Journal of Hospital Infection最新文献

{"title":"Risk factors for surgical site infection after hip replacement: A systematic review and meta-analysis.","authors":"Bufan Yang, Yuanhu Lei, Yuhuan Zeng, Mingjiang Luo, Zhengyu Li, Kun Lei, Yun Wang, Qunjie Xiao, Jianping Wen, Wenhua Yan, Huyong Yan","doi":"10.1016/j.jhin.2025.02.021","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.02.021","url":null,"abstract":"<p><strong>Background: </strong>We conducted a meta-analysis to determine the risk of infection following hip replacement and identified risk factors for surgical site infection.</p><p><strong>Methods: </strong>We systematically searched the PubMed/Medline, Embase and Cochrane Library databases, as well as the reference lists of previous systematic reviews and meta-analyses. The pooled odds ratio (OR) was estimated using a random effects model for each investigated factor. The evidence of observational studies was classified as high quality (class I), moderate quality (class II or III) or low quality (class IV) based on the GRADE system.</p><p><strong>Results: </strong>A total of 25,383 potential articles met the inclusion criteria in the database search. After reviewing the titles, abstracts, and full texts, 27 articles were included in the final analysis, encompassing 699,473 patients who underwent hip arthroplasty. High-quality evidence shows that BMI (≥30 kg/m²) (OR 2.16; 95% CI 1.72-2.70), male sex (OR 1.39; 95% CI 1.26-1.53), operation time (≥120 min) (OR 1.72; 95% CI 1.39-2.14), ASA class ≥3 (OR 2.05; 95% CI 1.49-2.83), diabetes (OR 1.33; 95% CI 1.23-1.43), and heart disease (OR 1.99; 95% CI 1.48-2.68) are associated with a greater risk of infection. The meta-analysis revealed that age and renal disease were not associated with infection.</p><p><strong>Conclusion: </strong>This meta-analysis identified significant risk factors for infection after hip replacement surgery, including BMI, male sex, operation time, heart disease, diabetes, and ASA class.</p><p><strong>Level of evidence: </strong>Level IV, systematic review of Level III and Level IV studies.</p><p><strong>Trial registration number: </strong>The review protocol was registered in PROSPERO. Unique Identifying Number (UIN) is \"CRD42024535902\".Hyperlink to the specific registration (must be publicly accessible and will be checked): \"https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=535902\".</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702345","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 impact of the COVID-19 national health alert on Enterobacteriaceae hospital outbreaks in Chile.","authors":"Cristian Lara, Mauro Orsini, Mónica Pohlenz, Karen Ulloa, Ignacio Castro, Carmen Muñoz-Almagro, Pedro Brotons","doi":"10.1016/j.jhin.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.03.003","url":null,"abstract":"<p><strong>Background: </strong>The impact of public health interventions against the COVID-19 pandemic on the occurrence of Enterobacteriaceae outbreaks in hospitals remains unclear.</p><p><strong>Objective: </strong>To determine the effect of the COVID-19 national health alert on the secular trend of Enterobacteriaceae outbreaks in Chilean public hospitals while characterizing their antibiotic resistance patterns.</p><p><strong>Methods: </strong>Nationwide retrospective ecological study using interrupted time series analysis of monthly outbreak-related cases over three periods: pre-pandemic (January 2017-February 2020), health alert (March 2020-August 2023), and post-pandemic (September-December 2023).</p><p><strong>Results: </strong>A total of 106 outbreaks, 1,131 associated cases, and 254 deaths were identified in 47/196 (24.0%) hospitals. Cases increased gradually (0.39 cases-month, 95% CI 0.02-0.75; p=0.040) in the pre-pandemic years. A sudden rise of 33.42 cases (95% CI 7.53-59.31 cases; p=0.012) in March 2020, followed by a gradual decrease (1.28 cases-month, 95% CI 0.38-2.17; p=0.006) during the health alert. A rebound of 18.02 cases (95% CI 2.89-33.15; p=0.020) occurred in September 2023 and preceded a gradual post-pandemic decline (6.21 cases-month, 95% CI 1.11-11.31; p=0.018). Prevalence of cases caused by carbapenemase-producing enterobacteria rose significantly (p<0.001) during (79.9%) and after the health alert (100.0%) compared to the pre-alert period (35.3%).</p><p><strong>Conclusions: </strong>The COVID-19 national health alert was associated with significant shifts in the secular trend of cases associated with Enterobacteriaceae outbreaks in Chilean public hospitals, including abrupt increases at the beginning and end of the health alert and gradual decreases during and after this period. A sharp increase in carbapenemase production was observed across outbreaks after the pandemic onset.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702346","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":"Impact of single-use oral care sets on reducing ventilator-associated pneumonia. among ICU patients: a multi-center study.","authors":"A Unahalekhaka, P Uirungroj, C Saenjum","doi":"10.1016/j.jhin.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.03.005","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated pneumonia is a serious hospital-associated infection among mechanically ventilated patients. Proper oral care is a critical intervention for reducing VAP incidence.</p><p><strong>Aim: </strong>To evaluate the effectiveness of single-use oral care sets in reducing VAP incidence and assessing ICU nurses' perspectives on their use.</p><p><strong>Methods: </strong>A multi-center study was conducted in the ICUs of 14 tertiary care hospitals. Single-use oral care sets were used for cleaning patients' oral cavities following a standardized oral care protocol. VAP rates and cost of VAP antibiotic treatment were compared before and after implementing the oral care sets. ICU nurses' opinions on the oral care sets were collected using a self-administered questionnaire.</p><p><strong>Findings: </strong>Before implementing the oral care sets, there were 269 VAP cases over 34,731 ventilator-days, with a VAP rate of 7.74 per 1,000 ventilator-days. The total antibiotic cost for VAP treatment was 5,137,622 Thai baht. After implementation, VAP cases decreased to 182 over 34,309 ventilator-days, with a significantly reduced VAP rate of 5.30 per 1,000 ventilator-days- a 31.52% reduction (p < 0.05). Antibiotic treatment costs also declined significantly to 2,101,940 Thai baht (p < 0.05). Among 220 ICU nurses surveyed, 96.3% agreed or strongly agreed that the oral care sets helped prevent healthcare-associated infections (HAIs). Over 85% reported improved ease of use, increased patient comfort, and better adherence to evidence-based guidelines.</p><p><strong>Conclusion: </strong>The use of single-use oral care sets within a standardized oral care protocol effectively reduces VAP incidence and associated costs. ICU nurses expressed high satisfaction with the oral care sets, highlighting their potential to enhance patient safety, improve adherence to guidelines, and reduce healthcare costs. Routine integration of single-use oral care sets into oral care protocols for mechanically ventilated patients is recommended.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702330","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":"Pneumatic tube transport system carries made from urethan contaminated with environmental pathogens.","authors":"Osamu Imataki, Ryoko Masumoto, Masahiro Hamano, Masaki Ishimatsu, Masayo Tamura, Akira Kitanaka","doi":"10.1016/j.jhin.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.03.006","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694689","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":"More than rewards: Insights into a hospital infection prevention and control gamification strategy.","authors":"Nicolás Reinoso Schiller, Ghazaleh Motaharina, Alexander König, Gesine Benze, Julia Eichkorn, Mark Weber-Krüger, Antonia Milena Köster, Lotta Fischer, Erika Schulte, Volker Ellenrieder, Simone Scheithauer","doi":"10.1016/j.jhin.2025.02.019","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.02.019","url":null,"abstract":"<p><p>Traditional infection prevention and control (IPC) education and training of healthcare workers (HCW) is expensive and rarely sustainable, gamification strategies support behaviour change by capitalizing on psychological drivers such as intrinsic and extrinsic motivation. However, little is known about which type of reward presentation best supports the engagement of HCW. This study aims to examine which reward strategy can facilitate engagement and acquisition of IPC knowledge. The study was performed in three gastroenterology wards, a palliative-care ward served as control. Endpoints on bed-occupancy, Alcohol-Based Hand Sanitizer (ABHS) consumption were collected during a two-month baseline period, number of right answers was gathered during the intervention phases and surveys on expectation and satisfaction were conducted pre and post intervention. The intervention of twice-weekly knowledge quizzes, employed loss aversion, standard reward, and in-game reward strategies. Multivariate analysis was used to analyze data on ABHS consumption and IPC knowledge. 105 HCW participated, leading to a 170% increase in the mean ABHS consumption between baseline and the last phase of the gamification. This represents a significant effect of the gamification phases (p < .05). However, no significant consumption difference was observed between the gamified wards (p > .05). Furthermore, Gamified strategies showed higher engagement than the control, though strategies of loss aversion and standard rewards did not display higher ABHS consumption or game engagement over gamification alone. The intervention effectively engaged medical and non-medical staff in IPC topics, positively influencing HCW workflow and increasing ABHS consumption. These findings highlight gamification as a promising approach for IPC education.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651955","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":"Stability and inactivation of hepatitis A virus on inanimate surfaces.","authors":"Lilli Pottkämper, Michelle Jagst, Daniel Todt, Eike Steinmann","doi":"10.1016/j.jhin.2025.02.020","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.02.020","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis A virus (HAV) is one of the leading causes of viral hepatitis with an estimated 159 million acute infections annually. The primary route of transmission is faecal-orally through contaminated drinking water and food. Limited data regarding its surface stability and sensitivity to surface disinfectants is available. Implementing effective disinfectants could have a significant impact on the prevention of HAV transmission. Therefore, the aim of this study was to evaluate HAV stability and sensitivity to surface disinfectants based on an established carrier assay.</p><p><strong>Methods: </strong>We evaluated the stability of HAV on stainless steel discs over a period of 60 days and its sensitivity to different commercially available surface disinfectants. Steel-disc carriers were inoculated with HAV particles and incubated over a respective period. Furthermore, HAV resistance against several groups of disinfectant agents were tested with varying concentrations and exposure times according to the manufacturers' guidelines.</p><p><strong>Results: </strong>We observed that HAV was recoverable from stainless steel discs for up to 40 days with an estimated half-life of 18.63 days. The evaluation of several surface disinfectants showed that, except for the aldehyde-based products, all other products insufficiently inactivated HAV.</p><p><strong>Conclusion: </strong>Overall, HAV demonstrated a high resistance to a wide range of the tested surface disinfectants. Out of the nine surface disinfectants evaluated, only two aldehyde-based products demonstrated a reduction in viral titer below the limit of detection. These findings have strong implications for the recommendation of evidence-based hygiene guidelines to reduce HAV transmission.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639882","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 Associated with Surgical Glove Perforation in Minimally Invasive Procedures: A Prospective Study.","authors":"Wang Weixiao, Tang Jinmeng, Cao Zhengyuan, Xue Jia, Lu Ye, Wang Nana","doi":"10.1016/j.jhin.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.03.002","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"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":"Association Between Medication Use and Hospital-Acquired Infections: A Multicentre Case-Control Study.","authors":"XiaoLiang Zhang, FangBin Li, Lin Li, Yan Liang, HaoJun Zhang","doi":"10.1016/j.jhin.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.03.001","url":null,"abstract":"<p><strong>Objectives: </strong>Hospital-acquired infections (HAIs) pose a significant risk to hospitalised patients. This study aimed to assess the relationship between medication use and the occurrence of HAIs.</p><p><strong>Methods: </strong>This retrospective multicentre case -control study included 604 HAI cases reported across three hospitals in northwest China from January 2023 to July 2024. The control group consisted of 604 patients without HAIs from the same period and same hospitals. We performed multivariable log-binomial regression to assess the association between medication use and HAIs, adjusting for confounding variables. A trend chi-squared test was also used to evaluate if the risk of HAIs increased with longer medication durations.</p><p><strong>Results: </strong>Univariate analysis revealed that the use of proton pump inhibitors (PPIs), antibiotics, glucocorticoids, and H2 receptor blockers significantly increased the risk of HAIs (P < 0.05. Multivariable log-binomial regression indicated that PPIs, glucocorticoids, and H2 receptor antagonists were associated with an elevated risk of HAIs, with relative risks (RRs) of 1.37 (95% CI: 1.19-1.57), 1.33 (95% CI: 1.10-1.62), and 1.84 (95% CI: 1.04-3.24), respectively. The duration of prolonged use of PPIs and glucocorticoids was significantly longer in the case group.</p><p><strong>Conclusions: </strong>Glucocorticoids, PPIs, and H2 receptor antagonists increase HAI risk, with prolonged use exacerbating this risk. The use of a single antibiotic for up to 10 days is not associated with HAI acquisition.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639873","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}