Journal of Hospital Infection最新文献

{"title":"The Canopy - a Novel Vertical Airflow Device with Ceramic Wall Flow Filters for Reducing Airborne Pathogen Spread in Hospital Rooms.","authors":"Mauro Sousa de Almeida, Andreas Mayer, Joachim Frey, Christian Lämmle, Alke Petri-Fink, Barbara Rothen-Rutishauser, Heinz Burtscher","doi":"10.1016/j.jhin.2025.05.020","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.020","url":null,"abstract":"<p><strong>Background: </strong>Aerosol transmission of infectious diseases is of particular concern in hospital and care facilities where isolation rooms are limited, leading to capacity crises in the past, such as during the COVID-19 pandemic.</p><p><strong>Aim: </strong>This study introduces a canopy, i.e., a novel vertical airflow system with ceramic wall flow filters designed to reduce the spread of airborne pathogens in hospital environments. The system captures exhaled air above the patient, filters it via ceramic filters, and releases clean air beneath the bed.</p><p><strong>Methods: </strong>Laboratory tests were conducted in controlled environments with small (15 m²) and large (36 m²) rooms. The filtration efficiency was evaluated using nebulized salt particles, nebulized MS2 bacteriophages, and bacteria exhaled by an adult person sleeping in the bed. The performance of the system was further tested in conjunction with hospital separation curtains to assess combined effectiveness.</p><p><strong>Findings: </strong>Filtration efficiencies reached up to 95% for nebulized salt particles, 87% for nebulized MS2 bacteriophages, and 92% for bacteria exhaled by an adult person sleeping in the bed. Hospital separation curtains alone provided a modest reduction in aerosol spread; however, their performance was enhanced when used alongside the vertical airflow system.</p><p><strong>Conclusion: </strong>These results confirm the canopy system's potential to reduce nosocomial infections by reducing aerosol concentrations. The innovative combination of vertical airflow and robust filtration technology offers a practical solution for improving air quality and protecting patients and healthcare workers in hospitals.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250944","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":"Viral acute respiratory infections in NICU health-care workers: a nine-month point-prevalence cohort study.","authors":"Raakel Luoto, Eeli Aavasalo, Matti Waris, Liisa Lehtonen, Ville Peltola, Olli Ruuskanen","doi":"10.1016/j.jhin.2025.05.019","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.019","url":null,"abstract":"<p><p>Healthcare-acquired viral acute respiratory infections (ARIs) are a common problem in neonatal care. Health-care workers may transmit viruses to neonates when having a symptomatic or asymptomatic ARI. This prospective nine-month repeated point-prevalence cohort study aimed to investigate the occurrence and aetiology of asymptomatic and symptomatic ARIs in health-care employees in a tertiary neonatal intensive care unit (NICU). Flocked nasal swabs were collected on every second Tuesday in a NICU from all personnel working on that day. Additionally, in the case of ARI symptoms, a nasal swab was self-collected by the study subjects. A virus was detected in 16 (3.3%) of the asymptomatic subjects. Altogether 36 symptomatic ARIs (mean 0.5 per person) were reported. Our data suggests that ARIs are not uncommon among NICU health-care workers and moreover are commonly asymptomatic. It is noteworthy that these individuals may transmit respiratory viruses to vulnerable neonates. Intensified infection control measures are recommended to promote patient safety.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250945","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":"Bacterial Recolonization of Hospital Sink Biofilms.","authors":"Hannah G Healy, Eryn Pawluk, Lucien Dieter, Scott C Roberts, Windy Tanner, Trini Mathew, David Peaper, Richard A Martinello, Jordan Peccia","doi":"10.1016/j.jhin.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.013","url":null,"abstract":"<p><strong>Background: </strong>Hospital sink drains are known reservoirs for many pathogens that cause healthcare-associated infections (HAIs). Drain bacteria can migrate up to the drain cover and then spread to surrounding surfaces and patients through droplet dispersal during sink use. Therefore, cleaning sink surfaces represents a key intervention strategy to limit transmission between drains and patients. In this study, we aimed to: (i) characterize microbial community taxonomy and abundance in sink components and (ii) evaluate the kinetics and sources of bacterial recolonization onto sink surfaces after cleaning.</p><p><strong>Methods: </strong>Drain pipes, drain covers, sink basins, drinking water, and p-trap liquid from hospital sinks in New Haven, CT, USA were sampled before and after intervention surface cleaning/disinfection (n=251). Bacterial abundance and taxonomy were assessed via culture counts, digital droplet PCR, MALDI-ToF, and 16S rRNA gene amplicon sequencing.</p><p><strong>Findings: </strong>Drain biofilms had median bacterial abundance of 1.80 x 10⁸ 16S rRNA gene copies/cm² and 2.06 x 10⁶ CFU/cm², which correlated with bacterial abundance on sink surfaces. Hallway sinks, which were used more frequently than patient room sinks, had higher bacterial abundance. Drain microbial communities largely consisted of Novosphingobium and Sphingobium, with detection of Acinetobacter, Pseudomonas, Legionella, and Stenotrophomonas. Sink surfaces had abundant Mycobacterium, Methylobacterium-Methylorubrum, and Sphingobium, as well as genera common to skin microbiomes (e.g., Corynebacterium, Staphylococcus, Streptococcus). Immediately after cleaning/disinfection, culturable bacteria were generally undetectable on drain covers; bacterial gene copies were reduced but rebounded to over 80% of pre-cleaning levels within 24 hours. After seven days, 9.2% of recolonizing bacteria were derived from drains, and 15.7% were from tap water.</p><p><strong>Conclusion: </strong>This study contributes to our understanding of factors that influence pathogen abundance on hospital sink surfaces and limitations of routine cleaning and disinfection.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227699","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":"Trends in incidence rates of microorganisms among patients with bloodstream infections at intensive care units in South Korea from 2011 to 2022: Data from the Korean National Healthcare-Associated Infections Surveillance System (KONIS).","authors":"Yu-Mi Lee, Dong Youn Kim, Eun Jin Kim, Ki-Ho Park, Mi Suk Lee","doi":"10.1016/j.jhin.2025.04.037","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.04.037","url":null,"abstract":"<p><strong>Background: </strong>The trends in the microbiological distribution and incidence rates of multidrug-resistant pathogens in patients with bloodstream infections in intensive care units (ICUs) were evaluated.</p><p><strong>Methods: </strong>This retrospective analysis was conducted using data from the Korean National Healthcare-Associated Infections Surveillance System. Annual trends in microorganism distributions and multidrug-resistant pathogens in patients with bloodstream infections (BSIs) were investigated.</p><p><strong>Results: </strong>The incidence rate of Staphylococcus aureus infection in patients with BSIs decreased from 33.1 per 100,000 patient-days in 2011 to 9.7 in 2022. The incidence rate of BSIs due to Klebsiella pneumoniae has increased 6.4 per 100,000 patient-days in 2015 to 12.1 in 2022. The incidence rate of BSIs due to methicillin-resistant S. aureus (MRSA) [28.8/100.000 patient-days in 2011; 7.3/100,000 patient-days in 2022] and the percentage of MRSA strains [91.8% in 2011; 76.7% in 2022] decreased throughout the study period. The incidence rate of BSIs due to imipenem-resistant K. pneumoniae has significantly increased from 0.3 per 100,000 patient-days in 2011 to 6.1 in 2021, and the percentage of imipenem-resistant K. pneumoniae strains has increased from 4.3% in 2011 to 48.5% in 2022. The incidence of BSI due to imipenem-resistant Pseudomonas aeruginosa showed an increasing trend from 2011 to 2021.</p><p><strong>Conclusion: </strong>The incidence rate of BSIs due to MRSA in the ICUs decreased, whereas the incidence rates of BSIs caused by imipenem-resistant K. pneumoniae and imipenem-resistant P. aeruginosa in the ICUs showed an increasing trend. Over the past decades, there has been a significant shift from gram-positive bacteria to gram-negative bacteria in BSIs.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227700","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":"Yeasticidal efficacy of far-UV-C radiation with 233 nm peak wavelength for inactivating Candida spp. with focus on the clinically relevant species C. auris for potential application on the skin.","authors":"Claudia Sicher, Nevin Opitz, Vanessa Gering, Lucas Wittenbecher, Nils-Olaf Hübner, Axel Kramer, Paula Zwicker","doi":"10.1016/j.jhin.2025.05.011","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.011","url":null,"abstract":"<p><p>Candida (C.) spp. are significant pathogens for hospital acquired infections. Especially infections with C. auris have gained increased attention due to their transmissibility and resistance properties making new decolonization tools necessary. Far-UV-C radiation might be a new tool to inactivate Candida spp. independent of their resistance profile. The use of LEDs allows a flexible application of the radiation enabling e.g. the treatment of areas that are not accessible by the use of common antiseptics such as the throat or the middle ear. A blood agar spot test and a carrier test were used to quantify the efficacy of Candida spp. inactivation by skin tolerable doses of UV-C radiation (10 -60 mJ/cm²) with a peak wavelength of 233 nm. C. albicans, C. parapsilosis, C. glabrata, C, tropicalis and C. auris were used for the tests. C. parapsilosis was furthermore incubated with L-DOPA for melanin externalization. A dose of 60 mJ/cm² was able to inactivate > 3lg of all Candida spp.; in some experiments, a 4 lg reduction was achieved. C. parapsilosis with melanin and C. auris DSM 105987 were the least susceptible strains. In conclusion, far-UV-C radiation might be an additional measure for the treatment of Candida infections due to its yeasticidal effects combined with its skin tolerability.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Evaluation of MAP-1 Antimicrobial Coating on Patient Privacy Curtains: Insights from a Randomized Trial in a Hong Kong Hospital.","authors":"Awais Farid, Wei Han, Christopher K C Lai, Joseph K C Kwan, King Lun Yeung","doi":"10.1016/j.jhin.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.012","url":null,"abstract":"<p><strong>Background: </strong>Microorganisms, including multidrug-resistant organisms (MDROs), can persist on hospital surfaces, posing significant health risks. Patient privacy curtains (PPCs) are particularly vulnerable due to their porous nature, serving as potential reservoirs for pathogens.</p><p><strong>Aim: </strong>This study evaluates the effectiveness of a multilevel antimicrobial polymer (MAP-1) coating on PPCs in reducing microbial loads, including MRSA. The objective is to determine its potential in lowering bacterial contamination and mitigating hospital-acquired infections (HAIs).</p><p><strong>Methods: </strong>A cross-over, randomized, double-blind clinical trial was conducted in male and female cubicles of a Hong Kong rehabilitation ward. 1,824 samples compared mean microbial load on MAP-1-coated PPCs to standard laundered PPCs on 76 patient bed curtains (patients aged 18-99 with stays >48 hours). The primary outcome measured was the percentage reduction in bacterial counts on treated versus untreated PPCs across three 4-week phases, with secondary outcomes on staff feedback.</p><p><strong>Findings: </strong>MAP-1 coated PPCs showed a 96.8% reduction in total viable bacteria (p < 0.00001; 95% CI, 94.8-98.2%) and 99.3% in MRSA (p < 0.00001; 95% CI, 97.4-99.5%) compared with uncoated PPCs. Effectiveness was maintained over all 4-week periods, consistently reducing bacteria and MRSA by over 95%. Staff feedback indicated strong acceptance of the technology for routine use.</p><p><strong>Conclusion: </strong>The MAP-1 coating demonstrated high efficacy in reducing pathogen presence on PPCs, with sustained effectiveness suggesting its potential for long-term application in hospital settings.</p><p><strong>Clinical trial registry: </strong>NCT03795090.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210285","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":"Effects of Reminders from Sanibit^TM Electronic Hand Hygiene System and Incentives on Hand Hygiene Compliance - A Prospective, Four Phased, Observational Study.","authors":"Emma C Huang, Qian Xu, Yang Liu, Peng Liu, Maiying Kong, Jiapeng Huang","doi":"10.1016/j.jhin.2025.05.014","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.014","url":null,"abstract":"<p><strong>Background: </strong>We aim to comprehensively evaluate the implementation of the Sanibit^TMsystem in the ICU using individualized reminders and incentives and study the impact of these interventions on hand hygiene compliance in a 4 phased, prospective trial at a tertiary care hospital in the USA.</p><p><strong>Methods: </strong>An automated hand hygiene monitoring systems was installed in a 10-bed neurological intensive care unit. Phase 1: No reminder, Cash incentive. Phase 2a: Lights ONLY, Cash Incentive. Phase 2b: Lights + Vibrations, Cash Incentive. Phase 3: No reminder, Point System Incentive. Phase 4: Lights + Vibrations, Point System Incentive.</p><p><strong>Results: </strong>The accuracy rate detected by the Sanibit^TM, compared with direct observations, was 85.1%. Phase 2a with lights only and cash incentives achieved the most hand hygiene opportunities in the middle of the week. Phase 4 with lights and vibrations reminders and point system incentives achieved the best in terms of total, full and partial hand hygiene compliance while phase 2a with lights only and cash incentives had the highest hand hygiene opportunities. Hand hygiene compliance rates of going-out of room events were significantly lower than those of going-in room events for quick in-and-out room while the opposite held true for long in-and-out room events.</p><p><strong>Conclusions: </strong>Hand hygiene opportunities, compliance, and patient contact times varied significantly among different reminders/incentives, individual healthcare workers, date of the week and time of the day. Lights and vibration reminders and point system incentives achieved the best hand hygiene compliance.</p><p><strong>Clinical trial registration: </strong>NCT03948672.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210286","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":"Exploring Infection Risk Factors and Multidrug-Resistant Organisms (MDROs) in Burn Intensive Care Units: A Multicenter Case-Control Study.","authors":"Seema Nasser, Zahra Alnasser, Ohoud Aljuhani, Aisha Alharbi, Johanna Rice, Abdullah F Alharthi, Raed Kensara, Faisal E Al Mutairi, Dalil Zaabee, Shuroug A Alowais, Nader Damfu, Samiah Alsohimi, Asma A Alshehri, Sultan Alotaibi, Marwah Bin Abdulqader, Saja Almarhoun, Najat Waggas, Munirah Alajmi, Nourah Alrashidi, Maher Alharbi, Mohammed Al Asiri, Ashjan Ali Hadadi, Haifa A Alhaidal, Ghaida Alahmari, Ahlam H Almutairi, Faisal A Alwadani, Abdullah M Musally, Reem A Mahboob, Dania T Bakor, Ramesh Vishwakarma, Khalid Al Sulaiman","doi":"10.1016/j.jhin.2025.05.010","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.010","url":null,"abstract":"<p><strong>Background: </strong>Despite the widespread incidence of MDRO within burn centers, there is a lack of research investigating infection risks in critically ill burn patients. This study aimed to identify the risk factors associated with the acquisition of MDROs among critically ill burn patients admitted to the Burn ICU (BICU) and to determine the prevalence of MDROs in this population.</p><p><strong>Method: </strong>This was a multicenter observational case-control study included adult patients (age≥18) admitted to BICU between January, 2015, to December, 2022. Patients were excluded if burn injury affected < 10% of the body surface area (BSA), died within 24 hours of ICU admission, unknown timing of burn injury, and history of MDRO within 1 year prior to admission or antibiotics use 3 months prior to admission. We identified the risk factors and prevalence of MDROs, ICU length of stay (LOS), hospital LOS, 30-day mortality, and in-hospital mortality rates as the study outcomes. An exact matching approach with 1:1 ratio was used to match the groups based on age, gender, and admission year. Stepwise forward selection logistic and linear regression analyses were used when appropriate.</p><p><strong>Results: </strong>A total of 173 patients were included, and only 168 patients were matched: 84 patients in the case group (MDR) were matched with 84 patients in the control group (non-MDR). Patients who had MDR organisms had lower Glasgow Coma Scale (GCS) baseline (Unadjusted OR: 0.88, 95% CI [0.827, 0.944]), higher baseline Sequential Organ Failure Assessment (SOFA) score (Unadjusted OR: 1.19, 95% CI [1.069, 1.329]), APACHE II score (Unadjusted OR: 1.11, 95% CI [1.054, 1.161]), invasive mechanical ventilation (MV) status at admission (Unadjusted OR: 3.76, 95% CI [1.96, 7.20]), and higher total body surface area (TBSA) affected (Unadjusted OR: 1.04, 95% CI [1.024, 1.058]) compared to the non-MDR group. However, regression analysis showed that those with lower Baseline GCS (OR: 0.904, 95% CI [0.828, 0.987]), higher TBSA affected (OR: 1.023, 95% CI [1.002, 1.045]), and urinary tract infections (UTIs) (OR: 7.198, 95% CI [1.973, 26.259]) were significantly more prone to MDR infections. The most common isolated pathogens in the MDRO group was Acinetobacter baumannii (57%), while the most common infection was pneumonia (52.4%). The MDR group had significantly longer MV duration and ICU LOS (median: 12 vs. 0 days, P=0.0002) and (median: 28 vs. 17 days, P=0.0002), respectively. There was no significant difference between the groups in other outcomes.</p><p><strong>Conclusion: </strong>Our study showed a significantly increased risk of infections with MDRO in patients with burn who had larger TBSA burns, lower GCS, and higher SOFA and APACHE II scores. Future studies with larger sample size are needed to confirm our results.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210287","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":"Postoperative risk of infection with klebsiella in adults – a retrospective case–control study","authors":"J.L.G. Haitsma Mulier ,&nbsp;M. Falcone ,&nbsp;G. Tiseo ,&nbsp;A.M. Azzini ,&nbsp;R. Scardellato ,&nbsp;E. Franceschini ,&nbsp;S. Tafuri ,&nbsp;M. Merli ,&nbsp;B. Carević ,&nbsp;E. Roilides ,&nbsp;N.L.J. van Sluis ,&nbsp;D. Bottigliengo ,&nbsp;V. Vella ,&nbsp;C.H. van Werkhoven ,&nbsp;C. Alaimo","doi":"10.1016/j.jhin.2025.04.036","DOIUrl":"10.1016/j.jhin.2025.04.036","url":null,"abstract":"<div><h3>Background</h3><div>Hospital-acquired infections with <em>Klebsiella</em> spp. and emerging multi-drug-resistant strains are a persistent concern. Identifying high-risk groups is crucial for the evaluation of preventive interventions such as vaccines. We determined the incidence and developed prediction models for postsurgical klebsiella infections in adult elective surgery patients.</div></div><div><h3>Methods</h3><div>This multi-centre retrospective case–control study, in seven European hospitals, included patients ≥50 years old who underwent elective surgery between 2012 and 2021. Using multi-variable logistic regression, we modelled the risk of postsurgical klebsiella infection and investigated trial enrichment scenarios.</div></div><div><h3>Results</h3><div>Of 139,778 eligible surgeries identified, 1781 were included: 840 patients with postsurgical klebsiella infection and 941 without. The incidence of postsurgical klebsiella infection was 1.38% (95% confidence interval 1.24–1.54%). Pre-surgical klebsiella colonization, gastrointestinal surgery, abdominal surgery, trauma surgery and chronic cardiovascular disease were independent predictors of postoperative klebsiella infection. Minimally invasive surgery and peri-operative antibiotic prophylaxis predicted a lower risk. Trial enrichment simulation indicated a 72% reduction in required participants when enrolling patients with a predicted risk above 2%.</div></div><div><h3>Conclusions</h3><div>A multi-variable model incorporating klebsiella colonization status and clinical factors can accurately predict klebsiella infections in elective surgery patients. This model can select high-risk patients, enhancing the efficiency of phase-III trials of preventive interventions, including vaccination.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 26-35"},"PeriodicalIF":3.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180346","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":"Effectiveness of Heating Hospital Sink Drainpipes for Reducing Bacterial Colonisation.","authors":"Satoshi Kakiuchi, Takeshi Tanaka, Junya Kawaguchi, Yoshitomo Honda, Yoshikazu Harada, Ayumi Fujita, Masato Tashiro, Tsuneki Kusaba, Koichi Izumikawa","doi":"10.1016/j.jhin.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.008","url":null,"abstract":"<p><strong>Background: </strong>Hospital sink drains act as reservoirs for nosocomial infection-causing bacteria. Drainpipe thermal disinfection unit (DTDU) inhibit or reduce bacterial colonisation by elevating drainpipes temperature. However, their effectiveness remains to be comprehensively evaluated.</p><p><strong>Aim: </strong>This study investigated the effectiveness of a DTDUs, in addition to routine cleaning and disinfection, in preventing bacterial colonisation of new metal drainpipes in a clinical setting.</p><p><strong>Methods: </strong>This non-blinded parallel group comparative study was conducted in the intensive care unit of Nagasaki University Hospital, Japan. DTDUs were installed in three and five new sink drains for cleaning oral care devices (OC) and staff handwashing (HW), respectively. Two new sink drains without DTDUs for OC and HW were used as controls. Sinks were used as usual, with daily cleaning with ethanol-wipes and weekly flushing of a drain cleaner containing 2% sodium hypochlorite. Additionally, OC drainpipes were disinfected using foam-type sodium hypochlorite. Samples were collected from insides of drainpipes biweekly for bacterial identification, semi-quantitative culturing, and antibiotic sensitivity test. The effect of the DTDUs on drainpipe bioburden was assessed using Fisher's exact test.</p><p><strong>Findings: </strong>Each sink was sampled 14 times. Bioburden was significantly lower in DTDU-equipped drainpipes than in controls for both OC and HW (both p<0.01). Pseudomonas aeruginosa was the most frequently isolated bacterium (46.3%); however, it was not detected in DTDU-equipped OC drainpipes. Carbapenemase-producing Enterobacterales were detected in control HW drainpipes but not in DTDU-equipped HW drainpipes.</p><p><strong>Conclusion: </strong>Thermal disinfection of drainpipes may suppress bacterial colonisation, including strains resistant to regular cleaning and disinfection.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182746","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}