Journal of Hospital Infection最新文献

{"title":"Modelling the joint effects of single occupancy and N95 respirators on COVID-19 outbreaks in hospital wards.","authors":"Cameron Zachreson, Robyn Schofield, Caroline Marshall, Marion Kainer, Kirsty Buising, Jason Monty, Sheena Sullivan, Kanta Subbarao, Nicholas Geard","doi":"10.1016/j.jhin.2025.06.014","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.06.014","url":null,"abstract":"<p><strong>Background: </strong>Outbreaks of respiratory pathogens on hospital wards present a major challenge for control of hospital-acquired infections. Structural controls such as single-occupancy patient rooms, or routine precautions such as the use of N95 respirators by healthcare staff can play an important role in preventing and mitigating outbreaks.</p><p><strong>Methods: </strong>This study applies an agent-based extension of the Wells-Riley model of airborne pathogen exposure to simulate COVID-19 outbreaks on hospital wards. We simulated secondary attack rates and the sizes of outbreaks resulting from introduction of unrecognised cases in hospital wards with double- or single-occupancy patient rooms. We further simulated the impact of N95 respirator use by nurses during patient care activities, assuming an efficacy of 90% for protection and source control.</p><p><strong>Results: </strong>The size of simulated outbreaks recorded at day 14 was markedly lower in wards with only single-occupancy rooms, compared to double-occupancy rooms (with means of 14.1 and 22.8 infections, respectively). Nurses were more likely to acquire infection than patients for both single- and double-occupancy scenarios. Single occupancy was associated with smaller outbreak sizes, with a larger relative impact on patients than staff. N95 respirators were effective at mitigating outbreaks, with higher impacts in wards with single-occupancy patient rooms.</p><p><strong>Conclusions: </strong>Our results are consistent with claims that single-occupancy patient rooms reduce transmission of SARS-CoV-2 on hospital wards. Our findings also support the claim that use of N95 respirators by nurses when caring for patients can reduce the effective reproductive ratio of the pathogen. Finally, we demonstrated that switching to single occupancy can increase the benefit of N95 respirator use by healthcare staff.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555824","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 a novel automated pre-cleaning method for endoscopy.","authors":"Françoise Mevel, Gabriel Rahmi, Axelle Sornet, Anne-Marie Hillion, Camille Ronceray, Christophe Cellier, Isabelle Podglajen, Najiby Kassis-Chikhani","doi":"10.1016/j.jhin.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.06.011","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531179","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 kitchens/pantries in the spread of multi-drug-resistant organisms.","authors":"A Cobb, C Molyneux, V Raviprakash, C Skull, M Weinbren","doi":"10.1016/j.jhin.2025.04.022","DOIUrl":"10.1016/j.jhin.2025.04.022","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996555","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":"Soap scum in drainage during the COVID-19 pandemic.","authors":"O Imataki, K Konishi, T Taguchi, T Tateishi, M Tamura, S Uehara","doi":"10.1016/j.jhin.2025.06.009","DOIUrl":"10.1016/j.jhin.2025.06.009","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509492","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":"Monitoring Antimicrobial Resistance in Care Homes Through Wastewater Surveillance - A Scoping Review.","authors":"Ben S Alford, Carmel M Hughes, Deirdre F Gilpin, John W McGrath","doi":"10.1016/j.jhin.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.06.010","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance poses a growing threat, especially in care homes where older residents are particularly vulnerable due to frequent antibiotic use and co-morbidities. Following the COVID-19 pandemic, there has been a growing focus on wastewater surveillance for detecting and monitoring pathogens in healthcare settings.</p><p><strong>Aim: </strong>This study followed the Joanna Briggs Institute scoping review framework to map the extent of available literature on wastewater-based epidemiological studies addressing antimicrobial resistance in care homes for older adults.</p><p><strong>Methods: </strong>Six electronic databases (MEDLINE, Embase, Scopus, Web of Science, ProQuest, and Google Scholar) were searched from date of inception until 26^th August 2024. The search strategy employed variations of the keywords; 'antimicrobial resistance,' 'wastewater-based epidemiology,' and 'care homes for older adults.' Studies were screened based on eligibility criteria, with data extracted by one researcher. Another researcher reviewed the charted data and resolved any queries. The search identified 83 studies, from which 11 studies, conducted between 2015 and 2024, were included.</p><p><strong>Findings: </strong>The studies used grab or composite sampling, combined with culture-based methods for bacterial identification, antimicrobial susceptibility testing, and molecular techniques such as polymerase chain reaction and whole genome sequencing. Enterobacterales, including Escherichia coli and Klebsiella spp., were the most frequently detected, with high resistance rates, especially to some penicillins and cephalosporins.</p><p><strong>Conclusion: </strong>Despite the small sample sizes reported in this review, wastewater-based epidemiology shows promise in monitoring antibiotic-resistant bacteria in care home wastewaters, offering insights into trends and genetic diversity, with the potential to inform public health strategies and antibiotic stewardship programmes.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term effect of carbapenem preauthorization: an interrupted time-series study over 20 years","authors":"T. Urakami ,&nbsp;T. Matono ,&nbsp;Y. Oka ,&nbsp;Y. Aoki","doi":"10.1016/j.jhin.2025.06.005","DOIUrl":"10.1016/j.jhin.2025.06.005","url":null,"abstract":"<div><h3>Background</h3><div>Preauthorization of carbapenems is considered effective in reducing carbapenem overuse; however, long-term evaluations are lacking.</div></div><div><h3>Aim</h3><div>We aimed to evaluate the long-term effects of judicious carbapenem restriction over almost two decades in a tertiary teaching hospital in Japan.</div></div><div><h3>Methods</h3><div>Interrupted time-series (ITS) analysis was applied to investigate changes in the level and trend of antimicrobial use density (AUD) of carbapenems by comparing the pre-intervention (2004 and 2005) and intervention (2006–2023) periods. Furthermore, this study explored the relationship between carbapenem AUD in hospitalized patients, the mortality rate of hospital-acquired bacteraemia, and the prevalence of bacteraemia caused by antibiotic-resistant nosocomial pathogens.</div></div><div><h3>Findings</h3><div>The ITS analysis demonstrated remarkably significant reductions in the level change of carbapenem AUD following the preauthorization (−0.367 per 100 patient days (95% confidence interval (CI), −0.131 to −0.603; <em>P</em>=0.002). In addition, the trend shift was −0.014 per 100 patient days (95% CI, −0.001 to −0.028; <em>P</em>=0.048). Following the implementation of carbapenem preauthorization, no increase in the 28-day mortality due to nosocomial bacteraemia was observed. Significant positive correlations were found between carbapenem AUD and the prevalence of meticillin-resistant <em>Staphylococcus aureus</em> (correlation coefficient (<em>ρ</em>) = 0.77 (<em>P</em>&lt;0.001)), meropenem-resistant in <em>Pseudomonas aeruginosa</em> (<em>ρ</em> = 0.85 (<em>P</em>&lt;0.001)), and <em>Acinetobacter baumannii</em> (<em>ρ</em> = 0.80 (<em>P</em>&lt;0.001)).</div></div><div><h3>Conclusions</h3><div>Long-term implementation of carbapenem preauthorization consistently proved to be effective with no adverse consequences for hospital epidemiology in a 20-year ITS analysis.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 319-325"},"PeriodicalIF":3.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509489","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 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":"Onur Ozalp, Baran Ortakci, Selda Komec, Ozlem, Eda, Ozlem Altuntas Aydin","doi":"10.1016/j.jhin.2025.06.007","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.06.007","url":null,"abstract":"<p><strong>Background: </strong>Providencia 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 Providencia spp. poses a significant therapeutic challenge due to limited treatment options.</p><p><strong>Objectives: </strong>This study aimed to evaluate the clinical characteristics, risk factors, and outcomes of patients with carbapenem-resistant and carbapenem-sensitive Providencia infections.</p><p><strong>Methods: </strong>A retrospective, observational study was conducted, including hospitalised patients with Providencia spp. isolates between 1 January 2020 and 1 January 2024. Patients were stratified based on carbapenem susceptibility. Clinical data, risk factors, and mortality rates were compared between carbapenem-resistant and carbapenem-sensitive cases. Statistical analyses were performed to identify independent risk factors for carbapenem resistance.</p><p><strong>Results: </strong>Among 118 Providencia-associated infections, 53 (44.9%) were carbapenem-resistant. Providencia rettgeri was the predominant species (67.8%), with a significantly higher carbapenem resistance rate than P. stuartii (p=0.003). Carbapenem-resistant infections were most commonly urinary tract infections (58.5%), while carbapenem-sensitive infections were more frequently associated with skin and soft tissue infections (40.0%) (p<0.001). Carbapenem-resistant cases exhibited longer hospital stays, increased ICU admissions, and higher mortality rates (p<0.05). Risk factors for carbapenem resistance included prior ICU admission, mechanical ventilation, urinary catheterisation, and prior carbapenem use.</p><p><strong>Conclusion: </strong>Carbapenem-resistant Providencia 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 characterise resistance mechanisms and optimal treatment strategies.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"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 of anaesthesiology department in China.","authors":"Ruirong Chen, Yingjie Du, Jianbo Zhang, Lei Wang, Hao Cheng, Lili Wu, Tiankuo Yu, Quan Chen, Guyan Wang","doi":"10.1016/j.jhin.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.06.003","url":null,"abstract":"<p><strong>Objective: </strong>This study aims 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.</p><p><strong>Materials and methods: </strong>A cross-sectional nationwide online survey was conducted from November 1 to December 31, 2024, targeting anaesthesiology staff in Chinese hospitals. Developed by a multidisciplinary team, the questionnaire covered socio-demographics, hand hygiene practices, proficiency, and knowledge. Of 2,580 responses, 2,512 were valid after quality control. Descriptive statistics, chi-square tests, and logistic regression were used to analyse the data and identify predictors of hand hygiene compliance.</p><p><strong>Results: </strong>The study analysed 2,512 valid responses, mostly from male anaesthesiologists (90.84% and 59.39%, respectively). Most participants were from tertiary A hospitals (60.67%). A large majority 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%) 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.</p><p><strong>Conclusions: </strong>This study highlights the need for improved hand hygiene practices among anaesthesiology personnel in China, emphasizing the role of training, knowledge, and addressing barriers to compliance.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"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 methicillin-resistant Staphylococcus aureus to the SNV level using Oxford Nanopore simplex reads and HERRO error correction.","authors":"Max Bloomfield, Sarah Bakker, Megan Burton, M Leticia Castro, Kristin Dyet, Alexandra Eustace, Samantha Hutton, Donia Macartney-Coxson, William Taylor, Rhys T White","doi":"10.1016/j.jhin.2025.06.004","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.06.004","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>To determine whether Haplotype-aware ERRor cOrrection (HERRO) of ONT data could permit high-resolution comparison of outbreak isolates.</p><p><strong>Methods: </strong>We used ONT simplex reads from isolates involved in a recent outbreak of methicillin-resistant Staphylococcus aureus (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).</p><p><strong>Findings: </strong>Five of nine outbreak isolates were analysed; four had insufficient read lengths (N50 values <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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"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}