Antimicrobial stewardship & healthcare epidemiology : ASHE最新文献

{"title":"Antimicrobial stewardship programs in a network of Canadian acute care hospitals: a cross-sectional survey.","authors":"Erin McGill, Andrew Neitzel, Jessica J Bartoszko, Maureen Buchanan-Chell, Jennifer Grant, Jenine Leal, Stephanie Smith, Reena Titoria, Olivia Varsaneux, Charles Frenette","doi":"10.1017/ash.2025.181","DOIUrl":"10.1017/ash.2025.181","url":null,"abstract":"<p><strong>Objective: </strong>Antibiotics are essential to combating infections; however, misuse and overuse has contributed to antimicrobial resistance (AMR). Antimicrobial stewardship programs (ASPs) are a strategy to combat AMR and are mandatory in Canadian hospitals for accreditation. The Canadian Nosocomial Infection Surveillance Program (CNISP) sought to capture a snapshot of ASP practices within the network of Canadian acute care hospitals. Objectives of the survey were to describe the status, practices, and process indicators of ASPs across acute care hospitals participating in CNISP.</p><p><strong>Design: </strong>The survey explored the following items related to ASP programs: 1) program structure and leadership, 2) human, technical and financial resources allocated, 3) inventory of interventions carried and implemented, 4) tracking antimicrobial use; and 5) educational and promotional components.</p><p><strong>Methods: </strong>CNISP developed a 34-item survey in both English and French. The survey was administered to 109 participating CNISP hospitals from June to August 2024, responses were analyzed descriptively.</p><p><strong>Results: </strong>Ninety-seven percent (106/109) of CNISP hospitals responded to the survey. Eighty-four percent (89/106) reported having a formal ASP in place at the time of the study. Ninety percent (80/89) of acute care hospitals with an ASP performed prospective audit and feedback for antibiotic agents and 85% (76/89) had formal surveillance of quantitative antimicrobial use. Additionally, just over 80% (74/89) provided education to their prescribers and other healthcare staff.</p><p><strong>Conclusions: </strong>CNISP acute care hospitals employ multiple key aspects of ASP including implementing interventions and monitoring/tracking antimicrobial use. There were acute care hospitals without an ASP, highlighting areas for investigation and improvement.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e122"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200908","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}

{"title":"Real-world interpretation of procalcitonin to guide antibiotic prescribing: a retrospective cohort study with regression discontinuity analysis.","authors":"Leela Chockalingam, Thomas Mee, Tiffany Gardner, Eric Grimm, Amiran Baduashvili","doi":"10.1017/ash.2025.72","DOIUrl":"10.1017/ash.2025.72","url":null,"abstract":"<p><strong>Objective: </strong>It is unknown how providers are utilizing procalcitonin in the real world to make antibiotic prescribing decisions, and whether procalcitonin can limit harms related to antibiotic misuse. We examined how the probability of receiving antibiotics changed just below and above the pre-specified procalcitonin cut-points. We sought to understand whether providers interpret procalcitonin as a dichotomous or continuous diagnostic test.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>We included adult inpatients who had procalcitonin collected as part of routine care. Patients with procalcitonin collected more than 48 hours after the first antibiotic dose, those discharged from the emergency department, or those on an obstetrics service were excluded.</p><p><strong>Methods: </strong>We used administrative data from the Health Data Compass database (2018-2019) at the University of Colorado Hospital to examine the correlation of pre-specified procalcitonin cut-points (0.1, 0.25, and 0.5 ng/mL) with the antibiotic treatment decisions using a regression discontinuity analysis (RDA), stratified by level of care. We constructed receiver operating characteristic (ROC) curves depicting the relationship between procalcitonin level and antibiotic prescribing. We performed sensitivity analyses by varying bandwidth for RDA.</p><p><strong>Results: </strong>The study included 4383 patients. A total of 68.9% received a full antibiotic course. RDA did not demonstrate any discontinuity at the pre-specified cut-points. However, sensitivity analyses showed a potential discontinuity at the 0.25 ng/mL cut-point in the ICU subgroup. The ROC curves were consistent with the RDA findings.</p><p><strong>Conclusions: </strong>This study suggests that most clinicians in real-world settings interpret procalcitonin as a continuous diagnostic test when prescribing antibiotics.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e119"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200909","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}

{"title":"Tailor swiftly: lessons learned from a nationwide implementation of an antimicrobial stewardship program for asymptomatic bacteriuria.","authors":"Trenton M Haltom, Sophia Braund, Rogelio Hernandez, Larissa Grigoryan, Barbara W Trautner, Eva Amenta","doi":"10.1017/ash.2025.63","DOIUrl":"10.1017/ash.2025.63","url":null,"abstract":"<p><strong>Objective: </strong>Overtreatment of asymptomatic bacteriuria (ASB) is a major cause of antibiotic overuse. We facilitated a nationwide implementation of an ASB antimicrobial stewardship intervention in 41 Veterans Affairs facilities. Twenty-one sites participated in a Virtual Learning Collaborative (VLC) with monthly webinars. We assess what VLC teams learned from one another in these webinars.</p><p><strong>Methods: </strong>The bi-monthly VLC webinars featured expert presentations and spotlighted 1-2 site teams, asking them to discuss their barriers and facilitators for the intervention. Data come from analyses of descriptive field notes from the webinars and chat transcripts. Field notes were analyzed using the \"sort and sift, think and shift\" method. We sorted and labeled common strategies thematically, sifted through illustrative quotes, and iteratively discussed the results to reach consensus.</p><p><strong>Results: </strong>Across 22 webinars (August 2023-April 2024), sites discussed different resources, team membership, and organizational structures. Sites had to \"tailor swiftly\" to their site needs and target audiences by adapting educational materials for timing, length, audience, and outreach location. Sites used five tailoring strategies to implement the antimicrobial stewardship program: Organizational and Structural Strategies, Recruitment Strategies, Data- and Information-Based Strategies, Interpersonal Strategies, and Resource Provision.</p><p><strong>Conclusion: </strong>VLC webinars allowed sites to share tips and strategies for the implementation of a nationwide antimicrobial stewardship program wherein rapid tailoring and local adaptations were effective. Our supportive approach to tailoring allowed implementation sites to adapt antimicrobial stewardship materials and intervention delivery to their different resources and organizational contexts.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e118"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200910","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}

{"title":"Comparison of intravenous vs intravenous with step-down to oral antibiotic treatment course for Streptococcus and Enterococcus bloodstream infections.","authors":"Kelsey Bouwman, Jacob W Pierce, Jennifer Emberger, Alexandra Te Stang, Paul Vos, Aaron M Kipp, Nicole C Nicolsen","doi":"10.1017/ash.2025.168","DOIUrl":"10.1017/ash.2025.168","url":null,"abstract":"<p><strong>Objective: </strong>To compare clinical failure of intravenous vs intravenous with oral step-down antibiotic treatment for Streptococcus and Enterococcus bloodstream infection.</p><p><strong>Design and setting: </strong>Multicenter, retrospective, cohort study at one academic medical center and eight community hospitals.</p><p><strong>Patients: </strong>Hospitalized adult patients with blood cultures positive for Streptococcus or Enterococcus were included. Patients were excluded if they had complicated infection, had polymicrobial bacteremia, received less than 5 days of therapy, or died before completing therapy.</p><p><strong>Methods: </strong>Patients who completed intravenous therapy were compared with patients who transitioned to oral therapy after 3 to 7 days. The primary endpoint was clinical failure, defined as 90-day all-cause mortality or recurrent bacteremia. The primary analysis excluded patients with unknown outcomes, and the sensitivity analysis treated them as failures.</p><p><strong>Results: </strong>429 patients were included (intravenous group: n = 225; oral step-down group; n = 204). The intravenous group had more comorbidities and vasopressor use. The intravenous group had a higher risk of clinical failure in the primary analysis (17.5% vs. 8.8%; adjusted OR 2.14 [95% CI, 1.09-4.2]; <i>p</i> = 0.03) while the sensitivity analysis found no difference in clinical failure (adjusted OR 1.1 [95% CI, 0.69-1.74], <i>p</i> = 0.69). The oral step-down group had a mean length of stay of 9.2 days shorter than the intravenous group ([95% CI, 7.5-11.0]; <i>p</i><0.001).</p><p><strong>Conclusion: </strong>Oral step-down therapy was not associated with an increased risk of clinical failure compared to a full course of intravenous therapy for uncomplicated Streptococcus and Enterococcus bloodstream infections. Patients with more comorbidities or who required vasopressors were less likely to be switched to oral therapy.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e117"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112843","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}

{"title":"Impact of a multi-step testing algorithm on hospital-onset <i>Clostridioides difficile</i> rates and clinical outcomes.","authors":"Matthew A Moffa, Dustin R Carr, Nathan R Shively, Adriana Betancourth, Nitin Bhanot, Zaw Min, Charmaine Abalos, Arshpal Gill, Salman Bangash, Thomas L Walsh","doi":"10.1017/ash.2025.180","DOIUrl":"10.1017/ash.2025.180","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of implementing a multi-step <i>Clostridioides difficile</i> infection (CDI) testing algorithm on hospital-onset (HO)-CDI rates and clinical outcomes.</p><p><strong>Design: </strong>Retrospective pre-intervention/post-intervention study.</p><p><strong>Setting: </strong>Two academic hospitals in Pittsburgh, Pennsylvania.</p><p><strong>Methods: </strong>In the pre-intervention period, a standalone polymerase chain reaction (PCR) assay was used for diagnosing CDI. In the post-intervention period, positive PCR assays were reflexed to a glutamate dehydrogenase antigen test and an enzyme immunoassay for toxin A/B.</p><p><strong>Results: </strong>The implementation of a multi-step testing algorithm resulted in a significant reduction in HO-CDI cases per 10,000 patient days from 5.92 to 2.36 (<i>P</i> < 0.001). Despite the decrease in reportable HO-CDI cases, there were no significant differences in clinical outcomes such as hospital length of stay, intensive care unit admissions, and treatment courses. In addition, there was a significant reduction in all-cause 30-day readmissions in the post-intervention group, though CDI-related readmissions remained similar.</p><p><strong>Conclusions: </strong>The multi-step testing algorithm significantly reduced HO-CDI rates without compromising clinical outcomes. The study supports the use of a multi-step CDI testing algorithm to assist healthcare providers with CDI management decisions and potentially to reduce financial penalties burdened on healthcare systems.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e112"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112806","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}

{"title":"The use and misuse of procalcitonin in the management of pneumonia: a retrospective analysis at a large tertiary care center.","authors":"Doris C Obimba, Aaron Shaykevich, Danielle R Vitale, Christopher A Rudmann, Heather Korrie, Joseph Miles, Christopher Noel, Ivayla I Geneva","doi":"10.1017/ash.2025.175","DOIUrl":"10.1017/ash.2025.175","url":null,"abstract":"<p><strong>Objective: </strong>Antibiotics overuse leads to bacterial resistance. The biomarker procalcitonin rises with bacterial pneumonias and remains normal in viral respiratory tract infections. Its use can distinguish between these etiologies and thus guide antibiotics use. We aimed to quantify the effect of procalcitonin use on clinical decision-making.</p><p><strong>Design: </strong>A retrospective study, spanning a year at a tertiary care center, where 348 patients hospitalized with aspiration pneumonia and 824 with non-aspiration pneumonia were evaluated with regards to procalcitonin use, the length of stay (LOS) and antibiotics prescribing practices. Descriptive statistics and univariate analyses were applied to the ensemble data. Subsets of cases were manually reviewed and analyzed with descriptive statistics. <i>P</i> < 0.05 indicated statistical significance.</p><p><strong>Results: </strong>21% of both the aspiration and non-aspiration pneumonia cases had procalcitonin checked. In the ensemble analyses, a check of procalcitonin was more likely to happen in prolonged hospitalizations with aspiration pneumonia. The LOS was statistically the same regardless of procalcitonin results (elevated or normal) for both the aspiration and non-aspiration pneumonia cohorts. The overall use of antibiotics was not affected by the procalcitonin results. After excluding two extreme outliers, the per-person antibiotics cost was not affected by the procalcitonin results. Detailed chart reviews of 33 cases revealed that for the vast majority, the procalcitonin results were not used by clinicians to guide the duration of antibiotics use.</p><p><strong>Conclusions: </strong>Despite its promise as a biomarker for antibiotics stewardship, procalcitonin results appeared to not be utilized by clinicians as a decision-making tool in the management of pneumonia.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e115"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112883","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}

{"title":"Five essential lessons in antimicrobial stewardship and leadership I have learned from running.","authors":"Miranda So","doi":"10.1017/ash.2025.188","DOIUrl":"10.1017/ash.2025.188","url":null,"abstract":"<p><p>As an antimicrobial stewardship pharmacist and an avid runner, I identified the five essential lessons I have learned from running that are transferrable to implementing initiatives, conducting practice-based research and leading an antimicrobial stewardship program. To ensure this commentary will resonate with the reader, I provided an illustrative example connecting each lesson from running with a transferrable concept or practice in antimicrobial stewardship.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e114"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112847","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}

{"title":"Knowledge, attitudes, and practices regarding antimicrobial resistance and antimicrobial stewardship among healthcare workers in outpatient medical centers in Kenya: a qualitative study.","authors":"Mary W Kaniu, Wahu R Gitaka, Rupali Jain, Ann N Munyare, Rodney D Adam, Aliza Monroe-Wise","doi":"10.1017/ash.2025.41","DOIUrl":"10.1017/ash.2025.41","url":null,"abstract":"<p><strong>Objective: </strong>Antimicrobial resistance (AMR) is a major global health threat with a projected 10 million deaths globally by 2050. Antimicrobial stewardship (AMS) programs are coordinated efforts involving doctors, nurses, pharmacists, and other healthcare providers. Understanding knowledge, attitudes, and practices of health providers is pivotal for implementing strategies to curb the spread of AMR. The aim of this study was to evaluate knowledge, attitudes, and practices surrounding AMR and AMS among healthcare workers in Kenya.</p><p><strong>Design: </strong>A qualitative study using in-depth semi-structured interviews.</p><p><strong>Setting: </strong>12 private outpatient clinics in Kenya.</p><p><strong>Participants: </strong>Healthcare workers including administrators and clinicians.</p><p><strong>Methods: </strong>A thematic analysis approach was used; the Capability, Opportunity, and Motivation for Behavior model was used to understand the knowledge, attitudes, and practices surrounding AMR and AMS.</p><p><strong>Results: </strong>Twenty-four participants were interviewed. They had some knowledge regarding AMR but lacked knowledge about AMS and its components. Although participants did not perceive AMR as a problem in their clinics, they reported it was a major problem in the country and globally. There was lack of prioritization of AMS in the clinics.</p><p><strong>Conclusions: </strong>The lack of knowledge on AMS and its components coupled with failure to recognize AMR as a problem in the facilities led to a lack of prioritization of AMS. There is therefore an urgent need to educate healthcare administrators and clinicians on AMR and AMS to foster a sense of ownership of the problem of AMR and to be pro-active in implementing measures to curb it.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e113"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112814","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}

{"title":"The impact of mindfulness training on infection prevention practices in intensive care units.","authors":"Anucha Apisarnthanarak, Panuch Eiamprapaporn, Punchong Hanvivadhanakul, Watcharee Chancharoenrat, Suphannee PhetSaen, Tipanan Tamsuan, Kittiya Jantarathaneewat, Piyaporn Apisarnthanarak, Linda M Mundy, Aunchaya Yeamsukon, Duangrutai Aksarachaipruk, Isaree Naisangunsri, Ven Surapoj Saddhadhigo Bhikkhu, Ven Tawatchai Dhammadipo Bhikkhu","doi":"10.1017/ash.2025.174","DOIUrl":"10.1017/ash.2025.174","url":null,"abstract":"","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e116"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112879","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}

{"title":"Epidemiological data on the acquisition of carbapenem-resistant <i>Enterobacterales</i> through weekly rectal swabs in non-critically ill patients undergoing antimicrobial therapy: a short-term surveillance study.","authors":"Naruemit Sayabovorn, Naruemon Maknakhon, Naratchaphan Pati, Teerawit Tangkoskul, Anupop Jitmuang","doi":"10.1017/ash.2025.169","DOIUrl":"10.1017/ash.2025.169","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the connection between non-critically ill hospitalized patients and the acquisition of carbapenem-resistant <i>Enterobacterales</i> (CRE).</p><p><strong>Design: </strong>An observational prospective cohort study from January 2018 to December 2019.</p><p><strong>Setting: </strong>A single tertiary referral center.</p><p><strong>Participants: </strong>Non-critically ill subjects admitted to general medical wards who received antimicrobial therapy <48 h.</p><p><strong>Methods: </strong>Rectal swab cultures at admission and weekly for CRE surveillance. CRE isolates were confirmed using carbapenem disk diffusion susceptibility and genotypic carbapenemase testing. Clinical characteristics and outcomes were also evaluated.</p><p><strong>Results: </strong>Of 110 subjects, 66.4% were women, the mean age was 67 years, and 336 bacterial isolates were detected from rectal swab cultures. 55 (16.4%) isolates from 25 subjects exhibited phenotypic resistance to carbapenem. <i>Klebsiella pneumoniae</i> (50.9%) and <i>Escherichia coli</i> (30.9%) were common CRE, harboring New Delhi metallo-beta-lactamase (NDM) (50.9%), oxacillinase-48 (OXA-48) (12.7%), and co-NDM/OXA-48 (20.0%). Subjects with acquired CRE had higher APACHE II scores (<i>P</i> = 0.030), received piperacillin-tazobactam (<i>P</i> = 0.004), underwent prolonged antimicrobial therapy (<i>P</i> = 0.009), and experienced longer hospital stays (<i>P</i> = 0.001) compared to CRE-negative subjects. None of the CRE-positive subjects developed an acquired infection.</p><p><strong>Conclusions: </strong>Acquired CRE colonization is prevalent among non-critically ill patients. Factors such as disease severity, the type and duration of antimicrobial therapy, and the length of hospital stays may increase the risk of CRE acquisition in non-critically ill populations.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e105"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103410","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}