Journal of Hospital Infection最新文献

{"title":"Aquatic reservoir-associated outbreaks of multi-drug-resistant bacteria: a hospital outbreak report of Pseudomonas aeruginosa in perspective from the Dutch national surveillance databases","authors":"S.B. Debast ,&nbsp;M.I. van den Bos-Kromhout ,&nbsp;S.V. de Vries-van Rossum ,&nbsp;S.E.M. Abma-Blatter ,&nbsp;D.W. Notermans ,&nbsp;J.A.J.W. Kluytmans ,&nbsp;B. Immeker ,&nbsp;J.K. Zuur ,&nbsp;M.L. Hijmering ,&nbsp;A.A. Bergwerff ,&nbsp;M.J. Bruins ,&nbsp;Y.J.W.M. Bisselink ,&nbsp;A.P.A. Hendrickx ,&nbsp;J.W.A. Rossen","doi":"10.1016/j.jhin.2025.05.024","DOIUrl":"10.1016/j.jhin.2025.05.024","url":null,"abstract":"<div><h3>Background</h3><div>Water fixtures can be involved in hospital outbreaks with multi-resistant pathogens.</div></div><div><h3>Aim</h3><div>To document an outbreak of a Verona integron-encoded metallo-<em>β</em>-lactamase type 2-producing carbapenem-resistant <em>Pseudomonas aeruginosa</em> (CRPA-VIM) and evaluate infection control measures. Additionally, to overview waterborne outbreaks involving multi-resistant pathogens in Dutch healthcare institutions.</div></div><div><h3>Methods</h3><div>Epidemiologic analysis, selective culturing, PCR, and whole-genome sequencing (WGS) identified the outbreak sources. National surveillance databases were consulted.</div></div><div><h3>Findings</h3><div>In December 2023, three ICU patients tested positive for CRPA-VIM with multi-locus sequence type (MLST) ST111. Contaminated sinks were identified as the source. Despite interventions, a new cluster of five CRPA-VIM-positive patients emerged in March–April 2024. WGS linked this to a decommissioned sink (November 2021) and two patients (December 2021 and April 2023). Contact tracing and source investigations found no interpatient transmission; sinks were identified as the sole source. Measures, including contact precautions, intensified cleaning and hygiene procedures, retraining, installing and frequently replacing splash- and aerosol-reducing inlets, and faucet modifications failed to halt the transmission. No new cases occurred after the removal of all water fixtures in the ICU patient rooms. The outbreak strain was unique to the hospital and showed no genetic clustering in the national surveillance. Nationally, three to five waterborne outbreaks with highly resistant micro-organisms in hospitals are reported annually.</div></div><div><h3>Conclusions</h3><div>CRPA-VIM was transmitted from sinks to ICU patients without interpatient transmission. Infection control requires comprehensive surveillance of patients and the environment. A water-restricted and drain-free environment ended the outbreak. Future hospital design should minimize contamination from drains and sinks to reduce the nosocomial infection risk.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 310-318"},"PeriodicalIF":3.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327781","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":"Effect of Air Flow Rate Over Time on SARS-CoV-2 Viability During Representative Sampling Using MD8 Airport Air Sampler.","authors":"Ian Nicholls, Okechukwu Onianwa, Sean Collins, Antony Spencer, Simon Parks, Barry Atkinson, Thomas Pottage","doi":"10.1016/j.jhin.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.06.002","url":null,"abstract":"<p><p>Studies involving air sampling for SARS-CoV-2 commonly return either negative data or non-viable virus. We assessed the desiccative impact of time parameters during air sampling by aerosolising SARS-CoV-2 onto gelatine Sartorius MD8 AirPort filters; contaminated filters were then attached to a Sartorius MD8 AirPort and run at 50L/min up to 40 minutes. These filters were then analysed by viral plaque assay and qRT-PCR, results showed no significant difference in recovery of infectious virus or genomic copy numbers with increasing air sampled. These results show that sampling for 40 minutes or less with a Sartorius MD8 AirPort does not reduce the viability of SARS-CoV-2.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for surgical site infection in patients after hysterectomy: A systematic review and meta-analysis.","authors":"Yuhuan Zeng, Yuanhu Lei, Min Li, Shu Yang, Siyi Liu, Mengfei Liu, Wei Liu, Can Peng, Jie Zhou, Changming Xiao, Xiangfang Tan, Qunfeng Zhang","doi":"10.1016/j.jhin.2025.05.018","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.018","url":null,"abstract":"<p><strong>Introduction: </strong>The authors conducted this meta-analysis to determine the risk of post-hysterectomy infection and to assess risk factors for post-hysterectomy surgical site infection (SSI).</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and the Cochrane Library and manually searched reference lists from previous systematic reviews and meta-analyses. A random effects model was used to estimate the combined OR values. In addition, subgroup analyses were stratified on the basis of study baseline features, and sensitivity analyses were performed to explore potential sources of heterogeneity and stability of the results.</p><p><strong>Results: </strong>A total of 88,735 potential articles in the database search met the inclusion criteria. After the titles, abstracts, and full texts were reviewed, 23 articles were included in the final analysis. The 23 articles included 681,695 patients who underwent hysterectomy. High-quality (Class I) evidence showed that abdominal hysterectomy (AH) (OR, 4.17; 95% CI, 3.42-5.07), vaginal hysterectomy (VH) (OR, 1.22; 95% CI, 1.05-1.42), obesity (BMI≥30 kg/m²) (OR, 1.56; 95% CI, 1.40-1.75), gynecological cancer (OR, 1.49; 95% CI, 1.30-1.72), operative time≥160 min (OR, 1.58; 95% CI, 1.36-1.84), diabetes (OR, 1.57; 95% CI, 1.23-2.00), and smoking (OR, 1.41; 95% CI, 1.14-1.74) were associated with a greater risk of infection. The meta-analysis revealed no associations of age or intraoperative blood loss ≥500 ml with infection.</p><p><strong>Conclusion: </strong>This meta-analysis identified seven significant risk factors for post-hysterectomy infection, including AH, VH, obesity, gynecological cancer, operative time, diabetes, and smoking. These findings can help identify patients who have a higher risk of infection after hysterectomy so that appropriate measures can be implemented to improve the prognosis of these patients.</p><p><strong>Trial registration number: </strong>The review protocol was registered in PROSPERO. Unique Identifying Number (UIN) is \"CRD42024593870\".Hyperlink to the specific registration (must be publicly accessible and will be checked):\"https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=593870\".</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327784","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":"Clostridioides difficile in Honduras: a genomic and phenotypic characterization of the persistent RT027 and emergent RT002 genotypes.","authors":"Mauricio Andino-Molina, Mostafa Abdel-Glil, Fanny Hidalgo-Villeda, Edgardo Tzoc, Gernot Schmoock, Mathias W Pletz, Heinrich Neubauer, Christian Seyboldt","doi":"10.1016/j.jhin.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.06.001","url":null,"abstract":"<p><strong>Background: </strong>Clostridioides (C.) difficile is an anaerobic enteropathogen of clinical relevance in hospital and community settings. Its ubiquitous presence in pets, livestock, food, and the environment, together with its ability to form spores, facilitates its survival and spread. Hypervirulent and multidrug-resistant genotypes have been previously reported from Central America.</p><p><strong>Aim: </strong>To characterize thirty-one isolates from patients of two major hospitals in Honduras.</p><p><strong>Methods: </strong>second- and third-generation whole genome sequencing (WGS) and phenotypic antimicrobial susceptibility testing (AST).</p><p><strong>Findings: </strong>Two toxigenic PCR-ribotypes RT027 (ST1) and RT002 (ST8) were detected. All RT027/ST1 isolates (n=29) were resistant to moxifloxacin, tetracycline and linezolid, whereas RT002/ST8 isolates (n=2) were susceptible. In addition, a number of mobile genetic elements (MGE) associated with antimicrobial resistance were found in all RT027 isolates. Notably, core genome multilocus sequence typing and core genome single nucleotide polymorphism analysis demonstrated the close genetic relationship among RT027/ST1 isolates, their persistence since 2016, and an interhospital transfer event with unknown sanitary and economic consequences. In addition, RT002, a genotype with known implications for community-acquired C. difficile infection (CA-CDI) and possible zoonotic implications, is a remarkable finding in the national epidemiologic context.</p><p><strong>Conclusions: </strong>Taken together, our findings highlight the presence of persistent and community-relevant C. difficile strains and the consequent need to adopt and develop interventions to control and prevent CDI in the Honduran national health system within a One Health research approach.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327782","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 gowns in preventing nosocomial transmission of respiratory viruses: a systematic review.","authors":"Laura M Orsel, Juliëtte A Severin, Marjolein Knoester, Mariëtte Lokate, Andreas Voss, Cynthia P Haanappel, Jeroen J A van Kampen, Bart L Haagmans, Marion P G Koopmans, Karin Ellen Veldkamp, Rosa van Mansfeld, Herbert J de Jager, Anne F Voor In 't Holt, Edmée C Bowles","doi":"10.1016/j.jhin.2025.05.023","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.023","url":null,"abstract":"<p><strong>Introduction: </strong>During the COVID-19 pandemic, long-sleeved gowns were advocated as personal protective equipment for healthcare workers (HCW). The purpose of gowns is preventing transmission of infectious agents via the uniform or arms during contact with patients and their surroundings. Gowns, however, entail a substantial burden; in costs, workload for HCW, and generated waste. Our objective is to evaluate the current knowledge regarding the use of gowns during care of patients with COVID-19 and other respiratory viruses to prevent nosocomial transmission.</p><p><strong>Methods: </strong>We used the PRISMA guidelines and searched five databases (Medline, Embase, Web of Science, Cochrane, Google Scholar) until April 11th, 2023.</p><p><strong>Results: </strong>The search identified 2667 potentially relevant studies, of which 30 were selected and divided into four categories. In 12 studies, contamination rates of gowns ranged from 0% to 77.5% (median = 1.43%). Three out of seven studies showed that virus remained infectious the longest on Tyvek coveralls and plastic gowns, and the shortest on cotton and polyester. Two out of seven studies found a protective effect between HCW protective clothing and infection of HCW. Finally, three out of four studies concluded that short-sleeves, cotton gowns or no gowns provided the same level of protection as standard gowns.</p><p><strong>Conclusion: </strong>The results show viral RNA can be found on clothing, but it is unclear if viruses are transmitted to HCW and/or patients. Evidence for the protective effect of long-sleeved gowns over alternatives is still insufficient. Therefore, well-controlled and adequately powered laboratory transmission experiments that simulate real-life conditions are necessary.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327785","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":"Effect of an educational antimicrobial stewardship programme on antibiotic prescriptions' appropriateness in three medical units of a large university hospital: an interrupted time series analysis","authors":"F. Giovannenze ,&nbsp;P. Del Vecchio ,&nbsp;F. Frondizi ,&nbsp;E. Rando ,&nbsp;G.M. Leanza ,&nbsp;M.M. Gross ,&nbsp;A. Frater ,&nbsp;E. Magrini ,&nbsp;B. Liguoro ,&nbsp;F. Sangiorgi ,&nbsp;M. Fantoni ,&nbsp;C. Torti ,&nbsp;R. Murri","doi":"10.1016/j.jhin.2025.05.017","DOIUrl":"10.1016/j.jhin.2025.05.017","url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial stewardship (AMS) programmes aim to enhance antibiotic prescription quality, reduce antibiotic use, and combat multi-drug-resistant pathogens. However, the optimal AMS intervention for different clinical settings remains unclear, with previous studies predominantly focusing on antibiotic consumption rather than prescription appropriateness.</div></div><div><h3>Aim</h3><div>This study aimed to evaluate the impact of an education-based AMS intervention on antibiotic prescription appropriateness in three medical units of a 1500-bed university hospital.</div></div><div><h3>Methods</h3><div>We conducted a retrospective interventional, interrupted time series study, to test the effect of an educational programme in three medical units of our 1500-bed university hospital in Rome, from June 2018 to October 2019. The intervention comprised six educational meetings held over 3 months (December 2018 to February 2019). The primary outcome was the appropriateness of antibiotic prescriptions, with in-hospital survival as a secondary outcome.</div></div><div><h3>Findings</h3><div>Of 609 antibiotic prescriptions evaluated, the programme led to a significant and sustained reduction in inappropriate prescriptions in one unit (change in level: -18.15%, <em>P</em>&lt;0.01; change in trend: -3.21%, <em>P</em>=0.01), while it failed to demonstrate a significant reduction in the other two units and globally in the three units.</div></div><div><h3>Conclusion</h3><div>The same educational AMS programme led to variable results in terms of antibiotic appropriateness in three medical units with similar structural and organizational features. Larger and more tailored high-quality AMS interventional studies are needed to better understand the impact of educational programmes on the appropriateness of antibiotic prescriptions.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 127-135"},"PeriodicalIF":3.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259337","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":"Spillover effects on mortality within randomized concurrent controlled trials of antimicrobial based infection prevention interventions among the mechanically ventilated patient population. A reappraisal of Cochrane review data.","authors":"James C Hurley","doi":"10.1016/j.jhin.2025.05.021","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.05.021","url":null,"abstract":"<p><strong>Background: </strong>The ventilator associated pneumonia (VAP) and mortality prevention effects of topical chlorhexidine and topical antibiotic prophylaxis (TAP) have been widely studied in randomized concurrent controlled trials (RCCT's) among ICU patients receiving mechanical ventilation (MV). Do these interventions have spillover (population) effects on VAP and mortality incidences among these RCCT's additional to any direct (individual level) effects?</p><p><strong>Methods: </strong>The per-protocol (PP) and intention-to-treat (ITT) VAP and mortality data within five recent Cochrane reviews of antimicrobial based VAP prevention interventions were reconciled. VAP and mortality prevention effect size (ES) risk ratio estimates were derived using random effects for RCCT's with control group VAP incidences above versus below the upper limit of the widely accepted VAP incidence range.</p><p><strong>Results: </strong>The mortality prevention ES for RCCT's with control group VAP incidence >40% versus ≤40% was (Risk ratio & 95% confidence interval, 0.85; 0.76 - 0.96; n = 24) versus (1.0; 95% CI 0.91 - 1.1; n = 29), respectively. The corresponding summary control group mortality incidences were 29% (95% CI 24-35) versus 25% (95% CI 20-30), respectively, whereas the corresponding intervention group mortality incidences were 24% (95% CI 20-29) versus 23% (95% CI 19-28). Paradoxically, there was more dispersion amongst the control group mortality and VAP incidences than amongst the intervention group incidences.</p><p><strong>Conclusions: </strong>The findings here implicate spillover increasing VAP and mortality incidences and dispersion within control groups of topical antimicrobial intervention RCCT's. Hence, any inference of prevention is spurious. Moreover, these topical antimicrobial interventions increase mortality and are unsafe for ICU populations.</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":"144250943","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":"Regarding \"Optimization and evaluation of new decontamination procedures inactivating human prions\" recently published by Herzog and colleagues.","authors":"S Frol, U Jensen-Kondering, A Ihan","doi":"10.1016/j.jhin.2025.05.022","DOIUrl":"10.1016/j.jhin.2025.05.022","url":null,"abstract":"","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":"144250942","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":"Healthcare-associated infections and antimicrobial use in Ukrainian acute care hospitals involved in treatment of casualties of war: multi-centre cross-sectional study in 2024","authors":"A. Vodianyk ,&nbsp;E. Diomin ,&nbsp;A. Husakov ,&nbsp;I. Havrilov ,&nbsp;A. Horbachevskyi ,&nbsp;J. Habicht","doi":"10.1016/j.jhin.2025.05.015","DOIUrl":"10.1016/j.jhin.2025.05.015","url":null,"abstract":"<div><h3>Background</h3><div>The true burden of healthcare-associated infections (HAIs) in Ukraine remains unknown. A pilot point prevalence survey (PPS) of HAIs and antimicrobial use (AMU) was undertaken in Ukrainian hospitals in 2021, but the data are limited and do not represent changes in the burden of HAIs associated with the invasion of the Russian Federation in 2022. As such, in 2024, a PPS on HAI and AMU was conducted in five healthcare facilities to understand the burden of HAIs in Ukraine.</div></div><div><h3>Methods</h3><div>This research was designed as a multi-centre cross-sectional study. Four acute care tertiary level hospitals and one specialized institution participated in the study. Patients of all ages from surgical wards, intensive care units (ICUs) and medical wards were included. Data were collected on a single day for every ward, and the timeframe for the whole study was 1 month. HAI case definitions and the PPS procedure were based on the most recent documents of the European Centre for Disease Prevention and Control.</div></div><div><h3>Results</h3><div>In total, 660 patients were included in the study. Eighty-three patients had 91 HAIs, and the prevalence of HAIs was 12.6% point prevalence (pp). Thirty-seven (40.7%) HAIs were present on admission, and 54 (59.3%) were acquired during the current hospitalization. The most common type of HAI was surgical site infection (50.5%), followed by pneumonia (12.1%), skin and soft tissue infection (9.9%), urinary tract infection (6.6%), bloodstream infection (5.5%) and systemic infection (5.5%). The highest prevalence of HAI (51.9% pp) was observed in ICUs, followed by 12.1% pp on surgical wards. The most common organisms were <em>Acinetobacter</em> spp. (22.4%) and <em>Klebsiella</em> spp. (22.4%). All HAI pathogens showed very high resistance (66–100%) to third-generation cephalosporins, glycopeptides and carbapenems. The highest use of antimicrobials was recorded in ICUs (88.9% pp).</div></div><div><h3>Conclusions</h3><div>This study found a significant prevalence of HAIs in Ukrainian hospitals, higher than the European average. The AMU rate was comparable with the European rate, but with disproportionally higher use in ICUs.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 333-338"},"PeriodicalIF":3.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250940","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 cohorting carbapenem-resistant Acinetobacter baumannii (CRAB) patients combined with enhanced environmental cleaning on CRAB bloodstream infections: a prospective surveillance-based study","authors":"I. Margalit ,&nbsp;N. Pinas-Zade ,&nbsp;A. Fridlin ,&nbsp;B. Mechnik ,&nbsp;Y. Peretz ,&nbsp;H. Jaber ,&nbsp;R. Rapaport ,&nbsp;Y. Weiss-Ottolenghi ,&nbsp;M. Brod ,&nbsp;I. Ben-Zvi ,&nbsp;S. Amit ,&nbsp;Y. Levy ,&nbsp;N. Barda ,&nbsp;H. Yonath ,&nbsp;G. Regev-Yochay","doi":"10.1016/j.jhin.2025.05.016","DOIUrl":"10.1016/j.jhin.2025.05.016","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenem-resistant <em>Acinetobacter baumannii</em> (CRAB) infections carry high case-fatality rates. Although the incidence of these infections is increasing and therapeutic options are limited, effective interventions to prevent the cross-transmission of CRAB have rarely been tested.</div></div><div><h3>Aim</h3><div>To assess the impact of cohorting CRAB patients combined with intensified environmental cleaning on CRAB bloodstream infections (BSIs).</div></div><div><h3>Methods</h3><div>A quasi-experimental study at a tertiary hospital during January 2022 to June 2024. All patients with CRAB (either colonization or infection) hospitalized in the internal medicine departments were cohorted. Simultaneously, a twice-daily routine and a double terminal cleaning of all hospital rooms occupied by CRAB patients were performed. The monthly acquired CRAB BSI rates were calculated and the incidence rate ratio (IRR) estimated using Poisson regression discontinuity analysis with robust standard errors controlled for the influx of CRAB patients into the hospital.</div></div><div><h3>Findings</h3><div>During January 2022 to June 2024, 610 hospitalized patients with CRAB were identified, 350 (57%) of whom acquired the bacterium in hospital and 138 (39%) developed BSI. The average overall 30-day mortality rate was 61% and remained relatively similar throughout the study period. Cumulative BSI incidence decreased by 55%, from 1.43 per 10,000 hospitalization-days before the intervention to 0.65 afterwards. The slope of the BSI incidence rate decreased by 9% per month (adjusted IRR: 0.909; 95% CI: 0.834–0.990; <em>P</em> = 0.029).</div></div><div><h3>Conclusion</h3><div>Cohorting CRAB patients in the internal medicine departments, combined with intensified cleaning throughout the hospital, significantly reduced the incidence of CRAB BSI across the entire institution.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 326-332"},"PeriodicalIF":3.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250941","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}