Journal of Hospital Infection最新文献

{"title":"A Systematic Review of Antimicrobial Stewardship Interventions Implemented in Intensive Care Units.","authors":"Onyansaniba K Ntim, Bismark Opoku-Asare, Eric S Donkor","doi":"10.1016/j.jhin.2025.04.020","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.04.020","url":null,"abstract":"<p><p>Antimicrobial stewardship (AS) is essential to ensure appropriate antimicrobial usage and subsequently reduce the emergence of microbial resistance. The intensive care unit is a crucial place for monitoring antimicrobial usage due the frequent exposure to infections. This review provides an update on the current status of antimicrobial stewardship intervention utilized in intensive care settings. A comprehensive search was performed in Cochrane, Web of Science, and PubMed using keywords grouped into Antimicrobial, Stewardship, and Intensive care unit. The search was restricted to original articles published from April 2015 to November 2024. Out of 1,234 records retrieved from the databases, 55 studies were included in this systematic review. Most of the studies were conducted in the United States (n = 9), followed by China (n = 8), India (n = 5), and Italy (n = 4). We identified seven key antimicrobial stewardship (AS) strategies: multi-interventions ASP (22 studies, 40%), prospective feedback and audit (11 studies, 20%), procalcitonin (PCT) protocols for guiding antimicrobial use (12 studies, 21.8%), protocols for antimicrobial de-escalation (4 studies, 7.3%), antimicrobial restrictions or preapprovals (4 studies, 7.3%), diagnostic stewardship (1 study, 1.8%), and guidelines for antimicrobial prescription (1 study, 1.8%). A reduction in targeted or overall antimicrobial usage was reported in most studies (34/42). Specifically, all studies implementing multi-invention ASPs reported a successful reduction in antimicrobial utilization. Some antimicrobial stewardship interventions significantly enhanced the appropriateness of antimicrobial prescriptions. In addition, patient health outcomes were not compromised by antimicrobial reduction. Nonetheless, future studies at a larger scale over a longer time are recommended to accurately assess the impact of AS programme on patient health outcomes.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009218","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":"Implementation of surgical site infection prophylaxis in children - a cross sectional prospective study.","authors":"Chiara Paganetti, Ulrike Subotic, Carlos Sanchez, Csongor Deak, Rachel Kusche, Giuseppe Autorino, Mario Mendozy-Sagaon, Viktoria Amanda Pfeifle, Renato Gualtieri, Klara Posfay-Barbe, Rebecca Oppenheim, Nicolas Jauquier, Markus Lehner, Michael Buettcher, Jasmin Männer, Angela Beccarelli, Kathrin Meier, Julia A Bielicki, Isabella N Bielicki","doi":"10.1016/j.jhin.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.03.018","url":null,"abstract":"<p><strong>Background: </strong>Surgical Site Infections (SSI) are a common cause for morbidity and mortality in both adults and children. In paediatric surgery, evidence on specific prevention measures is lacking and practice mainly depends on local guidelines and treating team's preferences. Aim We aimed to investigate current practice for children undergoing surgery with respect to SSI prevention using a standardized surveillance tool.</p><p><strong>Methods: </strong>Nine Swiss paediatric surgery centres participated in a standard period prevalence study. SSI prevention measures were recorded in these hospitals during seven consecutive days in October 2022 for any paediatric surgical procedure resulting in a surgical wound. The SSI prevention measures of interest were drawn from the most recent WHO guidelines. Findings 351 procedures were included. All Swiss language regions were represented. Traumatologic/orthopaedic surgeries were most common. Surgical antibiotic prophylaxis was administered in 161/351 (46%) of all cases, though in 33/161 (21%) of cases, there was no indication for the administration of antibiotics. Alcohol-based or iodine-based solutions were most often used for surgical skin preparation. Antimicrobial-coated sutures were only used in 84/351 (24%) of cases. Regional differences in prevention measures were noted between participating centres for skin preparation solution, suture material, wound dressing, and implementation of warming devices.</p><p><strong>Conclusion: </strong>This study provides an overview of current SSI prevention practices in Swiss paediatric surgery centers, identifies targets for improvement, and highlights areas of clinical uncertainty requiring further investigation. The findings underscore the need for standardized guidelines to ensure consistent and evidence-based SSI prevention strategies in paediatric surgery.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026677","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 use of a Poisson hidden Markov model for automated detection of hospital outbreaks with vancomycin-resistant enterococci in routine surveillance data","authors":"S.A.M. van Kessel ,&nbsp;C.C.H. Wielders ,&nbsp;J. van de Kassteele ,&nbsp;A. Verbon ,&nbsp;A.F. Schoffelen ,&nbsp;ISIS-AR study group ,&nbsp;SO-ZI/AMR study group","doi":"10.1016/j.jhin.2025.04.025","DOIUrl":"10.1016/j.jhin.2025.04.025","url":null,"abstract":"<div><h3>Background</h3><div>Despite the low prevalence of infections due to vancomycin-resistant enterococci (VRE) in the Netherlands, VRE is a frequent source of hospital outbreaks. We investigated whether a Poisson hidden Markov model (PHMM) can detect in-hospital VRE outbreaks in routine data from the Dutch Infectious Diseases Surveillance Information System for Antimicrobial Resistance (ISIS-AR).</div></div><div><h3>Methods</h3><div>We performed a retrospective data linkage study from 2013 up to 2023, including data from 89 hospitals on VRE isolates from ISIS-AR. A PHMM was used to detect potential outbreaks based on weekly VRE counts at hospital level. Per week <em>t</em>, the model provides the probability <em>P</em> that the observed count arose from an outbreak. Thresholds of <em>P</em>(<em>t</em>) &gt;0.5, <em>P</em>(<em>t</em>) &gt;0.7, and <em>P</em>(<em>t</em>) &gt;0.9 for at least two consecutive weeks were used. The PHMM's results were compared with outbreaks voluntarily reported to the ‘Early warning and response meeting on highly resistant microorganism outbreaks in healthcare institutes’. Detection percentages were calculated and VRE counts of reported but undetected outbreaks, and detected but unreported outbreaks were described.</div></div><div><h3>Findings</h3><div>Of the 85 reported outbreaks, the model detected 87%, 86%, and 81% for thresholds <em>P</em>(<em>t</em>) &gt;0.5, <em>P</em>(<em>t</em>) &gt;0.7, and <em>P</em>(<em>t</em>) &gt;0.9, respectively. Undetected outbreaks were mainly small outbreaks. The PHMM detected 66, 55, and 44 unreported potential outbreaks, respectively, with 44%, 35%, and 30% involving only one to two VRE-positive patients.</div></div><div><h3>Conclusion</h3><div>Overall, the PHMM shows potential for detecting in-hospital VRE outbreaks in routine surveillance data, with high detection rates. A prospective study is needed for further optimization for clinical practice.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 62-67"},"PeriodicalIF":3.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029377","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":"Predictors of early line removal and successful line retention in potential central line-associated blood stream infections (CLABSIs) in haematology patients: A retrospective cohort study.","authors":"Samuel Thorburn, Sara Vogrin, Sarah Garner, Olivia Smibert, Gemma Reynolds, Jason Kwong, Jason A Trubiano, Abby P Douglas","doi":"10.1016/j.jhin.2025.04.019","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.04.019","url":null,"abstract":"<p><strong>Background: </strong>Patients with haematologic malignancies are at risk of central line associated bloodstream infections (CLABSI) and their adverse outcomes. Line removal is often considered necessary for cure but creates substantial morbidity, and neutropenic patients often have alternative sources of bloodstream infection (BSI). Patients suitable for a line retention strategy remain ill-defined.</p><p><strong>Methods: </strong>We conducted a single centre retrospective cohort study of haematology inpatients who developed BSI with a central line in situ. Line retention was defined as line remaining in situ for ≥72 hours post BSI. The primary outcome was failure of line retention, defined as line removal >72 hours post BSI or recurrent BSI with the same organism within 3 months. Predictors of failure of line retention, early line removal (<72 hours) and IDSA central line related BSI (CRBSI) (research-definition CRBSI) were assessed using multivariable analysis.</p><p><strong>Results: </strong>Of 288 episodes of BSI included between 1/1/2018 and 31/12/2022, 209 cases had retention of line >72 hours and 52 of these (24.9%) experienced failed line retention, with prolonged culture positivity predicting this outcome, and source of BSI other than the line associated with successful line retention on multivariate analysis. 79 (27.4%) had early line removal, with factors associated including intensive care admission, prolonged positive cultures and meeting research-definition CRBSI. Only 27 (9.4%) BSI episodes met the research-definition CRBSI.</p><p><strong>Conclusions: </strong>Many central lines were removed despite infrequent formal CLABSI diagnoses. Thorough assessments for alternative sources and use of non-invasive diagnostics including repeat blood cultures prior to line removal, may allow increased appropriate retention of lines.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060226","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 worker attitudes to lateral flow device testing and sick leave for influenza-like illness in the UK: A hypothetical scenario-based study.","authors":"Katie Munro, Quisha Bustamante, Lucy Findlater, Dominic Sparkes, G James Rubin, Ana Atti, Sarah Foulkes, Susan Hopkins, Victoria Hall, Jasmin Islam","doi":"10.1016/j.jhin.2025.04.018","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.04.018","url":null,"abstract":"<p><strong>Background: </strong>Widespread use of lateral flow device (LFD) testing of healthcare workers (HCW) during the COVID-19 pandemic allowed for rapid diagnosis, informing sickness absence.</p><p><strong>Aims: </strong>In winter 2023-24, we investigated HCW attitudes towards sickness absence based on LFD availability and results.</p><p><strong>Methods: </strong>Within the SIREN (SARS-CoV-2 Immunity and Reinfection Evaluation) HCW cohort, participants were randomised into one of four hypothetical scenarios: waking-up with fever, cough, runny nose and: a) LFD unavailable b) LFD negative c) LFD positive for COVID-19 or d) LFD positive for influenza. For each scenario, participants were then asked if they would attend work, their rationale, when they would return to work, and their attitudes toward LFD use. Proportions were calculated to compare scenarios.</p><p><strong>Findings: </strong>5,357 participants were included, with similar demographics across scenarios. >80% would stay at home if COVID-19 or influenza LFD positive, 54% if testing was unavailable and 39% if LFD negative. The main reason for not taking leave was concern about increasing their colleagues' workload. For each scenario, most participants reported they would return to work only when feeling well enough. However, in the COVID-19 positive scenario, a higher proportion of participants reported they would wait 5 days before returning to work. 84% reported they would use an LFD before work if they had influenza-like illness symptoms, regardless of hospital policy.</p><p><strong>Conclusion: </strong>We demonstrate LFD results are useful in helping HCWs make decisions on whether to attend work if symptomatic. LFDs remain an important consideration in managing HCW infections and may reduce transmission of respiratory infections during winter.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058610","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":"Comparative Analysis of Machine Learning Models for Predicting Hospital- and Community-Associated Urinary Tract Infections Using Demographic, Hospital, and Socioeconomic Predictors.","authors":"Arash Arjmand, Majid Bani-Yaghoub, Gary Sutkin, Kiel Corkran, Susanna Paschal","doi":"10.1016/j.jhin.2025.04.024","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.04.024","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTI) are among the most common infections encountered in both community and healthcare settings. Differentiating between community-associated UTI (CA-UTI) and healthcare-associated UTI (HA-UTI) is crucial for understanding their epidemiology, identifying risk factors, and developing appropriate treatment strategies. Machine learning (ML) techniques have shown significant potential in improving the accuracy of predicting these infections, enabling more effective interventions and better patient outcomes. While previous studies have demonstrated the utility of ML models in various healthcare settings, there is still a need for a comparative analysis of different ML approaches, particularly in distinguishing between CA-UTI and HA-UTI and assessing the risk of UTI among hospitalized patients.</p><p><strong>Objective: </strong>Using 2019-2023 patient demographics, hospital, and socioeconomic data, this study aims to build, validate, and compare machine learning models-Decision Tree (DT), Neural Network (NN), Logistic Regression (LR), Random Forest (RF), and Extreme Gradient Boosting (XGBoost) to differentiate between the incidences of HA-UTI and CA-UTI. Additionally, it seeks to identify key predictors of UTI using demographic, hospital, and socioeconomic variables.</p><p><strong>Results: </strong>The DT model demonstrated the highest sensitivity, particularly in handling the highly imbalanced data of HAI, with a sensitivity of 87%. LR achieved the best overall accuracy, at 95.9% for HA-UTI and 93.2% for HA-UTI vs. CA-UTI. RF performed best in cross-validation, reaching 99.1% for HA-UTI and 96.2% for HA-UTI vs. CA-UTI. NN showed the highest specificity, at 93.4%, for HA-UTI vs. CA-UTI. The AUC values further supported these findings, ranging from 71.9% for NN to 96% for RF, reflecting the robustness of these models across different annual datasets. Among patient demographics, hospital, and socioeconomic variables, all models consistently identified the nurse units (e.g., inpatient units and mental health units) as the most significant predictors of UTI. In addition to nurse units, LR and DT identified location (e.g., various clinics and medical centres) as a key predictor. For HA-UTI versus CA-UTI, variations were observed across the years, with patient age, median household income, and gender intermittently emerging as key predictors.</p><p><strong>Conclusion: </strong>The predictive accuracy of the machine learning models is relatively the same, with some differences in sensitivity and specificity for identifying both HA-UTI vs. CA-UTI and HA-UTI. Nurse units consistently emerge as the most significant predictors across all years. The importance of all predictors, such as socioeconomic factors and location, varies from year to year, highlighting the need for incorporating those variables in the surveillance systems to optimize the accuracy of predictions.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995708","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":"Glove breach occurrence during surgical procedures: the benefits of double/indicator system gloves","authors":"M.G. Rippon ,&nbsp;A.A. Rogers ,&nbsp;K.J. Ousey","doi":"10.1016/j.jhin.2025.04.010","DOIUrl":"10.1016/j.jhin.2025.04.010","url":null,"abstract":"<div><h3>Background</h3><div>The use of gloves during surgery aims at preventing surgical site infections (SSIs) and to protect both staff and patients from cross-contamination.</div></div><div><h3>Aim</h3><div>To assess the rate of surgical glove breaches, whether these pose an increased risk of infection, and, if so, how might this be overcome (using double/indicator system glove techniques).</div></div><div><h3>Methods</h3><div>A scoping review was undertaken to address the primary research questions identified in the objectives. The search strategy was as follows: ‘surgical AND gloves AND perforations’ with a search date from January 1^st, 1970 to July 31^st, 2024 using the PubMed database. The articles were screened independently by two separate reviewers using the PRISMA-Scr checklist methodology.</div></div><div><h3>Findings</h3><div>The initial search identified 343 articles that were then screened to provide 129 articles for full review. The results showed that surgical glove perforations are frequently reported to various levels in a variety of different surgical procedures, but that importantly a high proportion of glove breaches go undetected. The incidence of these perforations varies, but analysis of the data indicates that orthopaedic, oral/maxillofacial and obstetrics/gynaecology were pertaining the highest levels, probably due to the use of mechanical procedures that can easily damage the gloves. Increased levels of bacterial transmission and SSIs are associated with increased frequency of surgical glove perforations. The use of indicator system gloves demonstrated significant benefits in terms of identification of surgical glove breaches.</div></div><div><h3>Conclusion</h3><div>In high-risk surgical procedures the use of an indicator system provides both surgeon and patient added protection with the perforation/breach detection helping prevent bacterial transmission and cross-infection.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 92-113"},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Bacterial reservoir in deeper skin is a potential source for surgical site and biomaterial-associated infections'; reply to Xiao et al.","authors":"C Guarch-Pérez, M Riool, L de Boer, P Kloen, S A J Zaat","doi":"10.1016/j.jhin.2025.03.013","DOIUrl":"10.1016/j.jhin.2025.03.013","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996372","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 challenge of endoscope reprocessing delays","authors":"B. Casini ,&nbsp;F. Chiovelli ,&nbsp;Y. Ferchichi ,&nbsp;C. Meozzi ,&nbsp;L. De Santa ,&nbsp;L. Zurlo ,&nbsp;E. Marciano","doi":"10.1016/j.jhin.2025.01.007","DOIUrl":"10.1016/j.jhin.2025.01.007","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"159 ","pages":"Pages 156-160"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076538","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":"Antimicrobial Resistance Situation and Control Measures in Hong Kong: From a One Health Perspective.","authors":"Vincent Chi-Chung Cheng, Shuk-Ching Wong, Edmond Siu-Keung Ma, Hong Chen, Kelvin Hei-Yeung Chiu, Jonathan Hon-Kwan Chen, Simon Yung-Chun So, David Christopher Lung, Pak-Leung Ho, Kwok-Yung Yuen","doi":"10.1016/j.jhin.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.01.019","url":null,"abstract":"<p><p>Multidrug-resistant organisms pose a critical public health challenge globally, particularly in densely populated Hong Kong with a rapidly aging population, where over 90% of food is imported. This review examines the targeted surveillance and control efforts implemented under the One Health framework to combat antimicrobial resistance (AMR). Between 2010 and 2023, surveillance revealed a prevalence of extended-spectrum-beta-lactamase-producing Escherichia coli (ESBL-E.coli) in tested pigs (51.5%) and chickens (86.3%). Alarmingly, carbapenemase-producing E. coli was increasingly detected in pigs (<5 to 19.2% from 2017 to 2023). For other food items, ESBL-producing Enterobacterales were found in sashimi (11.5%), sushi (4.8%) ready-to-eat (RTE) vegetables (26.9%), RTE cut fruits (5.6%), braised dishes (19.8%), and roast meat (2.4%). Mean antimicrobial consumption in food animals was 113.4mg/kg target animal biomass for pigs from 2019 to 2022. Antimicrobial consumption in hospitals and community, expressed as defined daily doses per 1,000 inhabitants per day, declined from 20.4 to 13.8 during the COVID-19 pandemic, and gradually rebounded to 17.1 in 2023. In residential care homes for the elderly (RCHE), MRSA prevalence rapidly escalated from 2.8 to 48.7% between 2005 and 2021, triggering a pilot MRSA decolonization program in 257 RCHEs, which led to a significant reduction in community-onset MRSA infections (from 3.526 to 2.632 per 1,000-resident-days,p<0.005) and MRSA bacteremia (from 0.322 to 0.197 per 1,000-resident-days,p=0.025). These findings highlight the challenges in the control of ESBL and carbapenemase-producing E. coli in animals, compliance with food hygiene measures, and infection control in overcrowded and understaffed RCHE or hospitals in perpetuating MRSA infections in healthcare settings.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026827","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}