.2025.02.013","url":null,"abstract":"<div><h3>Background</h3><div>Surgical site infections (SSIs) after intracranial neurosurgical procedures derive from both endogenous and exogenous factors, and are associated with increased morbidity, mortality and additional socio-economic costs. The addition of mobile laminar airflow (MLAF) units to the operating room ventilation decreases bacteria-carrying particles, but their influence on the incidence of SSIs, and concurrence with other factors, is unclear. This is a continuation study of a previous study using MLAF units.</div></div><div><h3>Aim</h3><div>To explore factors associated with SSIs after intracranial procedures during a period when MLAF units were used.</div></div><div><h3>Methods</h3><div>This retrospective register study had an explorative design. The electronic medical records of patients undergoing intracranial neurosurgical procedures were reviewed retrospectively for signs or symptoms of SSIs using a 45-item protocol. Demographic, patient-specific and procedure-specific variables were collected, as well as exogenous factors and SSI variables regarding depth of SSI, type of bacteria, time to infection, and treatment. Data were analysed using univariate and multi-variate logistic regression.</div></div><div><h3>Findings</h3><div>An SSI occurred in 55 of 800 included patients (6.9%). On univariate and multi-variate analysis, only remote infections during the hospital stay were associated with risk of SSI (odds ratio 2.02, 95% confidence interval 1.07–3.82; <em>P</em>=0.031). Superficial SSIs were most common, the median time to infection was 18 days, and the most common causative micro-organism was <em>Staphylococcus aureus</em>.</div></div><div><h3>Conclusions</h3><div>In the clinical context, considerations are recommended for neurosurgical patients with ongoing remote infections during their hospital stay. Further peri-operative studies are needed in the field of surgical infection prevention.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"160 ","pages":"Pages 81-87"},"PeriodicalIF":3.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588263","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":"Vancomycin Resistant Enterococcus (VRE) - emergence to endemicity in a tertiary hospital in Singapore.","authors":"Indumathi Venkatachalam, May Kyawt Aung, Deborah Chooi Mun Lai, Mabel Zhi Qi Foo, Jean Xiang Ying Sim, Shalvi Arora, Aung Myat Oo, Yuke Tien Fong, Kwee Yuen Tan, Lai Chee Lee, Moi Lin Ling","doi":"10.1016/j.jhin.2025.02.017","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.02.017","url":null,"abstract":"<p><strong>Objective: </strong>To describe the evolving epidemiology and risk associations of vancomycin-resistant Enterococcus (VRE) between 2018 and 2023 in a tertiary hospital in Singapore.</p><p><strong>Methods: </strong>Inpatients in Singapore General Hospital (SGH) between January 2018 and December 2023 were included. VRE surveillance criteria changed in August 2020 and November 2022. Incidence of any VRE (VRE (all)), VRE from surveillance (VRE (surveillance)), clinical VRE isolates (VRE (clinical)), healthcare-associated VRE infections (HA-VRE (infections)) and bacteremia (VRE (bacteremia)) were reviewed. Three case-control studies were conducted. Environmental screening was performed.</p><p><strong>Results: </strong>Over the six-year study period there were 5,173 patients with VRE, of whom 3,141 (60.7%) had HA-VRE, 5157 (99.7%) had E.faecium and 4,336 (84%) carried vanA.121 (2.2%) patients had VRE bacteraemia with mortality 50.4%. There were significant changes in incidence of VRE (all), VRE (surveillance) and VRE (clinical) but HA-VRE (infections) and VRE (bacteremia) remained stable. VRE acquisition was associated with presence of concurrent MRSA (OR 9.4, 95% CI 1.3-66.8, p-value < 0.02), CPE (OR 7.2, 95% CI 2.0-26.0, p-value <0.001), ICU admission (OR 6.1, 95% CI 2.8-13.2, p<0.001), hemodialysis (OR 4.6, 95% CI 1.8-12.0, p<0.001), surgery (OR 3.7, 95% CI 1.6-8.3, p<0.001), vancomycin use (OR 28.2, 95% CI 5.4-146.5, p<0.001) and metronidazole use (OR 4.4, 95% CI 1.0-19.0, p-value 0.04) in the preceding three-months. VRE infection had similar risk associations. 12.5% of environmental samples were VRE positive.</p><p><strong>Conclusion: </strong>VRE endemic state in SGH is associated with significant patient and environmental VRE burden. VRE acquisition and infection have been associated with co-carriage of MRSA or CPE, vancomycin and metronidazole use, ICU admission and prior surgery. Targeted infection prevention and antimicrobial-stewardship programs may reduce VRE (infections).</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598423","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":"Evaluating the risk of duodenoscope-associated colonization and duodenoscope-associated infection: a prospective observational study","authors":"K. van der Ploeg ,&nbsp;C.H.W. Klaassen ,&nbsp;S.H.J. Renkens ,&nbsp;B.C.G.C. Mason-Slingerland ,&nbsp;J.A. Severin ,&nbsp;M.J. Bruno ,&nbsp;M.C. Vos","doi":"10.1016/j.jhin.2025.02.014","DOIUrl":"10.1016/j.jhin.2025.02.014","url":null,"abstract":"<div><h3>Background</h3><div>The risk of duodenoscope-associated colonization (DAC) and infection (DAI) after endoscopic retrograde cholangiopancreatography (ERCP) with a contaminated duodenoscope remains unknown. Determining the incidence of these events is crucial for developing prevention strategies.</div></div><div><h3>Aim</h3><div>To assess the incidence of DAC and DAI.</div></div><div><h3>Methods</h3><div>This prospective observational study included adult patients who underwent ERCP from January 2022 to December 2023. Duodenoscopes were sampled prior to each procedure. Contamination was defined as the presence of micro-organisms of gut or oral origin (MGO). Post ERCP, upon availability of culture results, patients exposed to contaminated duodenoscopes were asked to provide a stool sample and were followed for six months. Micro-organisms isolated from patient samples and clinical cultures were compared with those found in the duodenoscopes. Whole-genome sequencing (WGS) was used to confirm DAC or DAI.</div></div><div><h3>Findings</h3><div>Among 341 ERCP patients, 73 (21.4%) procedures involved MGO-contaminated duodenoscopes. No duodenoscope-associated outbreaks occurred during the study. Stool samples were returned by 45 of the 73 patients (61.6%). Additionally, 80 MGOs from clinical cultures and 37 residual samples were stored. WGS was performed on eight duodenoscope–patient micro-organism pairs from six patients. No DAC or DAI cases were detected.</div></div><div><h3>Conclusion</h3><div>In a non-outbreak setting, supported by monthly routine microbiological surveillance and a quarantine protocol for duodenoscopes, the risk of DAC and DAI appears low. These findings suggest limited value in intensive patient surveillance for DACs/DAIs. Further research is warranted to confirm these results and address knowledge gaps regarding risk factors for DACs and DAIs.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"160 ","pages":"Pages 101-108"},"PeriodicalIF":3.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588301","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":"Outbreak and persistence of dual carbapenemase (OXA-23 and NDM-1)-producing Acinetobacter baumannii international clone 2 (ST2) in a tertiary hospital intensive care unit in Brazil","authors":"P.O.S. Castilho ,&nbsp;F.M. Takahashi ,&nbsp;M.J. Onça Moreira ,&nbsp;T. Martins-Gonçalves ,&nbsp;F.E. Carrara ,&nbsp;N. Lincopan ,&nbsp;E.C. Vespero","doi":"10.1016/j.jhin.2025.02.016","DOIUrl":"10.1016/j.jhin.2025.02.016","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"160 ","pages":"Pages 121-124"},"PeriodicalIF":3.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588304","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":"Evaluating the accuracy of point prevalence surveys: a comparative analysis with Hungarian National Nosocomial Surveillance (NNSR) data","authors":"K.E. Horváthné,&nbsp;Z. Balogh","doi":"10.1016/j.jhin.2024.12.011","DOIUrl":"10.1016/j.jhin.2024.12.011","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"157 ","pages":"Pages 83-84"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958669","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":"Revisiting antimicrobial stewardship in the paediatric intensive care unit: insights from an unconventional approach","authors":"C. Liberati ,&nbsp;G. Brigadoi ,&nbsp;E. Gres ,&nbsp;E. Barbieri ,&nbsp;F. Cavagnero ,&nbsp;L. Maestri ,&nbsp;S. Trivellato ,&nbsp;A. Zenere ,&nbsp;M. De Pieri ,&nbsp;C. Di Chiara ,&nbsp;D. Mengato ,&nbsp;F. Venturini ,&nbsp;E. De Canale ,&nbsp;C. Del Vecchio ,&nbsp;A. Tessari ,&nbsp;A. Tosoni ,&nbsp;C. Zaggia ,&nbsp;C. Contessa ,&nbsp;C. Giaquinto ,&nbsp;E. Carrara ,&nbsp;D. Donà","doi":"10.1016/j.jhin.2025.02.010","DOIUrl":"10.1016/j.jhin.2025.02.010","url":null,"abstract":"<div><h3>Background</h3><div>Patients admitted to the paediatric intensive care unit (PICU) constitute a high-risk group with increased likelihood of receiving inappropriate antimicrobial prescriptions. This study describes an antimicrobial stewardship programme (ASP) in the PICU of a tertiary hospital in Italy.</div></div><div><h3>Method</h3><div>A pre–post quasi-experimental study was conducted between 1^st January 2019 and 31^st December 2022 in the PICU of the Department for Women's and Children's Health, University Hospital of Padova. The ASP intervention was implemented in February 2021 by a multi-disciplinary team using the ‘handshake’ approach. The population included all patients admitted to the PICU. The primary outcome was antibiotic consumption measured as days of therapy administered (DOTs)/1000 patient-days. An interrupted time series analysis was used to assess trends in antibiotic prescribing before and after the intervention.</div></div><div><h3>Results</h3><div>In total, 616 patients (episodes) were admitted in the pre-intervention phase (January 2019–January 2021) and 602 patients were admitted in the post-intervention phase (February 2021–December 2022). Implementation of the ASP resulted in a significant decrease in overall antibiotic consumption by 3.0% every month (<em>P</em>&lt;0.0001). Monthly reductions in higher consumption antibiotics were: meropenem, 4.9% (<em>P</em>=0.009); glycopeptides, 3.8% (<em>P</em>=0.014); and piperacillin-tazobactam 4.8% (<em>P</em>=0.034). The consumption of third-generation cephalosporins and amikacin did not change significantly.</div></div><div><h3>Conclusions</h3><div>The ASP intervention was effective in reducing the consumption of antimicrobials in this complex setting. These results show the importance of antimicrobial stewardship in the scenario of critically ill children.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"160 ","pages":"Pages 53-59"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544492","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":"Evaluating decontamination interventions to control carbapenemase-producing Enterobacterales transmission from sinks: a retrospective analysis","authors":"A. Arbel ,&nbsp;R. Abdo ,&nbsp;M. Amar ,&nbsp;R. Yasin ,&nbsp;M. Feldman ,&nbsp;O. Salah ,&nbsp;G. Weber ,&nbsp;R. Najjar-Debbiny","doi":"10.1016/j.jhin.2025.02.011","DOIUrl":"10.1016/j.jhin.2025.02.011","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"160 ","pages":"Pages 118-120"},"PeriodicalIF":3.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538180","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}