Journal of Hospital Infection最新文献

{"title":"Comparison of brushing efficacy for gastroscopes using different brush types under simulated contamination conditions","authors":"J.Y. Li,&nbsp;W.Q. Hu,&nbsp;C.Y. Zhou,&nbsp;Y.X. Ge,&nbsp;Q. Gu","doi":"10.1016/j.jhin.2025.04.029","DOIUrl":"10.1016/j.jhin.2025.04.029","url":null,"abstract":"<div><h3>Background</h3><div>Channel-cleaning brushes are an important tool in the reprocessing of endoscopes.</div></div><div><h3>Aim</h3><div>To investigate the efficacy of cleaning brushes composed of various materials in removing organic matter from the biopsy channels of flexible endoscopes.</div></div><div><h3>Methods</h3><div>In total, 168 cleaned gastroscopes were divided at random into six groups (A, B, C1, C2, C3 and D) based on the specific characteristics of four different types of cleaning brush. A suspension containing 12% bovine serum and 10⁶ units of <em>Escherichia coli</em> was injected into the biopsy channels of each endoscope to ensure sufficient contamination. After a 5-min incubation period, brushing and sampling were performed according to the experimental protocol. The effectiveness of the cleaning process was evaluated using a protein detection test and an adenosine triphosphate test.</div></div><div><h3>Results</h3><div>Cleaning brushes with a metal shaft demonstrated superior performance in removing organic matter from flexible endoscopes compared with cleaning brushes with a plastic shaft (<em>P</em>&lt;0.05). Similarly, brushes with bristles made of cylindrical DuPont fibres exhibited superior cleaning efficacy compared with those made of strip microfibres or caterpillar polyolefins (<em>P</em>&lt;0.05). Better results were achieved when the cleaning brush was passed through the biopsy channel four times compared with once or twice (100%).</div></div><div><h3>Conclusion</h3><div>From the perspective of cleaning outcomes and economic benefits, the use of a cleaning brush with a metal shaft and cylindrical DuPont fibre bristles during the reprocessing of flexible endoscopes, combined with a cleaning technique involving four brush passes through the biopsy channels, can remove organic matter more effectively compared with the use of a cleaning brush made of microfibres, polyolefins and plastics.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 160-166"},"PeriodicalIF":3.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082150","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":"Defining a genomic threshold for investigating Pseudomonas aeruginosa hospital outbreak","authors":"S. Romano-Bertrand ,&nbsp;M. Virieux-Petit ,&nbsp;F. Mauffrey ,&nbsp;L. Senn ,&nbsp;D.S. Blanc","doi":"10.1016/j.jhin.2025.04.028","DOIUrl":"10.1016/j.jhin.2025.04.028","url":null,"abstract":"<div><h3>Background</h3><div>When investigating <em>Pseudomonas aeruginosa</em> (PA) outbreaks, the clonality of isolates should be demonstrated using a molecular typing method. Whole-genome sequencing (WGS) is the new gold standard for bacterial genotyping, but care should be taken in the interpretation of results regarding considering isolates as part of the same chain of transmission.</div></div><div><h3>Aim</h3><div>To determine genomic threshold to identify recent transmission events considering the spatiotemporal scale of the outbreak.</div></div><div><h3>Methods</h3><div>PA outbreaks occurring in our hospital during the past 15 years were retrospectively analysed by both core-genome MLST and single-nucleotide polymorphism (SNP) with regard to epidemiological data. Our results were discussed in the light of previous published literature employing WGS to investigate hospital outbreaks of PA.</div></div><div><h3>Findings</h3><div>Fourteen investigations of PA outbreaks in our hospital were included, lasting a few days to nine years. Isolates belonging to the same chain of transmission presented up to 13 loci differences and 25 SNPs. These results were in accordance with the 19 published outbreaks that mostly reported a similarity among epidemiologically related isolates below 15–25 SNPs. The impact of time and space on the threshold of eligible SNPs or loci differences was possibly masked by other factors including the genotype, the number of isolates included in the WGS analysis, the path of transmission and the presence of environmental reservoir.</div></div><div><h3>Conclusions</h3><div>Our study emphasizes the need to integrate genomic thresholds with epidemiological data, especially when environmental reservoirs or hypermutators are involved, to accurately assess transmission dynamics and outbreak origins.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 119-129"},"PeriodicalIF":3.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029306","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 tissue adhesive application on central line-associated bloodstream infections: a multi-centre retrospective study","authors":"Y. Kwon ,&nbsp;D.J. Shim ,&nbsp;J.H. Lee ,&nbsp;D. Kim ,&nbsp;S.H. Baek ,&nbsp;J. Kim ,&nbsp;E.J. Kim ,&nbsp;Y.J. Kim ,&nbsp;T.W. Choi ,&nbsp;J.H. Won","doi":"10.1016/j.jhin.2025.04.030","DOIUrl":"10.1016/j.jhin.2025.04.030","url":null,"abstract":"<div><h3>Background</h3><div>Use of central venous access devices (CVADs) has been plagued by various adverse events, including central line-associated bloodstream infection (CLABSI), inadvertent dislocation, exit-site haemorrhage, and local infection.</div></div><div><h3>Aim</h3><div>To investigate whether tissue adhesive (TA, 2-octyl blended with <em>n</em>-butyl cyanoacrylate) application to centrally/femorally inserted central catheter (CICC/FICC) exit sites could reduce the occurrence of CLABSI.</div></div><div><h3>Methods</h3><div>This retrospective review with historical controls was conducted in three tertiary care institutions. The TA group was established from December 2021 to July 2022 with the simultaneous initiation of TA application to the exit site of CICCs/FICCs. Patients in the control group received CICCs/FICCs before TA application between February 2021 and November 2021. Adverse event rates, including CLABSI, oozing, dislocation, and skin problems, were compared between groups. Risk factors were analysed using inverse probability of treatment weighting (IPTW)-adjusted Cox analysis.</div></div><div><h3>Findings</h3><div>The TA group comprised 1061 patients; the control group included 1049 patients. The CLABSI rate was significantly lower in the TA group (1.84 per 1000 catheter-days) compared with the control group (3.66 per 1000 catheter-days), with a rate ratio of 0.5 (95% confidence interval: 0.28–0.87; <em>P</em> = 0.01). The oozing rate was significantly lower (TA: 120; control: 158; <em>P</em> = 0.01). IPTW-adjusted analysis revealed TA as risk-reducing factor (<em>P</em> = 0.003), while age (<em>P</em> = 0.04) and triple-lumen (<em>P</em> = 0.04) were significant risk factors for CLABSI.</div></div><div><h3>Conclusion</h3><div>TA application at CICCs/FICCs exit sites could significantly lower CLABSI rates without serious adverse events.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 153-159"},"PeriodicalIF":3.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996535","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":"Silver-based dressings for the prevention of surgical site infections: evidence from randomized trials","authors":"S. Younes ,&nbsp;N. Younes ,&nbsp;S. Abunasser ,&nbsp;F. Tamimi ,&nbsp;G. Nasrallah","doi":"10.1016/j.jhin.2025.04.026","DOIUrl":"10.1016/j.jhin.2025.04.026","url":null,"abstract":"<div><h3>Background</h3><div>Surgical site infections (SSIs) are a major cause of postoperative complications, increasing morbidity and healthcare costs. Silver-based dressings are commonly used due to their antimicrobial properties, but their effectiveness in reducing SSIs remains unclear.</div></div><div><h3>Aim</h3><div>To evaluate the efficacy of silver-based dressings compared with non-silver dressings in preventing SSIs in randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Cochrane Library and Embase to identify RCTs comparing silver-based dressings with non-silver dressings for the prevention of SSIs. The study protocol was registered in PROSPERO (CRD42024592966). Meta-analysis using a random-effects model calculated pooled risk ratios (RR) with 95% confidence intervals (CI). Heterogeneity was assessed with the <em>I</em>² statistic, and publication bias was evaluated through funnel plots and Egger's test.</div></div><div><h3>Results</h3><div>Twelve RCTs with 2928 participants were included in the meta-analysis. Silver-based dressings reduced the risk of SSIs by 40% compared with non-silver dressings (RR 0.60, 95% CI 0.41–0.89; <em>P</em>&lt;0.05); this difference was significant. Heterogeneity was moderate (<em>I</em>²=53%).</div></div><div><h3>Conclusions</h3><div>Silver-based dressings reduce the risk of SSIs significantly; however, further high-quality RCTs are needed to confirm their benefits across different surgical contexts and patient populations.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 293-300"},"PeriodicalIF":3.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048421","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":"Surgical site infections complicating coronary artery bypass graft surgery in Australia: time trends in infection rates, surgical antimicrobial prophylaxis, and pathogens using a comprehensive surveillance network, 2010–2023","authors":"S.K. Tanamas ,&nbsp;L.L. Lim ,&nbsp;A.L. Bull ,&nbsp;M.J. Malloy ,&nbsp;J. Brett ,&nbsp;Z. Dickson ,&nbsp;L.J. Worth ,&nbsp;N.D. Friedman","doi":"10.1016/j.jhin.2025.04.027","DOIUrl":"10.1016/j.jhin.2025.04.027","url":null,"abstract":"<div><h3>Background</h3><div>In cardiac surgery, surgical site infection (SSI) is associated with increased morbidity and mortality, reoperations, lengthy antimicrobial treatment, increased hospital length of stay, and increased healthcare costs.</div></div><div><h3>Aim</h3><div>To report trends in SSI epidemiology complicating coronary artery bypass graft (CABG) surgery and to record changes in surgical antimicrobial prophylaxis (SAP) compliance and causative pathogens over time.</div></div><div><h3>Methods</h3><div>Data on CABG procedures from 2010 to 2023 submitted to the Victorian healthcare-associated infection surveillance coordinating centre were analysed. Trends in the SSI rate and choice, timing, and duration of SAP were modelled using Poisson regression. The most common pathogens causing SSI and their change over time were assessed.</div></div><div><h3>Findings</h3><div>A total of 32,446 CABG procedures were reported during the study period. Sternal SSI rate decreased from 2.7 per 100 procedures in 2010 to 1.6 per 100 procedures in 2023, representing a 15% annual decrease, when the model was adjusted for the number of years of participation in surveillance. This decrease was most marked during the first decade (IRR 0.70 [95% CI 0.64, 0.76]) followed by stable rates between 2020 and 2023 (IRR 1.08 [95% CI 0.93, 1.27]). Compliance with SAP choice was consistently &gt;98%, while compliance with timing increased by an average of 1% per year to 83%, and compliance with duration fluctuated between 75% and 86%. The most frequent pathogens responsible for SSI were <em>Staphylococcus aureus</em>, <em>Serratia marcescens</em>, <em>Staphylococcus epidermidis</em>, and <em>Klebsiella pneumoniae.</em> The proportion of sternal and donor site SSIs involving Gram-negative pathogens increased from 38% to 59%.</div></div><div><h3>Conclusion</h3><div>This analysis of 14 years of surveillance data for SSI complicating CABG procedures highlighted a reduction in rates of SSI, high rates of compliance with antimicrobial choice for SAP, and the predominance of <em>S. aureus</em> as a causative pathogen of SSI in our region. Notably, we observed Gram-negative pathogens, particularly <em>S. marcescens</em>, to be responsible for a larger proportion of SSIs over recent years.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 44-52"},"PeriodicalIF":3.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029354","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":"Application of the PEN-FAST tool to safely administer cephalosporins to patients with ‘low risk’ penicillin allergy","authors":"K.K. Badyal ,&nbsp;K. Bhatt ,&nbsp;A.J. Plant","doi":"10.1016/j.jhin.2025.04.031","DOIUrl":"10.1016/j.jhin.2025.04.031","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 130-131"},"PeriodicalIF":3.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057875","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":"Fighting antimicrobial resistance in a resource-limited setting: an integrated approach to infection prevention and antimicrobial stewardship is the ‘best buy’","authors":"B.D. Fofanah ,&nbsp;I.F. Kamara ,&nbsp;R.Z. Kamara ,&nbsp;R. Musoke ,&nbsp;S.M. Tengbe ,&nbsp;L. Kabego ,&nbsp;S. Lakoh","doi":"10.1016/j.jhin.2025.02.023","DOIUrl":"10.1016/j.jhin.2025.02.023","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 132-134"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032899","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":"VanB transposon analysis detects horizontal gene transfer in vancomycin-resistant Enterococcus faecium: description of two outbreaks","authors":"H.J. Schuster ,&nbsp;R. van Mansfeld ,&nbsp;W.A. van der Reijden ,&nbsp;R. van Houdt ,&nbsp;S. Matamoros","doi":"10.1016/j.jhin.2025.04.021","DOIUrl":"10.1016/j.jhin.2025.04.021","url":null,"abstract":"<div><h3>Background</h3><div>Outbreaks with vancomycin-resistant <em>Enterococcus faecium</em> (VRE) are common in hospitals worldwide. Whole-genome MLST (wgMLST) is often used to identify outbreak strains, but VRE typing can still be challenging due to their limited genomic variation.</div></div><div><h3>Aim</h3><div>Developing a method for sequence analysis of vancomycin resistance genes in parallel with wgMLST and application of this new method for real-time investigation of two parallel VRE outbreaks.</div></div><div><h3>Methods</h3><div>A bioinformatics pipeline was developed to compare the sequences of transposons containing vanB resistance genes. This pipeline was used in addition to wgMLST to investigate two separate ongoing VRE outbreaks. Five separate colonies from 15 different samples and 10 vancomycin-susceptible isolates were also sequenced.</div></div><div><h3>Findings</h3><div>Of 46 strains collected during two outbreaks, 26 and nine strains were identified as being part of the two outbreaks based on wgMLST clustering. In six strains an identical vanB transposon but a different wgMLST cluster were identified, indicating horizontal gene transfer. This potential outbreak spread would have been missed without transposon analysis. There was no evidence of variability in vanB transposon sequence or wgMLST profiles within different colonies from the same sample. One vancomycin-susceptible <em>E. faecium</em> in blood culture was identified, with a wgST similar to one of the outbreak strains.</div></div><div><h3>Conclusion</h3><div>Real-time analysis of transposons containing vancomycin resistance genes provides additional information for analysis of vanB-VRE outbreaks. It detects possible horizontal gene transfer which would not be detected using conventional methods. Transposon analysis is a valuable addition to whole-genome sequence analysis during vanB-VRE outbreaks.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 351-359"},"PeriodicalIF":3.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034463","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":"Cellular and material-specific responses of Candida parapsilosis biofilms to biocides","authors":"J.K.S. Dourado ,&nbsp;C.M. Álvarez-Ormeño ,&nbsp;G. Benard ,&nbsp;R.H. Pires","doi":"10.1016/j.jhin.2025.04.023","DOIUrl":"10.1016/j.jhin.2025.04.023","url":null,"abstract":"<div><h3>Background</h3><div><em>Candida parapsilosis</em> biofilms pose significant challenges in clinical settings due to their resilience to biocides and the presence of persister cells. This study evaluated the efficacy of amphotericin B (AmB), chlorhexidine (CLX), and ortho-phthalaldehyde (OPA) against biofilms formed by fluconazole-resistant <em>C. parapsilosis</em> isolates and examined the role of persister cells and catheter materials in biofilm resilience.</div></div><div><h3>Methods</h3><div>Clinical isolates of <em>C. parapsilosis</em> from hospital surfaces were exposed to CLX (0.5%) and OPA (0.55%). Minimum inhibitory concentrations (MICs) were determined by broth microdilution. Biofilm susceptibility was assessed using the crystal violet assay and total plate counts. Scanning electron microscopy (SEM) analysed biofilm structural changes on different catheter materials.</div></div><div><h3>Findings</h3><div>AmB demonstrated high efficacy with low MIC and MFC values. CLX showed moderate efficacy, with higher MICs and MFCs in clinical isolates compared with the standard strain. OPA exhibited the lowest efficacy, with higher MIC, MFC, and SMIC₈₀ values. Persister cells were confirmed in isolate CBL 1031, while isolates 17D, 26E, and ATCC 90019 displayed significant SMIC80 reductions, indicating high susceptibility. PTFE materials showed significant biofilm reductions post-biocide exposure, while HDPE displayed the greatest biofilm resilience with higher residual cell counts. SEM revealed material-specific biofilm disruption, with greater structural damage on HDPE and silicone-coated latex (SCL) compared with PTFE.</div></div><div><h3>Conclusions</h3><div>These findings underscore the importance of optimizing cleaning protocols, selecting appropriate medical materials, and addressing persister cells to mitigate biofilm-related infections in healthcare settings.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 84-94"},"PeriodicalIF":3.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041191","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":"A systematic review of antimicrobial stewardship interventions implemented in intensive care units","authors":"O.K. Ntim ,&nbsp;B. Opoku-Asare ,&nbsp;E.S. Donkor","doi":"10.1016/j.jhin.2025.04.020","DOIUrl":"10.1016/j.jhin.2025.04.020","url":null,"abstract":"<div><div>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 AS 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. Of 1234 records retrieved from the databases, 55 studies were included in this systematic review. Most of the studies were conducted in the USA (<em>N</em> = 9), followed by China (<em>N</em> = 8), India (<em>N</em> = 5), and Italy (<em>N</em> = 4). We identified seven key AS strategies: multi-intervention AS programmes (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 (four studies, 7.3%), antimicrobial restrictions or preapprovals (four studies, 7.3%), diagnostic stewardship (one study, 1.8%), and guidelines for antimicrobial prescription (one study, 1.8%). A reduction in targeted or overall antimicrobial usage was reported in most studies (34/42). Specifically, all studies implementing multi-invention AS programmes reported a successful reduction in antimicrobial utilization. Some AS 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.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 272-283"},"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}