Journal of Hospital Infection最新文献

{"title":"The efficacy and safety of disposable endoscopes in reducing persistent microbial contamination: a systematic review and meta-analysis comparing technical performance with reusable endoscopes","authors":"H. Hamdar ,&nbsp;A.M. Agour ,&nbsp;G.T. Guergues ,&nbsp;P. Sydhom ,&nbsp;A.S. Al-Shammari ,&nbsp;A. Al Bazzal ,&nbsp;J. Jaber ,&nbsp;J. Nasrallah ,&nbsp;A. Jawad ,&nbsp;S.M. Attalah ,&nbsp;M.T. Hassan","doi":"10.1016/j.jhin.2025.07.025","DOIUrl":"10.1016/j.jhin.2025.07.025","url":null,"abstract":"<div><h3>Background</h3><div>Endoscopy is essential for diagnosis and treatment, but reusable endoscopes pose contamination risks despite strict cleaning. Disposable endoscopes may reduce this risk.</div></div><div><h3>Aim</h3><div>To evaluate the effectiveness of disposable endoscopes in minimizing microbial contamination compared to reusable endoscopes.</div></div><div><h3>Methods</h3><div>In this systematic review and meta-analysis, PubMed, Web of Science, and Scopus were searched up to March 1^st, 2024, for cohort, case–control, and randomized controlled trials comparing reusable and disposable endoscopes in terms of performance and contamination. Data were analysed using mean difference (MD) and risk ratio (RR) with 95% confidence interval (CI). Publication bias was assessed using the Luis Furuya-Kanamori (LFK) index, and heterogeneity was evaluated with <em>I</em>² and Cochran's <em>Q</em> test.</div></div><div><h3>Findings</h3><div>This meta-analysis included 15 studies; disposable endoscopes were used by 2571 participants, reusable ones by 5607. The latter was found to have a 25% higher complication risk (RR: 1.25; 95% CI: 1.08–1.44). The fever incidence was much lower in the disposable group (RR: 0.38; 95% CI: 0.20–0.72). No meaningful differences were found in the hospital stay (MD: –0.14; 95% CI: –0.39 to 0.11). Significant differences were not shown by positive urine cultures (RR: 1.93; 95% CI: 0.03–123.15) or urosepsis rates (RR: 0.45; 95% CI: 0.16–1.27).</div></div><div><h3>Conclusion</h3><div>Disposable endoscopes have notably reduced fever risk in comparison to reusable ones. However, urosepsis rates, positive urine cultures, and hospital stay showed no differences. Consideration of cost and environmental impact is recommended.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"165 ","pages":"Pages 128-142"},"PeriodicalIF":3.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849663","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":"Bayesian Inference of Nosocomial Methicillin-resistant Staphylococcus aureus Transmission Rates in an Urban Safety-Net Hospital.","authors":"Kiel Corkran, Majid Bani-Yaghoub, Gary Sutkin, Arash Arjmand, Susanna Paschal","doi":"10.1016/j.jhin.2025.07.018","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.07.018","url":null,"abstract":"<p><p>Methicillin-resistant Staphylococcus aureus (MRSA) is a strain of Staphylococcus aureus that poses significant challenges for effective treatment and infection control within healthcare settings. Recent research suggests that the incidence of healthcare-associated MRSA (HA-MRSA) is higher among patients treated in safety-net hospitals when compared to other healthcare settings. This study aimed to identify HA-MRSA transmission patterns across various nursing units of a safety-net hospital. This study employed Bayesian inference to investigate the transmission patterns of HA-MRSA across multiple nursing units within a safety-net hospital. Using surveillance data from 2019 to 2023, a compartmental disease model was constructed and validated to estimate MRSA transmission rates and basic reproduction number () for each nursing unit. Posterior probability distributions for MRSA transmission, Isolation, and hospital discharge rates were computed using the Delayed Rejection Adaptive Metropolis (DRAM) Bayesian algorithm. Analysis of 187,040 patient records revealed that inpatient nursing units exhibited the highest MRSA transmission rates in three out of the five years studied. Notable transmission rates were observed in certain inpatient and progressive care units (0.55 per individual per month; 0.018 per individual per day) and the surgical ICU (0.44 per individual per month; 0.015 per individual per day). In contrast, the Nursery NICU and Medical ICU had the lowest transmission rates. Although MRSA transmission rates significantly declined across all units in 2021, these rates rebounded to pre-pandemic levels in subsequent years. Notably, outbreaks emerged in units such as ICUs and progressive care units that had not experienced prior MRSA outbreaks since 2019. While MRSA transmission significantly declined during the initial phase of the pandemic, the pathogen reestablished itself in later years. These findings highlight the persistent and evolving challenge of HA-MRSA transmission in safety-net hospital settings, where resource constraints and patient vulnerability may contribute to elevated transmission risks.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849654","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":"Beyond Handrubs: QAC Wipes as a Water-Sparing Alternative for Protein-Contaminated Hand Hygiene with Persistent Dorsum Challenges.","authors":"Yuhua Yuan, Jin Zhao, Kunkun Leng, Yang Cao, Hui Jin","doi":"10.1016/j.jhin.2025.07.015","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.07.015","url":null,"abstract":"<p><strong>Background: </strong>This study compared the effectiveness of quaternary ammonium compound (QAC) wipes, handwashing, and hydrogen peroxide-enhanced alcohol-based hand rubs (ABHRs) in removing microorganisms from hands contaminated with proteinaceous organic matter.</p><p><strong>Methods: </strong>A self-controlled crossover trial recruited 15 volunteers who received standardized hand hygiene training. Participants underwent three intervention methods: (1) handwashing with non-antimicrobial soap and running water for 60 seconds; (2) hand rubbing with 70% ethanol + 0.2% hydrogen peroxide for 30 seconds; and (3) hand wiping with QAC wipes for 60 seconds. Both hands were contaminated with Staphylococcus aureus (1.0-9.0 × 10⁶ CFU/mL) and supplemented with 3% bovine serum albumin (BSA). The microbial reduction was quantified using log₁₀ CFU/hand for three regions (fingers, palm, and dorsum).</p><p><strong>Results: </strong>The efficacy of QAC wipes in bacterial removal from all three hand regions was non-inferior to soap, whereas its performance was significantly superior to that of handrub. Wipes and soap showed lower efficacy on the dorsum compared to the fingers (P < 0.001). The efficacy ranking across hand regions was: fingers > palm > dorsum, and the overall intervention efficacy ranking was: soap = wipes > handrub.</p><p><strong>Conclusion: </strong>When QAC wipes are used under conditions of organic contamination with a 60-second procedural wiping protocol, the efficacy is not inferior to handwashing with soap, offering a feasible alternative in water-scarce environments. Handrubs show significantly lower efficacy in protein-rich environments. The poor bacterial removal efficiency on the dorsum of the hand highlights an anatomical oversight in hygiene practices, necessitating technical improvements.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849655","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":"Central venous catheters in very low birthweight infants: results from a national survey","authors":"J. Retzmann ,&nbsp;A. Grimm ,&nbsp;E. Frieauff ,&nbsp;D. Schröder ,&nbsp;S. Dartsch ,&nbsp;S. Kampmeier ,&nbsp;C. Härtel ,&nbsp;C. Silwedel","doi":"10.1016/j.jhin.2025.07.027","DOIUrl":"10.1016/j.jhin.2025.07.027","url":null,"abstract":"<div><h3>Background</h3><div>Central venous catheters (CVCs) are commonly used in preterm infants. They ensure secure vascular access but are also linked to relevant complications such as catheter-associated infections. Data on CVC practice in neonatal intensive care units (NICUs) are scarce, and management has rarely been comprehensively evaluated to date.</div></div><div><h3>Aim</h3><div>To evaluate daily practice of CVC usage in German tertiary level NICUs.</div></div><div><h3>Methods</h3><div>Using a web-based survey, all 163 tertiary level NICUs in Germany were asked to provide information on local CVC practices, including indications, catheter types, and infection prevention measures.</div></div><div><h3>Findings</h3><div>Anonymized data from <em>N</em> = 88 NICUs were analysed (response rate: 54%). Difficult venous access (85%) as well as administration of inotropes (90%) or parenteral nutrition (84%) were named as the most common reasons for CVC insertion. Peripherally inserted central catheters were the preferred catheter type (90–91% in weeks 1–2). Bloodstream infections were identified as the most frequent catheter-associated complication (65%). Key infection prevention measures highlighted by participants included strict hygiene upon catheter insertion (93%) and handling (83%) as well as early catheter removal (90%). However, practices varied significantly across units, particularly regarding skin antisepsis, routine dressing and catheter changes, antimicrobial prophylaxis, and device stewardship.</div></div><div><h3>Conclusion</h3><div>This survey provides a comprehensive overview of CVC use in German NICUs. It reveals significant variations in practices, reflecting both adherence to and deviations from national recommendations, thereby emphasizing areas of strength as well as opportunities for improvements, such as benchmarking for device stewardship.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"165 ","pages":"Pages 73-80"},"PeriodicalIF":3.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849656","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":"Feasibility of lock solutions for epicutaneo-caval catheters in neonates: the ‘LOOSEN’ pilot study","authors":"V. D'Andrea ,&nbsp;G. Prontera ,&nbsp;G. Vento","doi":"10.1016/j.jhin.2025.07.014","DOIUrl":"10.1016/j.jhin.2025.07.014","url":null,"abstract":"<div><div>Epicutaneo-caval catheters are vital in neonatal care, but are prone to occlusion and infection. This pilot study evaluated whether a 1-h saline lock, combined with proper flushing and anti-reflux connectors, affects catheter patency in neonates. Catheter patency was assessed using infusion pressure (pre- and post-lock) as a surrogate measure. The findings support the feasibility and safety of short lock periods, thereby laying the groundwork for future use of antimicrobial lock solutions in neonatal care.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"164 ","pages":"Pages 91-95"},"PeriodicalIF":3.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849657","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":"Use of continuous remote sensor water temperature monitoring to rationalize provision of clinical handwash basins in an ICU with water safety issues","authors":"L.B. Snell ,&nbsp;A. Hussein ,&nbsp;O. Abadioru ,&nbsp;M. Dibbens ,&nbsp;J. Whitehorn ,&nbsp;R. Nichols ,&nbsp;L. May ,&nbsp;S. Coates ,&nbsp;N.A. Barrett ,&nbsp;H. Winteridge ,&nbsp;J.A. Otter ,&nbsp;S.D. Goldenberg","doi":"10.1016/j.jhin.2025.07.021","DOIUrl":"10.1016/j.jhin.2025.07.021","url":null,"abstract":"<div><h3>Background</h3><div>Periodic manual measurement of water temperatures to demonstrate sufficient control of waterborne pathogens is labour intensive and does not provide a comprehensive overview of the whole water distribution system. In particular, low-use outlets (which result in water stagnancy and risk of growth of opportunistic premise plumbing pathogens) may be difficult to identify using such a limited dataset. Continuous remote sensor water temperature monitoring systems are used increasingly to obtain a more accurate dataset.</div></div><div><h3>Methods</h3><div>A continuous remote sensor water temperature monitoring system was installed to the hot and cold water supply of 15 clinical handwash basins in an intensive care unit to monitor usage and temperature fluctuations over 100 days.</div></div><div><h3>Results</h3><div>Two clinical handwash basins were clearly identified as low use and were unused on multiple occasions for periods &gt;24 h. This was likely related to the poor architectural design of the ward, placement of the outlets and lack of space. These two outlets were decommissioned and a further 100-day period of data monitoring was observed. The total number of days without activation decreased by 55% overall for the hot water supply (82 vs 37 days without activation) and by 36% overall for the cold water supply (193 vs 124 days without activation).</div></div><div><h3>Conclusion</h3><div>Continuous remote sensor water temperature monitoring systems can generate a more comprehensive and accurate dataset that is difficult to achieve with periodic manual monitoring. This allowed two outlets to be decommissioned, which was associated with improved water utilization across the rest of the unit.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"165 ","pages":"Pages 1-8"},"PeriodicalIF":3.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849664","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 effect of continuous UV-C disinfection on microbial contamination of a handwash basin.","authors":"P Norville, M A C Wilkinson, E Shale, E Holden, M Garvey","doi":"10.1016/j.jhin.2025.07.012","DOIUrl":"10.1016/j.jhin.2025.07.012","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849662","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":"Origin and transmission of carbapenemase-producing Enterobacterales and vancomycin-resistant enterococci in hospitalized patients: a genomic and epidemiological analysis","authors":"J.H. Kim ,&nbsp;J.E. Seong ,&nbsp;Y.S. Lee ,&nbsp;J.A. Lee ,&nbsp;J.Y. Ahn ,&nbsp;S.J. Jeong ,&nbsp;N.S. Ku ,&nbsp;J-S. Yeom ,&nbsp;D. Yong ,&nbsp;J.Y. Choi","doi":"10.1016/j.jhin.2025.07.017","DOIUrl":"10.1016/j.jhin.2025.07.017","url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial resistance is an emerging threat, with carbapenemase-producing Enterobacterales (CPE) and vancomycin-resistant enterococci (VRE) posing substantial challenges. This study investigated CPE/VRE acquisition and spread in hospitalized patients by analysing resistance genes and microbiomes using whole-genome sequencing (WGS), and exploring epidemiological and clinical risk factors.</div></div><div><h3>Methods</h3><div>This retrospective study included patients from the infectious disease department of a tertiary hospital. Stool samples were collected weekly, together with clinical and epidemiological information. Those in which CPE/VRE were isolated underwent WGS to evaluate the presence of resistance genes. Microbiome analysis was performed at admission and discharge. WGS was also performed for all positive samples collected within the hospital during the study period.</div></div><div><h3>Results</h3><div>Of the 102 participants, 16 (15.7%) had CPE/VRE at admission. Key risk factors for harbouring CPE/VRE at admission included recent hospitalization, surgery and antibiotic use. The first week of hospitalization was critical for acquiring CPE/VRE, with dementia, central or urinary catheters, and carbapenem use being significant risk factors. CPE/VRE acquired post-admission shared resistance genes with circulating hospital strains, whereas those present at admission featured novel genes such as <em>bla</em>_OXY-4-1 and <em>optrA</em>. Microbiome analysis revealed significant differences in species abundance and reduced diversity at discharge.</div></div><div><h3>Conclusions</h3><div>The probability of having CPE/VRE at admission to the infectious disease department was high. Stringent infection control measures are essential for preventing the spread of CPE/VRE and the introduction of novel resistance genes.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"165 ","pages":"Pages 100-108"},"PeriodicalIF":3.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849660","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":"New shine on an old habit: a pilot study on a glow soap faucet system","authors":"L. Kubas ,&nbsp;A. Swenson ,&nbsp;S. Penn ,&nbsp;K. Christenson ,&nbsp;J. Tjepkes ,&nbsp;J.Y. Ziegenfuss ,&nbsp;R.C. Aga ,&nbsp;J. Christenson","doi":"10.1016/j.jhin.2025.07.016","DOIUrl":"10.1016/j.jhin.2025.07.016","url":null,"abstract":"<div><div>Proper handwashing technique and consistent compliance reduce healthcare-associated infections. A recently developed glow soap faucet system (GSFS) illuminates a fluorescent soap, thereby allowing users to visualize glow soap coverage and removal in an engaging manner. A GSFS was placed in a medical training facility, and healthcare worker reception was very positive; 93% reported that a GSFS would ‘probably’ or ‘definitely’ decrease infection rates in workplaces similar to theirs (<em>N</em> = 136). Further, a handwashing study of non-medical participants found that GSFS washes left 3.1× fewer bacteria on hands compared with standard washes (bacteria log10 reduction of 2.1 vs 1.6; <em>P</em> &lt; 0.01).</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"164 ","pages":"Pages 51-54"},"PeriodicalIF":3.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849659","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 of surgical site infection in liver transplantation recipients: a systematic review and meta-analysis","authors":"S. Jin ,&nbsp;X. Wei ,&nbsp;X. Wang ,&nbsp;W. Zhang ,&nbsp;C. Wang ,&nbsp;Y. Kang ,&nbsp;Y. Sun ,&nbsp;W. Yang ,&nbsp;B. Wang","doi":"10.1016/j.jhin.2025.07.013","DOIUrl":"10.1016/j.jhin.2025.07.013","url":null,"abstract":"<div><div>Surgical site infection (SSI) is a common and significant complication following organ transplantation, with liver transplantation (LT) being particularly susceptible to high infection rate. Despite its prevalence, no systematic meta-analysis has integrated evidence across major risk factors associated with post-LT SSI. We performed a systematic review and meta-analysis of studies from PubMed, Embase, Web of Science, and the Cochrane Database. We searched for eligible articles through April 2025. Of 8593 articles screened, 18 were included. R 4.1.3 software was used for this meta-analysis. Eighteen studies, including data from 9874 LT recipients and 1619 reported infection events, were included. Our analysis identified two LT-specific factors associated with elevated SSI risk: Roux-en-Y anastomosis (odds ratio (OR) 2.61, 95% confidence interval (CI) 1.95 to 3.26, <em>I</em>^<em>2</em> = 43.37%), graft-to-recipient weight ratio (GRWR) &lt;0.01 (OR 2.19, 95% CI 1.54 to 2.84, <em>I</em>^<em>2</em> = 0%). In addition, re-transplantation, preoperative haemodialysis, biliary complications, and prior surgical history constitute significant risk factors. The meta-analysis revealed an overall SSI incidence rate of 21% across the investigated studies. Given the serious implications of SSI, increasing awareness of these risk factors and implementing targeted prevention strategies should be a priority for clinicians to reduce SSI rate after LT.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"164 ","pages":"Pages 34-42"},"PeriodicalIF":3.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849661","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}