Journal of Hospital Infection最新文献

{"title":"Antimicrobial resistance situation and control measures in Hong Kong: from a One Health perspective","authors":"V.C-C. Cheng ,&nbsp;S-C. Wong ,&nbsp;E.S-K. Ma ,&nbsp;H. Chen ,&nbsp;K.H-Y. Chiu ,&nbsp;J.H-K. Chen ,&nbsp;S.Y-C. So ,&nbsp;D.C. Lung ,&nbsp;P-L. Ho ,&nbsp;K-Y. Yuen","doi":"10.1016/j.jhin.2025.01.019","DOIUrl":"10.1016/j.jhin.2025.01.019","url":null,"abstract":"<div><div>Multi-drug-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. Between 2010 and 2023, surveillance revealed the prevalence rates of extended-spectrum-beta-lactamase (ESBL)-producing <em>Escherichia coli</em> in tested pigs (51.5%) and chickens (86.3%). Alarmingly, carbapenemase-producing <em>E. coli</em> was increasingly detected in pigs (&lt;5–19.2% 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 113.4 mg/kg target animal biomass for pigs from 2019 to 2022. Antimicrobial consumption in hospitals and the community, expressed as defined daily doses per 1000 inhabitants per day, declined from 20.4 to 13.8 during the coronavirus disease 2019 pandemic, and gradually rebounded to 17.1 in 2023. In residential care homes for the elderly (RCHEs), the prevalence of meticillin-resistant <em>Staphylococcus aureus</em> (MRSA) escalated rapidly from 2.8% to 48.7% between 2005 and 2021, triggering a pilot MRSA decolonization programme in 257 RCHEs, which led to a significant reduction in community-onset MRSA infections (from 3.526 to 2.632 per 1000 resident-days; <em>P</em>&lt;0.005) and MRSA bacteraemia (from 0.322 to 0.197 per 1000 resident-days; <em>P</em>=0.025). These findings highlight the challenges in the control of ESBL and carbapenemase-producing <em>E. coli</em> in animals, compliance with food hygiene measures, and infection control in overcrowded and understaffed RCHEs or hospitals in perpetuating MRSA infections in healthcare settings.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 174-185"},"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}

{"title":"Training of the global health workforce in antimicrobial stewardship and infection prevention and control: an approach to combat antimicrobial resistance","authors":"I.F. Kamara ,&nbsp;B.D. Fofanah ,&nbsp;R.Z. Kamara ,&nbsp;O.T. Abiri ,&nbsp;S. Lakoh ,&nbsp;J.S. Kanu ,&nbsp;S.M. Tengbe","doi":"10.1016/j.jhin.2025.02.024","DOIUrl":"10.1016/j.jhin.2025.02.024","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 52-54"},"PeriodicalIF":3.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058626","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 use in Japanese hospitals: results from a point-prevalence survey in Aichi, 2020","authors":"H. Morioka ,&nbsp;Y. Koizumi ,&nbsp;K. Oka ,&nbsp;M. Okudaira ,&nbsp;Y. Tomita ,&nbsp;Y. Kojima ,&nbsp;T. Watariguchi ,&nbsp;K. Watamoto ,&nbsp;Y. Mutoh ,&nbsp;T. Tsuji ,&nbsp;M. Yokota ,&nbsp;J. Shimizu ,&nbsp;C. Hasegawa ,&nbsp;S. Iwata ,&nbsp;M. Nagaoka ,&nbsp;Y. Ito ,&nbsp;S. Kawasaki ,&nbsp;H. Kato ,&nbsp;Y. Kitagawa ,&nbsp;H. Hamada ,&nbsp;T. Yagi","doi":"10.1016/j.jhin.2025.04.015","DOIUrl":"10.1016/j.jhin.2025.04.015","url":null,"abstract":"<div><h3>Background</h3><div>Comprehensive antimicrobial use (AMU) data are essential to promote effective antimicrobial stewardship. However, qualitative information on AMUs in Japanese hospitals is limited.</div></div><div><h3>Aim</h3><div>To provide an overview of AMU for inpatients in Japanese hospitals.</div></div><div><h3>Methods</h3><div>A multi-centre point-prevalence survey was conducted across Aichi Prefecture in 2020, collecting patient demographics, underlying conditions, indications of AMU (for treatment of community-acquired infections (CAIs)/healthcare-associated infections (HAIs), surgical prophylaxis (SP), medical prophylaxis (MP) and others), treated infections, and antimicrobial stewardship team (AST) intervention.</div></div><div><h3>Findings</h3><div>Among the 10,199 patients from 27 hospitals included in this study, a total of 3738 antimicrobials were prescribed to 3024 patients (29.6%; 95% confidence interval: 28.8–30.5). Of these, 1510 (40.4%) antimicrobials were prescribed for CAI treatment, 815 (21.8%) for HAI treatment, 745 (19.9%) for SP, and 639 (17.1%) for MP. SP administration over 2 days was observed in 31.2% of the cases. The top three prescribed antimicrobials were cefazolin (12.0%, 450), ceftriaxone (9.2%, 343), and oral trimethoprim–sulfamethoxazole (8.7%, 327). AMU per 1000 patients was highest in extra-large hospitals (472) and lowest in small hospitals (264). Ceftriaxone was most commonly prescribed for CAIs, while meropenem was typical for HAIs. AST intervention rates were 15.0% and 22.5% in CAIs and HAIs, respectively.</div></div><div><h3>Conclusion</h3><div>This study provides comprehensive AMU information from a region in Japan, highlighting variations linked to hospital size, frequent prescriptions of broad-spectrum antimicrobials for HAIs, high prescription rate of trimethoprim–sulfamethoxazole as MP, and prolonged SAP.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 140-147"},"PeriodicalIF":3.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996390","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":"Successful implementation of a bundle to prevent increased excessive-spectrum antimicrobial use under new EUCAST susceptibility definitions: a quasi-experimental study in a tertiary hospital","authors":"P. Duch-Llorach ,&nbsp;A.F. Simonetti ,&nbsp;A. Figueras-Roig ,&nbsp;A. Rivera ,&nbsp;E. Fernández de Gamarra‑Martínez ,&nbsp;L. Gras-Martin ,&nbsp;M-E. Moreno-Martinez ,&nbsp;J. Ruiz Ramos ,&nbsp;B. Zarate-Tamames ,&nbsp;F. Navarro ,&nbsp;J. López-Contreras ,&nbsp;L. Escolà-Vergé","doi":"10.1016/j.jhin.2025.04.016","DOIUrl":"10.1016/j.jhin.2025.04.016","url":null,"abstract":"<div><h3>Background</h3><div>This study evaluated the effectiveness of an implementation-bundle to prevent increased targeted excessive-spectrum antibiotics for wild-type <em>Pseudomonas aeruginosa</em> (PA) infections, following the introduction of 2019 EUCAST susceptibility categories redefinition.</div></div><div><h3>Methods</h3><div>This was a single-centre, quasi-experimental study at a tertiary University Hospital. All consecutive adult patients with wild-type PA infections between July 2023 and April 2024 were included and analysed across three-month periods: before the EUCAST update (Period 1), after the update with audit-feedback (Period 2), and after the update without audit-feedback (Period 3). The implementation-bundle included: (1) in-person educational sessions before the introduction of the redefinition; and (2) in antimicrobial susceptibility reports, replacing ‘I’ with ‘SE’, with a clarifying footnote and dosing information. An audit-feedback intervention was conducted during the first three months after the introduction of the redefinition. Selective reporting of antimicrobial susceptibility testing results was already in place in our hospital. Primary outcomes included targeted meropenem, and ceftolozane/tazobactam prescriptions; secondary outcomes were optimal anti-pseudomonal dosing and infectious diseases (IDs) consultations.</div></div><div><h3>Findings</h3><div>Among 158 patients (55 Period 1, 60 Period 2, 43 Period 3), targeted meropenem prescriptions did not increase (7.3% vs 6.7% (<em>P</em>=0.898) vs 0% (<em>P</em>=0.071)). No patients received targeted ceftolozane/tazobactam. ID consultations decreased (56.4% vs 38.3% (<em>P</em>=0.053) vs 34.9% (<em>P</em>=0.034)) and correct anti-pseudomonal dosing improved (70.9% vs 93.3% (<em>P</em>=0.002) vs 95.3% (<em>P</em>=0.002)). Risk factors for targeted meropenem prescriptions included age &lt;65 years, immunosuppression, septic shock, intensive care unit admission, and empirical excessive-spectrum antimicrobial use.</div></div><div><h3>Conclusion</h3><div>This implementation-bundle enabled the introduction of EUCAST susceptibility categories redefinition without increasing targeted excessive-spectrum antibiotics or ID consultations, while optimizing dosing.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 1-9"},"PeriodicalIF":3.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049284","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- and peripheral-line-associated bloodstream infections in Victorian neonatal intensive care units: findings from a comprehensive Victorian surveillance network, 2008–2024","authors":"Z.R. Liu ,&nbsp;A.L. Bull ,&nbsp;L.K. Phuong ,&nbsp;M.J. Malloy ,&nbsp;N.D. Friedman ,&nbsp;L.J. Worth","doi":"10.1016/j.jhin.2025.04.009","DOIUrl":"10.1016/j.jhin.2025.04.009","url":null,"abstract":"<div><h3>Background</h3><div>Neonates face a high risk of healthcare-associated bloodstream infections, leading to increased morbidity and mortality. Effective surveillance is crucial for safe neonatal care and infection prevention.</div></div><div><h3>Aim</h3><div>To evaluate infection trends, pathogen distribution and antimicrobial resistance patterns in central- and peripheral-line-associated bloodstream infections (CLABSIs and PLABSIs) in Victorian Level 6 neonatal intensive care units between 1^st July 2008 and 30^th June 2024.</div></div><div><h3>Methods</h3><div>Data were collected by the Victorian Healthcare Associated Infection Surveillance System Coordinating Centre using Centers for Disease Control and Prevention National Healthcare Safety Network guidelines. A retrospective data analysis of prospectively collected data was conducted to examine infection epidemiology.</div></div><div><h3>Findings</h3><div>Overall, 581 neonates developed CLABSIs or PLABSIs, corresponding to a mean CLABSI rate of 2.26 per 1000 central-line-days and a mean PLABSI rate of 0.60 per 1000 peripheral-line-days. The median age at diagnosis of all events was 16 days (interquartile range 9–35 days). No trends were observed in CLASBI or PLABSI rates over the study period. However, an increasing trend in CLABSI rates [incidence risk ratio (IRR) 1.04, 95% confidence interval (CI) 1.00–1.07; <em>P</em>=0.043] and a decreasing trend in PLABSI rates (IRR 0.95, 95% CI 0.92–0.99; <em>P</em>=0.021) were noted among neonates with birth weight ≤750 g. The most frequently reported organisms were coagulase-negative staphylococci, responsible for 44.0% of CLABSIs and 39.5% of PLABSIs.</div></div><div><h3>Conclusion</h3><div>Neonatal intensive care units in Victoria maintained low CLABSI and PLABSI rates over the study period. Higher infection rates in low-birthweight neonates emphasize the need for targeted infection prevention strategies for this vulnerable population.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 83-91"},"PeriodicalIF":3.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032897","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":"Decontamination methods of needleless connectors in central venous access: a randomized controlled trial","authors":"Y.Y. Wu ,&nbsp;W. Ding ,&nbsp;F.Q. Tao ,&nbsp;Q.H. Deng ,&nbsp;P.F. Wang ,&nbsp;B.L. Feng","doi":"10.1016/j.jhin.2025.04.013","DOIUrl":"10.1016/j.jhin.2025.04.013","url":null,"abstract":"<div><h3>Background</h3><div>Needleless connectors (NCs) are essential for central venous access but can cause bloodstream infections if contaminated. Currently, inconsistent guidelines on the optimal disinfectant and duration for NCs hinder nursing practice standardization. Notably, 75% ethanol, which is widely used in China, lacks rigorous comparison with 2% chlorhexidine gluconate (CHG) in ethanol, with existing evidence predominantly from intensive care units rather than outpatient settings.</div></div><div><h3>Aim</h3><div>To compare the decontamination efficacy of 75% ethanol and 2% CHG in ethanol with scrub durations of 5, 10, and 15 s on NCs in outpatients.</div></div><div><h3>Methods</h3><div>Using a factorial randomized controlled trial design, 360 NCs from 111 adult cancer patients with central venous access were randomized to six protocols: 75% ethanol or 2% CHG in ethanol, each scrubbed for 5, 10, or 15 s. Baseline and post-decontamination samples were collected for microbial culture to assess decontamination efficacy.</div></div><div><h3>Findings</h3><div>Baseline contamination occurred in 80.6% of 356 NCs, with brachial vein catheterization increasing risk (odds ratio: 3.12; 95% confidence interval: 1.20–8.12) and prolonged indwelling (&gt;6 months) reducing it (0.25; 0.07–0.88). No significant difference was observed between 75% ethanol and 2% CHG in ethanol (<em>P</em> &gt; 0.05). However, 15 s scrubbing achieved superior efficacy versus 5 s and 10 s protocols (<em>P</em> = 0.024).</div></div><div><h3>Conclusion</h3><div>This study found 75% ethanol equivalent to 2% CHG in ethanol for disinfection, supporting ≥15 s scrubs but noting residual contamination risks. By contextualizing disinfection protocols for outpatient populations and 75% ethanol-based practices, this study provides actionable evidence to standardize scrub durations and optimize resource allocation in diverse clinical settings.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"162 ","pages":"Pages 106-113"},"PeriodicalIF":3.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996532","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":"Timeliness of a potential automated system for national surveillance of healthcare-associated infections in England","authors":"T.P. Quan ,&nbsp;D.W. Eyre ,&nbsp;S. Shadwell ,&nbsp;D. West ,&nbsp;S. Hopkins ,&nbsp;D. Chudasama ,&nbsp;B. Muller-Pebody ,&nbsp;R. Hope ,&nbsp;A.S. Walker","doi":"10.1016/j.jhin.2025.04.008","DOIUrl":"10.1016/j.jhin.2025.04.008","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 10-12"},"PeriodicalIF":3.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of different pressures on the drying time of flexible endoscopes","authors":"W.Q. Hu,&nbsp;J.Y. Li,&nbsp;C.Y. Zhou,&nbsp;Y.X. Ge,&nbsp;Q. Gu","doi":"10.1016/j.jhin.2025.04.007","DOIUrl":"10.1016/j.jhin.2025.04.007","url":null,"abstract":"<div><h3>Background</h3><div>The complex structure of endoscopes causes non-uniform drying conditions. However, current clinical drying practices lack precise guidance, leading to the insufficient drying of some endoscopes, which increases the risk of infection. The pressure of compressed air has been shown to influence the effectiveness of endoscope drying; however, specific requirements are absent.</div></div><div><h3>Aim</h3><div>To determine the time required for the sufficient drying of different endoscopes under various pressure conditions.</div></div><div><h3>Methods</h3><div>Six different types of commonly used Olympus flexible endoscopes were selected, and for each type, multiple drying time groups were set under pressures of 0.102 and 0.204 MPa, with 10 endoscopes observed in each group.</div></div><div><h3>Findings</h3><div>Drying times varied according to the type and pressure. At 0.102 MPa, the instrument channel drying ranged from 80 s to 160 s (average: 123 s), while suction channel ranged from 260 s to 540 s (average: 428 s). At 0.204 MPa, the instrument channel dried in 50 s–90 s (average: 72 s), and suction channel in 130 s–230 s (average: 186 s).</div></div><div><h3>Conclusion</h3><div>Optimal drying times for endoscopes differ according to the type and pressure. A higher pressure (0.204 MPa) efficiently removes moisture and speeds up drying. Longer endoscopes with the same biopsy channel diameter require longer drying time. In addition, the instrument channel dries faster than the suction channel.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 37-43"},"PeriodicalIF":3.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006458","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 in-vitro antimicrobial activity of silver- and minocycline–rifampin–chlorhexidine-coated needle-free connectors","authors":"Y. Truong,&nbsp;J. Rosenblatt,&nbsp;B. Gerges,&nbsp;Y. Jiang,&nbsp;I. Raad","doi":"10.1016/j.jhin.2025.04.012","DOIUrl":"10.1016/j.jhin.2025.04.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Needle-free connectors (NFCs) are widely used to access vascular infusion circuits. Despite their safety benefits, NFCs still present risks for colonization and vascular ingress by pathogenic microbes. Antimicrobial NFCs present one approach to prevent microbial colonization over all colonizable surfaces of NFCs, with the advantage of potentially protecting all vulnerable internal and external NFC surfaces.</div></div><div><h3>Methods</h3><div>This study compared a commercially available silver-coated NFC with a novel minocycline–rifampin–chlorhexidine (MRC)-coated NFC in an in-vitro model posing a severe microbial challenge following 1 and 7 days of elution in a 50% serum solution to simulate clinical use of the NFCs. Microbial challenges were performed against clinical isolates of meticillin-resistant <em>Staphylococcus aureus</em> (MRSA), multi-drug-resistant <em>Pseudomonas aeruginosa</em> and <em>Candida albicans</em> as representative of the major classes of highly virulent bloodstream infectious pathogens.</div></div><div><h3>Results</h3><div>Results following 1 day of elution showed colonization of uncoated NFCs of 4.45 x 10⁶ colony-forming units (CFU)/NFC for MRSA, 5.20 x 10⁶ CFU/NFC for <em>C. albicans</em> and 3.68 x 10⁷ CFU/NFC for <em>P. aeruginosa</em>. The silver NFC presented approximately a 1 log₁₀ reduction for <em>P. aeruginosa</em> and similar colonization densities as the control for MRSA and <em>C. albicans</em>. In contrast, the MRC NFC showed no colonization by any of the challenge pathogens. Similar results were obtained following 7 days of elution.</div></div><div><h3>Conclusions</h3><div>The differences between the MRC and silver NFCs were significant (<em>P</em>&lt;0.005). The MRC NFC has potential to reduce line infections, and therefore merits further in-vivo and clinical testing.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 114-118"},"PeriodicalIF":3.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040695","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 complexity of Staphylococcus epidermidis molecular epidemiology in neonatal intensive care units (NICU) as revealed by genomic approaches","authors":"R.F. Rampelotto ,&nbsp;N.A. Faria ,&nbsp;R. Hörner ,&nbsp;M. Miragaia","doi":"10.1016/j.jhin.2025.04.011","DOIUrl":"10.1016/j.jhin.2025.04.011","url":null,"abstract":"<div><div>Bloodstream infections caused by <em>Staphylococcus epidermidis</em> are among the most frequent and serious infections in neonatal intensive care units (NICU), being responsible for high rates of morbidity and mortality. However, how <em>S. epidermidis</em> prevails, disseminates and evolves to cause outbreaks in NICU is poorly understood. We aimed to understand what is the genomic basis of <em>S. epidermidis</em> outbreaks in NICU to provide guidelines for a better infection control.</div><div>We collected all <em>S. epidermidis</em> isolated from newborn blood cultures admitted to a hospital NICU in Brazil over one-year and compared their genomes.</div><div>The <em>S. epidermidis</em> infection incidence rate was 1.17 per baby-year. 83,64% of <em>S. epidermidis</em> were resistant to methicillin (MRSE) and 84,5% belonged to sequence type 2 (ST2) or related, carrying the staphylococcal cassette chromosome <em>mec</em> (SCC<em>mec</em>) type III or IVa. Single nucleotide polymorphisms (SNPs) analysis showed that <em>S. epidermidis</em> infections resulted from the co-existence of three ST2 transmission chains originating from distinct endemic sources (&lt;50 SNPs). Each transmission chain was characterized by specific antibiotic resistance and virulence profile and content in staphylococcal cassette chromosome elements (SCC<em>mec</em>, SCC non-<em>mec</em> and ACME). During transmission, other mobile genetic elements were acquired/lost and mutations emerged in genes involved in adhesion, signal transduction, general metabolism, replication, recombination and repair.</div><div>Tracking <em>S. epidermidis</em> transmission chains in the NICU will require a deep genomic analysis, combining bacterial genetic background and accessory genome. This study highlighted the need for the integration of whole genome sequencing as a key surveillance tool for infection control in NICUs.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 148-158"},"PeriodicalIF":3.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058453","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}