Antimicrobial stewardship & healthcare epidemiology : ASHE最新文献

Barriers and facilitators to infection prevention and control practices at King Faisal Hospital, Kigali, Rwanda. 卢旺达基加利费萨尔国王医院感染预防和控制措施的障碍和促进因素。

Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-09-19 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10111

Jakob Weiss, Sandrine Berwa, Gladys Momanyi, Richard Nduwayezu, Dawd Siraj, Daniel Shirley

{"title":"Barriers and facilitators to infection prevention and control practices at King Faisal Hospital, Kigali, Rwanda.","authors":"Jakob Weiss, Sandrine Berwa, Gladys Momanyi, Richard Nduwayezu, Dawd Siraj, Daniel Shirley","doi":"10.1017/ash.2025.10111","DOIUrl":"10.1017/ash.2025.10111","url":null,"abstract":"Objective: To identify barriers and facilitators of infection prevention and control (IPC) practices at King Faisal Hospital (KFH) in Kigali, Rwanda, using the Systems Engineering Initiative for Patient Safety (SEIPS) model.Design: Qualitative study involving semi-structured interviews.Setting: King Faisal Hospital, a tertiary healthcare facility in Kigali, Rwanda.Participants: A purposive sample of 25 hospital staff members from various roles involved in infection control practices.Methods: Semi-structured interviews were conducted, guided by the SEIPS framework which includes domains of person, environment, tasks, organization, tools, and process. Interviews were transcribed, coded, and analyzed to identify recurring themes related to IPC barriers and facilitators.Results: Key barriers included overcrowding, lack of isolation rooms, and significant staff-related factors, such as new staff attitudes, infrequent training, and inconsistent monitoring. Facilitators of IPC practices included adequate availability of hand sanitizer, soap, water, and personal protective equipment, as well as strong IPC policies from hospital administration. A systemic barrier identified was consumer access to antibiotics without a prescription, raising concerns about inappropriate use and antibiotic resistance.Conclusions: To enhance IPC practices, interventions such as increased IPC training and monitoring are recommended. Long-term solutions may include hospital expansion and isolation room creation for each unit. Additionally, legislative action limiting consumer access to antibiotics without a physician's prescription could mitigate antibiotic resistance at the community and hospital levels.","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e197"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A little nudge goes a long way: assessing the impact of a microbiology nudge comment on narrow-spectrum antibiotic use in uncomplicated Streptococcus pneumoniae bloodstream infections. 一点推动就能走很长的路：评估微生物推动评论对无并发症肺炎链球菌血液感染使用窄谱抗生素的影响。

Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-09-18 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10137

Michael O Akon, Rachel M Kenney, Nathan A Everson, Sydney VanDorf, Geehan Suleyman, Robert J Tibbetts, Anita B Shallal, Michael P Veve

引用次数: 0

Estimating the likelihood of hospitalists to repeatedly prescribe high rates of antibiotics. 估计医院医生反复开出高使用率抗生素的可能性。

Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-09-18 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10132

Radhika Prakash Asrani, Samuel Parks, Chad Robichaux, K Ashley Jones, Kristen Paciullo, Jesse T Jacob, Shabir Hasan, Sujit Suchindran, Lucy S Witt, Scott Fridkin

引用次数: 0

Digital five-step questionnaire to enhance standard perioperative prophylaxis in surgical patients with reported allergy to beta-lactam-antibiotics. 数字五步调查问卷加强报告对β -内酰胺类抗生素过敏的手术患者的标准围手术期预防。

Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-09-18 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10140

Daniel Röder, Kathrin Eichhorn, Johanna Stoevesandt, Jan Stumpner, Patrick Meybohm, Güzin Surat

{"title":"Digital five-step questionnaire to enhance standard perioperative prophylaxis in surgical patients with reported allergy to beta-lactam-antibiotics.","authors":"Daniel Röder, Kathrin Eichhorn, Johanna Stoevesandt, Jan Stumpner, Patrick Meybohm, Güzin Surat","doi":"10.1017/ash.2025.10140","DOIUrl":"10.1017/ash.2025.10140","url":null,"abstract":"Background: Most self-reported beta-lactam antibiotic (BLA) allergies are inaccurate. This study evaluated a digital tool designed to reassess beta-lactam allergies and enable the use of standard perioperative antibiotic prophylaxis (PAP) without the need for prior allergy testing.Methods: In this retrospective, observational single-center cohort study, a digital five-step questionnaire was utilized during preoperative anesthesia evaluations for surgical patients reporting beta-lactam allergies. The algorithm assessed the likelihood of a beta-lactam allergy and provided recommendations for either standard PAP or the use of an alternative agent. Adherence to the algorithm's recommendations and the incidence of allergic reactions following PAP were analyzed.Results: Between September 2020 and October 2022, 983 surgical patients reported beta-lactam allergies. Of these, 322 patients (33%) either did not receive anesthesia or did not require PAP. Among the remaining 661 patients, the algorithm recommended standard prophylaxis for 420 (64%). Of these, 262 patients received BLA, resulting in 2 allergic reactions (0.8%; negative predictive value: 99.2%), while 158 received alternative antibiotics contrary to the recommendation, leading to 3 allergic reactions (1.9%). For the 241 patients (36%) in whom the algorithm indicated a high probability of beta-lactam allergy, 197 (82%) received alternative antibiotics with 4 allergic reactions (2%). Forty-four patients (18%) received BLA contrary to the algorithm's recommendation, with no allergic reactions observed.Conclusions: The digital five-step algorithm was a simple and effective tool during preoperative assessment, enabling safe administration of standard PAP in 64% of surgical patients with reported beta-lactam allergies.","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e231"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A cross-sectional survey of antimicrobial stewardship in the healthcare facilities of the South West Region of Cameroon. 在喀麦隆西南地区的卫生保健设施的抗微生物药物管理的横断面调查。

Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-09-18 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10134

Calvin Ncha OyongAkom, Orikomaba Obunge, Patrick A Njukeng, Ibitein Okeafor

{"title":"A cross-sectional survey of antimicrobial stewardship in the healthcare facilities of the South West Region of Cameroon.","authors":"Calvin Ncha OyongAkom, Orikomaba Obunge, Patrick A Njukeng, Ibitein Okeafor","doi":"10.1017/ash.2025.10134","DOIUrl":"10.1017/ash.2025.10134","url":null,"abstract":"Objective: The objective of the study was to assess the implementation of antimicrobial stewardship (AMS) in the referral hospitals in the South West Region of Cameroon.Methods: A cross-sectional survey was carried out in November 2024 across four hospitals in the South West Region of Cameroon: Limbe Regional Hospital, Buea Regional Hospital Annex, Baptist Hospital Mutengene, and Kumba Baptist Health Center. For data collection, we used the standard WHO checklist to assess AMS activities at the healthcare facilities designed for low- and middle-income countries. Key informant interview involving the AMS focal persons of various hospitals enabled data collection.Results: Limbe Regional Hospital has the highest full implementation rate of AMS activities (67%), while Buea regional hospital is the least of fully implemented activities (19%). An average of 49% of all AMS activities are fully implemented across the healthcare facilities, partially implemented activities made up 28%, only 3% of the activities are in the planning phase but not yet started. A 13% of the activities are not implemented across the studied facilities, while 7% of the activities are not implemented but identified as a priority.Conclusion: Although the rate is still low, there is good progress in implementation of AMS activities with most activities either fully or partially implemented; however, no health facility included AMS activities in their annual plans with key performance indicators, no management of any hospital allocated financial and human resources to initiate AMS activities. Strengthening institutional commitment and AMS training are recommended.","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e229"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety and efficacy of antimicrobial optimization based on negative results from BioFire FilmArray Pneumonia panel and respiratory culture. 基于BioFire FilmArray肺炎面板和呼吸培养阴性结果的抗菌药物安全性和有效性优化。

Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-09-18 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10117

Noah Yoo, Xian Jie Cindy Cheng, Juri Chung, Shalinee Chawla, Ioannis Zacharioudakis, Yanina Dubrovskaya

{"title":"Safety and efficacy of antimicrobial optimization based on negative results from BioFire FilmArray Pneumonia panel and respiratory culture.","authors":"Noah Yoo, Xian Jie Cindy Cheng, Juri Chung, Shalinee Chawla, Ioannis Zacharioudakis, Yanina Dubrovskaya","doi":"10.1017/ash.2025.10117","DOIUrl":"10.1017/ash.2025.10117","url":null,"abstract":"Background: The BioFire FilmArray Pneumonia (BFP) panel is a multiplexed nucleic acid test intended to detect respiratory pathogens from sputum or bronchoalveolar lavage (BAL) specimens. Efficacy and safety of de-escalation strategies in patients with negative BFP results remain unclear.Methods: This was a multicenter, retrospective analysis of patients with suspected pneumonia and negative BFP and respiratory cultures. Patients were stratified into two groups: those whose antibiotic therapy was discontinued or withheld within 48 hours of a negative BFP (ATDW group) and those whose antibiotic therapy was continued (ATC group). We evaluated composite primary outcome of in-hospital mortality and 30-day readmission due to pneumonia (PNA) or recurrent PNA during index admission and secondary safety outcomes.Results: Among 500 patients with negative BFP assay, a total of 185 patients were included in the final analysis (59 ATDW vs. 126 ATC). The ATDW group had significantly shorter total duration of antibiotic therapy (1 day vs 7 days, p < 0.001). The primary composite outcome was similar between ATDW and ATC groups (23.1% vs 35.3%, P = 0.15). Multivariate analysis identified ICU admission and/or intubation (OR 7.5, 95% CI 3.17-17.52, P < 0.001) as only independent predictor of the composite primary outcome. The ATDW group experienced fewer rates of acute kidney injury (AKI)(8% vs 37%, P = 0.004).Conclusion: Antimicrobial optimization based on negative results from both BFP and respiratory culture may potentially reduce unnecessary antibiotic exposure and AKI in hospitalized patients with suspected pneumonia without increasing the risk of mortality and readmission.","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e226"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Erratum: Race and ethnicity and the risk of community-acquired third-generation cephalosporin-resistant uropathogens: a systematic review and meta-analysis - CORRIGENDUM. 种族和民族与社区获得性第三代头孢菌素耐药尿路病原体的风险：系统回顾和荟萃分析-勘误。

Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-09-18 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10143

Sweta Balaji, Sarah Blackmon, Esther E Avendano, Samson Alemu Argaw, Rebecca A Morin, Nanguneri Nirmala, Shira Doron, Maya L Nadimpalli

引用次数: 0

Use of primary oral vancomycin prophylaxis to stem an outbreak of Clostridioides difficile infection in intensive care patients. 使用初级口服万古霉素预防重症监护患者难辨梭菌感染的爆发。

Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-09-18 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10095

Anjali Kewalramani, Shaurya Sharma, Katrina Sandejas, Daniel Rampersad, Qu Zhong, Briana Episcopia, Leon Boudourakis, John Quale

引用次数: 0

How health systems build capacity for antimicrobial stewardship: eight pillars to success. 卫生系统如何建设抗微生物药物管理能力：成功的八大支柱。

Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-09-18 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10102

Reese A Cosimi, Florian Daragjati, Melinda Mackey, Steve VanHook, Mohamad Fakih

{"title":"How health systems build capacity for antimicrobial stewardship: eight pillars to success.","authors":"Reese A Cosimi, Florian Daragjati, Melinda Mackey, Steve VanHook, Mohamad Fakih","doi":"10.1017/ash.2025.10102","DOIUrl":"10.1017/ash.2025.10102","url":null,"abstract":"Background: Antimicrobial stewardship (AMS) is crucial for improving infectious disease outcomes and mitigating antimicrobial resistance. Healthcare systems provide an ideal setting for implementing comprehensive AMS, but face challenges related to scale and complexity.Methods: This report describes Ascension's system-wide AMS program, a model built upon establishing program structures, standardized processes, and fostering empowerment and partnerships. The program is structured around eight key pillars: system-level governance, market-level support, data-driven decision-making, multidisciplinary collaboration, data tracking and reporting, targeted interventions, empowering frontline teams, and stakeholder partnerships.Results: The system's AMS program has yielded benefits, including the development and dissemination of standardized guidelines, the support of data-driven decisions through robust analytics and performance dashboards, and the deployment of clinical decision support tools. Capacity building has been enhanced through multidisciplinary collaboration and empowering frontline teams. Data tracking and reporting allow for the monitoring of key metrics.Conclusion: Healthcare systems can build capacity and support sustainability to AMS programs through developing structures, standardized processes, and empowerment to achieve optimal outcomes.","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e225"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the editor regarding "let's doff: a gown conservation strategy for multidrug-resistant organism colonization during the COVID-19 pandemic and beyond" by Rowe et al. Rowe等人就“let's doff：在COVID-19大流行期间及以后多药耐药生物定植的长袍保护策略”致编辑的信。

Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-09-17 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10138

Mahdee Saleh

引用次数: 0