Journal of Hospital Infection最新文献

{"title":"BURDEN OF CARBAPENEM RESISTANT GRAM-NEGATIVE BACTERIAL INFECTIONS IN VIETNAM - A NATIONAL HOSPITAL SURVEY.","authors":"Mattias Larsson, Truong Le Van Ngoc, Nguyen Thi Dung, Do Thi Ngat, Hoang Thi Bich Ngoc, Nong Minh Vuong, Doan Mai Phuong, Truong Thai Phuong, Pham Hong Nhung, Håkan Hanberger, Le Kien Ngai, Nandini Sreenivasan, Annick Lenglet, Anders Dalsgaard, Do Duy Cuong, Linus Olson","doi":"10.1016/j.jhin.2025.03.019","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.03.019","url":null,"abstract":"<p><strong>Introduction: </strong>The WHO Bacterial Pathogen Priority List 2024 highlights Carbapenem-Resistant Gram-Negative Bacteria (CRGNB), including Enterobacterales (CRE) and Acinetobacter baumannii (CRAB), followed by Pseudomonas aeruginosa (CRPA), as top priorities due to their virulence, resistance, transmission, and limited treatment options.</p><p><strong>Objective: </strong>This national hospital survey aimed to assess the burden of CRGNB infections and evaluate microbiological laboratory capacity across Vietnam.</p><p><strong>Methods: </strong>An online survey was distributed to central hospitals and provincial Departments of Health in Vietnam's 63 provinces, which then forwarded it to district and private hospitals.</p><p><strong>Results: </strong>A total of 324 hospitals participated: 20 central, 190 provincial, 106 district, and 8 private. Half reported microbiological capacity for bacterial culture and susceptibility testing. Among 57,667 reported Gram-negative isolates, 17,417 (30.2%) were CRGNB, including Klebsiella pneumoniae (CRE 37%), Escherichia coli (CRE 11%), Acinetobacter baumannii (CRAB 64%), and Pseudomonas aeruginosa (CRPA 39%). CRE sepsis treatment included cephalosporins, aminoglycosides, carbapenems, fluoroquinolones, and colistin. CRE infections were associated with higher crude mortality (31.7% vs. 20.2%, p<0.001), longer hospital stays (10.4 vs. 8.9 days, p<0.001), and higher costs (1,025vs.1,025vs.773, p<0.001) compared to carbapenem-susceptible Enterobacterales. Reported infection prevention and control (IPC) interventions included CRE surveillance (41%), isolation (36%), point prevalence surveys (15%), and cohort care (7%). IPC funding sources included general health insurance (40%) and hospital funds (32%).</p><p><strong>Conclusion: </strong>CRGNB pose a significant burden in terms of morbidity, mortality, and financial impact. Strengthening microbiological infrastructure, improving CRGNB screening, and enhancing IPC measures are urgently needed.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978373","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":"Facing Candidozyma auris: are Irish hospitals prepared?","authors":"S. Ali ,&nbsp;F. Fitzpatrick","doi":"10.1016/j.jhin.2025.08.002","DOIUrl":"10.1016/j.jhin.2025.08.002","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"165 ","pages":"Pages 16-18"},"PeriodicalIF":3.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978933","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":"Augmenting approaches to AMR prevention: a case for environmental sustainability within the WHO core components for infection prevention and control","authors":"J. Collins ,&nbsp;A. Krause","doi":"10.1016/j.jhin.2025.04.038","DOIUrl":"10.1016/j.jhin.2025.04.038","url":null,"abstract":"<div><h3>Background</h3><div>The growing challenge of antimicrobial resistance (AMR) is increasingly understood to be driven by multiple factors including the misuse of antimicrobial products and environmental pollution. However, targeted AMR action in health facilities focuses primarily on antimicrobial stewardship, with limited or no consideration for environmental drivers limiting programme impact. This article seeks to describe how health facilities can expand action against AMR through collaborative One Health approaches, building on the World Health Organization (WHO) core components for infection prevention and control (IPC).</div></div><div><h3>Methods</h3><div>A rapid review was conducted on the integration of environmental sustainability, IPC and antimicrobial stewardship across six databases for articles published globally, along with a review of publicly available contemporary guidance documents linked to IPC and environmental sustainability. Current IPC and sustainability practices were then compared with opportunities for sustainability identified across the WHO core components for IPC. Finally, a theorized causal pathway for the implementation of this strategy was developed.</div></div><div><h3>Results</h3><div>Despite increased calls for health facilities to embrace a One Health approach to AMR, there is limited evidence in the literature for how to achieve this. However, significant overlap exists between IPC and sustainability objectives. As such, the authors propose: (i) a theorized causal pathway; and (ii) a strategy to integrate environmental sustainability systematically across the eight WHO core components for IPC.</div></div><div><h3>Conclusion</h3><div>Action against AMR can be accelerated if hospital IPC and sustainability programmes adopt One Health approaches. A framework for this is proposed using the WHO core components for IPC given their widespread use.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"165 ","pages":"Pages 118-127"},"PeriodicalIF":3.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979343","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":"Variability in follow-up strategies for carbapenemase-producing Gram-negative carriers: results from an international scoping survey","authors":"A.C. Büchler ,&nbsp;A.F. Voor in ’t holt ,&nbsp;H. Humphreys ,&nbsp;J.A. Severin ,&nbsp;M.C. Vos ,&nbsp;ESCMID study group for Nosocomial Infections (ESGNI)","doi":"10.1016/j.jhin.2025.07.029","DOIUrl":"10.1016/j.jhin.2025.07.029","url":null,"abstract":"<div><h3>Background</h3><div>Follow-up strategies to confirm loss of carriage of multidrug-resistant bacteria are needed to safely discontinue infection prevention and control measures. There are currently no evidence-based criteria to determine when a carrier of carbapenemase-producing Gram-negative bacteria (CPGN) can be considered free of carriage.</div></div><div><h3>Aim</h3><div>This study assessed follow-up strategies currently used for known CPGN carriers.</div></div><div><h3>Methods</h3><div>An online survey was launched via the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Nosocomial Infections (ESGNI) to assess follow-up strategies for carbapenemase-producing Enterobacterales (CPE), <em>Acinetobacter baumannii</em> (CPAB), and <em>Pseudomonas aeruginosa</em> (CPPA), from October 2023 to February 2024. The survey consisted of 49 questions concerning follow-up strategies, and criteria for not screening and loss of carriage. Passive follow-up was defined as screening on occasions whereas active follow-up was prospectively planned. Descriptive analyses were performed.</div></div><div><h3>Findings</h3><div>One hundred and thirty-four respondents from 21 European and six non-European countries completed the survey. For CPE, more than 80% performed some kind of follow-up whereas 66.4% and 60.4% did so for CPAB and CPPA, respectively, with passive follow-up being most frequent. Passive follow-up was mostly performed when the carrier was newly admitted to hospital. Active follow-up was started within four months after first detection in 84–92%. Both consecutive negative screens and the interval from last detection were the most commonly reported criteria for confirming loss of carriage. However, there were no criteria for loss of carriage in 20–35%.</div></div><div><h3>Conclusion</h3><div>There is no consensus on the follow-up of CPGN carriers. Evidence-based strategies or consensus are urgently needed to decide when to stop preventive measures.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"165 ","pages":"Pages 109-117"},"PeriodicalIF":3.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978926","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":"Research priorities in infection prevention and control in Alberta, Canada: a modified Delphi process","authors":"J. Leal ,&nbsp;K. Bush ,&nbsp;F. Cundict ,&nbsp;J. Ellison ,&nbsp;H. Gagnon ,&nbsp;T. Herrick ,&nbsp;S. Jagpal ,&nbsp;G. Meyers ,&nbsp;C. Pearce ,&nbsp;E. Scott ,&nbsp;L. Stuber ,&nbsp;L. Armstrong ,&nbsp;B. McFerran ,&nbsp;B. Thurston ,&nbsp;J. Conly ,&nbsp;D. Dixit ,&nbsp;O. Larios ,&nbsp;S. Smith","doi":"10.1016/j.jhin.2025.07.023","DOIUrl":"10.1016/j.jhin.2025.07.023","url":null,"abstract":"<div><h3>Background</h3><div>Infection prevention and control (IPC) measures are critical to reduce the risk of healthcare-associated infections.</div></div><div><h3>Aim</h3><div>To identify, by consensus, specific IPC research questions where IPC evidence gaps exist, in the setting of Alberta Health Services/Covenant Health, Canada.</div></div><div><h3>Methods</h3><div>A multidisciplinary committee informed the consensus process. Individuals with expertise in IPC (Delphi panel) identified an initial set of questions (Delphi Round 1). Questions were grouped into common themes and categories. The committee conducted an interim prioritization to short-list the research questions. Using snowball sampling, local and national IPC partners ranked each research question by the level of importance and added questions missed in previous rounds (Delphi Round 2). The consensus meeting included elements from the James Lind Alliance and the Nominal Group Technique to prioritize the research questions. Participants included: infection control professionals; IPC leadership; physicians in IPC, infectious diseases, and microbiology; epidemiologists; analysts; government officials; quality and safety, and antimicrobial stewardship representatives; researchers; patients/family advisors.</div></div><div><h3>Findings</h3><div>There were 159 initial questions, with 63 categorized as research questions. Following interim prioritization and the second Delphi round, 21 questions were presented at the consensus meeting. The top ten research questions fell into five themes: behavioural science strategies with healthcare workers, impact of the patient environment, IPC guideline evaluation, intervention effectiveness, and surveillance and monitoring.</div></div><div><h3>Conclusion</h3><div>This consensus exercise identified IPC research questions that were important to healthcare workers, healthcare leaders, researchers, and patients. This work may generate a pan-Canadian dialogue to develop a national research agenda for IPC.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"165 ","pages":"Pages 89-99"},"PeriodicalIF":3.1,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876892","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":"Non-pharmacological interventions designed to support carriers of multi-drug-resistant organisms (MDROs): a systematic literature review","authors":"S. Gaube ,&nbsp;M. Pan ,&nbsp;A. Rath ,&nbsp;A. Caplunik-Pratsch","doi":"10.1016/j.jhin.2025.07.019","DOIUrl":"10.1016/j.jhin.2025.07.019","url":null,"abstract":"<div><h3>Background</h3><div>Carriers of multi-drug-resistant organisms (MDROs) often experience stigma, anxiety and uncertainty. Many feel inadequately informed, leading to distress and dissatisfaction.</div></div><div><h3>Aim</h3><div>To evaluate research on non-pharmacological interventions to support carriers of MDROs with their informational and psychological needs.</div></div><div><h3>Methods</h3><div>This systematic literature review followed the PRISMA guidelines, and MEDLINE, EMBASE and PsycINFO were searched between January 2000 and October 2024. Moreover, a comprehensive citation search was conducted to identify interventions. Findings on study characteristics, intervention types, and outcomes were synthesized narratively with a thematic analysis of reported implementation challenges and considerations.</div></div><div><h3>Finding</h3><div>Only four studies were identified, comprising a total of 238 participants. All interventions included educational components, and one also incorporated an emotional support element. The interventions aimed to improve knowledge, well-being and behavioural outcomes among MDRO carriers. Education was associated with improvements in knowledge, perceived informedness, and satisfaction, although findings on behavioural outcomes and well-being were mixed. Implementation challenges included resource constraints, integration into clinical workflows, sustainability, and variability in healthcare settings.</div></div><div><h3>Conclusions</h3><div>The main outcome of this review is the striking lack of research on how to address the non-medical needs of MDRO carriers. Although the limited available evidence suggests that education and emotional support interventions may be beneficial, methodological shortcomings limit the generalizability of these findings. This review highlights the urgent need for robust, scalable, patient-centred interventions to improve the experiences of MDRO carriers.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"164 ","pages":"Pages 114-124"},"PeriodicalIF":3.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859945","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":"Pharmacists’ perspective of antimicrobial stewardship programmes in the primary care setting in São Paulo","authors":"K. Mendonça ,&nbsp;A.R. Guedes ,&nbsp;B.M. Tavares ,&nbsp;D.A. Brandão ,&nbsp;G. Madalosso ,&nbsp;L.V. Perdigão- Neto ,&nbsp;A.S. Levin ,&nbsp;M.S. Oliveira","doi":"10.1016/j.jhin.2025.07.024","DOIUrl":"10.1016/j.jhin.2025.07.024","url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial stewardship programmes (ASPs) are essential to tackling antimicrobial resistance, particularly in primary care, where most prescribing occurs. Pharmacists play a key role in ASPs through patient education, prescription monitoring, and promoting appropriate use. This study assessed the status of ASPs in primary healthcare centres (PHCs) in São Paulo state from the pharmacists' perspective.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted between June 2023 and January 2024 among pharmacists working in PHCs across São Paulo. The questionnaire, based on CDC and ANVISA guidelines, addressed demographics, PHC characteristics, ASP activities, and pharmaceutical interventions. Descriptive statistics were used.</div></div><div><h3>Results</h3><div>Of 201 responses, 189 were eligible, representing PHCs in 68 cities. Most pharmacists (75%) had postgraduate education, and 70% worked in centres serving over 500 patients. Although 79% of PHCs used electronic medical records, only 32% had written ASP policies and 29% monitored antimicrobial use. Diagnostic resources were limited; respiratory virus tests were the most available (43%). Educational activities on antimicrobial use occurred in 26% of PHCs. Pharmaceutical interventions were reported by 77% of pharmacists, mainly related to dosage (54%) and treatment duration (25%), with high prescriber acceptance (≥80% in 34% of cases).</div></div><div><h3>Conclusions</h3><div>This study identified strengths and gaps in ASP implementation across PHCs. While improvements were seen in infrastructure and pharmacist training, key limitations remain in policy development, diagnostics, prescriber support, and public education. We recommend: (1) establishing local ASP policies, (2) expanding access to rapid diagnostics, (3) continuing education for prescribers and pharmacists, and (4) public awareness campaigns tailored to primary care.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"164 ","pages":"Pages 27-33"},"PeriodicalIF":3.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862712","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":"Patients' trust versus infection control: seeking an etiquette of hand hygiene.","authors":"C Tsagkaris, J Bartkova, S Streich, M Saridi","doi":"10.1016/j.jhin.2025.07.028","DOIUrl":"10.1016/j.jhin.2025.07.028","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859946","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":"Corrigendum to ‘Glove breach occurrence during surgical procedures: the benefits of double/indicator system gloves’ [Journal of Hospital Infection 161 (2025) 92–113]","authors":"M.G. Rippon ,&nbsp;A.A. Rogers ,&nbsp;K.J. Ousey","doi":"10.1016/j.jhin.2025.07.011","DOIUrl":"10.1016/j.jhin.2025.07.011","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"163 ","pages":"Page 87"},"PeriodicalIF":3.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828745","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 air pressure transients on the spread of bacteria from wash-hand basin sink traps in hospital en-suite bathrooms: a laboratory-based pilot study","authors":"M. Gormley ,&nbsp;D.A. Kelly ,&nbsp;D.P. Campbell ,&nbsp;T.J. Aspray ,&nbsp;T. Dight","doi":"10.1016/j.jhin.2025.07.026","DOIUrl":"10.1016/j.jhin.2025.07.026","url":null,"abstract":"<div><h3>Background</h3><div>There is growing evidence for the involvement of sink and wash-hand basin traps in the spread of hospital-acquired infections in clinical settings. This pilot study used a full-scale model of a hospital wash-hand basin and wastewater drainage system, typical in single-occupancy hospital bathrooms, to examine bacterial transmission from sink traps to wash-hand basins during drainage system air pressure surges.</div></div><div><h3>Methods</h3><div>Simulating real-world conditions in a laboratory, a 50-m pipe network was connected to the model en-suite bathroom. Air pressure surges were generated within the pipe connection to the sink trap containing <em>Pseudomonas alloputida</em> KT2440 as a safe model bacterium. Measurements were made of air pressure, aerosol levels, and viable bacterial counts of the sink appliance using contact plates.</div></div><div><h3>Results</h3><div>Positive air pressure surges allowed water from the sink trap containing <em>P. alloputida</em> KT2440 to enter the wash-hand basin. Positive air pressure surges generated aerosols above the sink trap strainer. The strainer became contaminated without visible water ingress. Aerosols formed even without visible water, indicating sub-strainer agitation. Bacteria from the sink trap spread to surfaces, with viable cells recovered. Pressure surges occur naturally and increase with activities such as drain jetting.</div></div><div><h3>Conclusions</h3><div>For the first time, it was shown that air pressure surges in wastewater drainage systems can spread bacteria from contaminated sink traps to wash-hand basins, particularly via aerosols. This emphasizes the need for a re-examination of hospital wastewater drainage system design and maintenance in order to mitigate this mechanism of contamination.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"165 ","pages":"Pages 32-40"},"PeriodicalIF":3.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857076","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}