Antimicrobial stewardship & healthcare epidemiology : ASHE最新文献

{"title":"Antidepressants and antibiotic resistance in urine cultures: a cohort study.","authors":"Isaac Sears, Michel Davis, Kevin Gibas, Leonard Mermel, Daithi S Heffernan","doi":"10.1017/ash.2025.73","DOIUrl":"https://doi.org/10.1017/ash.2025.73","url":null,"abstract":"<p><p><i>In vitro</i> evidence of antidepressant-driven antibiotic resistance has recently been described. In this retrospective cohort study, significant associations are identified between antidepressant use and antibiotic resistance on urine cultures taken in the Emergency Department. This epidemiologic data supports previous <i>in vitro</i> work and raises additional questions for further study.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e98"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059623","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":"Off-label use of intravenous rifampicin during surgery: analysis of Australian surveillance data and retrospective audit at a tertiary hospital.","authors":"Nadine T Hillock, Edward Raby, Matthew Rawlins","doi":"10.1017/ash.2025.71","DOIUrl":"https://doi.org/10.1017/ash.2025.71","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the use of rifampicin vials in Australian operating theaters (OT) to determine the method of administration and rationale for use.</p><p><strong>Methods: </strong>Retrospective (2022 and 2023) OT usage data for rifampicin 600 mg vials were analyzed to compare trends in use between Australian hospitals and between jurisdictions. An audit of rifampicin vials used in OT during 2023 was conducted at a large tertiary hospital.</p><p><strong>Results: </strong>Fifty-nine of 248 hospitals (24%) contributing data to the National Antimicrobial Utilisation Surveillance Program recorded OT use of rifampicin vials during 2022 and 2023. Excluding hospitals with no usage, the median use was 7 vials/annum/per hospital (IQR: 2-32). A wide variation in use was seen between Australian states and territories. An audit of OT use in 2023 at a large tertiary hospital found poor documentation of topical use; in most cases, documentation was in the operation note only, with no documentation on the medication charts, medical notes, or the anesthetic record. Of 33 rifampicin vials used in 2023, documented topical use was identified for 10 individual patients only, 4 of whom had a confirmed <i>Staphylococcus aureus</i> infection (1 methicillin-resistant and 3 methicillin-susceptible).</p><p><strong>Conclusion: </strong>Off-label, topical use of rifampicin during surgery is not uncommon in some Australian hospitals despite limited evidence of safety or efficacy. Given the potential for resistance, surgical use of rifampicin should be restricted to a named-patient basis, under the guidance of an infectious disease specialist/clinical microbiologist. Documentation of all medication use is recommended for patient safety.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e100"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036677","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":"Upholding the fundamental values of infection prevention and antimicrobial stewardship in the current political climate.","authors":"Priya Nori, Gonzalo Bearman","doi":"10.1017/ash.2025.67","DOIUrl":"https://doi.org/10.1017/ash.2025.67","url":null,"abstract":"<p><p>The healthcare and public health communities must adjust to a series of damaging, anti-science, and anti-innovation policies of the new administration. After a brief review of new healthcare and public health-oriented federal policies, we outline priority areas for the infection prevention and antimicrobial stewardship workforce and offer solutions for adaptation.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e97"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058206","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":"Validation of oral-nasal specimen collection for influenza and respiratory syncytial virus detection.","authors":"Matthew Young, Yuri Suico, Omid Kyle Vojdani, Janine McCready, Kevin Katz, Scarlett Pourmatin, Manija Rahimi, Christie Vermeiren, Jeff Powis, Christopher Kandel","doi":"10.1017/ash.2025.66","DOIUrl":"https://doi.org/10.1017/ash.2025.66","url":null,"abstract":"<p><strong>Objective: </strong>Respiratory virus testing is routinely performed and ways to obtain specimens aside from a nasopharyngeal swab are needed for pandemic preparedness. The main objective is to validate a self-collected oral-nasal swab for the detection of Influenza and respiratory syncytial virus (RSV).</p><p><strong>Design: </strong>Diagnostic test validation of a self-collected oral nasal swab as compared to a provider-collected nasopharyngeal swab.</p><p><strong>Setting: </strong>Emergency Department at Michael Garron Hospital.</p><p><strong>Participants: </strong>Consecutive individuals who presented to the Emergency Department with a suspected viral upper respiratory tract infection were included if they self-collected an oral-nasal swab. Individuals testing positive for Influenza or RSV along with randomly selected participants who tested negative were eligible for inclusion.</p><p><strong>Interventions: </strong>All participants had the paired oral-nasal swab tested using a multiplex respiratory virus polymerase chain reaction for the three respiratory pathogens and compared to the nasopharyngeal swab.</p><p><strong>Results: </strong>48 individuals tested positive for Influenza, severe acute respiratory coronavirus virus 2 (SARS-CoV-2) or RSV along with 80 who tested negative. 110 were symptomatic with the median time from symptom onset to testing of 1 day (interquartile range 2-5 days). Using the clinical nasopharyngeal swab as the reference standard, the sensitivity was 0.75 (95% CI, 0.43-0.95) and specificity was 0.99 (95% CI, 0.93-1.00) for RSV, sensitivity is 0.67 (95% CI, 0.49-0.81) and specificity is 0.96 (95% CI, 0.89-0.99) for Influenza.</p><p><strong>Conclusions: </strong>Multiplex testing with a self-collected oral-nasal swab for Influenza and RSV is not an acceptable substitute for a healthcare provider collected nasopharyngeal swab primarily due to suboptimal Influenza test characteristics.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e99"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014450","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 an evidence-based order panel on antibiotic prescribing in ambulatory patients with cystitis.","authors":"Matt Neumann, Ryan W Stevens, Kristin Cole, Paschalis Vergidis, Abinash Virk, Dan Ilges, Kelsey L Jensen","doi":"10.1017/ash.2025.62","DOIUrl":"https://doi.org/10.1017/ash.2025.62","url":null,"abstract":"<p><strong>Background: </strong>Optimizing antibiotic prescribing for urinary tract infections (UTI) represents an opportunity for ambulatory antibiotic stewardship programs (ASPs). A pre-populated order panel for UTI was implemented in the Mayo Clinic Enterprise in May 2022. The order panel provides antibiotic regimens aligning with institutional guidelines according to patient characteristics, presence or absence of complicating features, and antimicrobial allergy status. We assessed impacts of panel use on prescribing practices for cystitis.</p><p><strong>Methods: </strong>This retrospective cohort study of ambulatory encounters with a primary diagnosis of cystitis from May 16, 2022, to May 15, 2023, compared encounters in which the order panel was utilized to encounters managed without the panel. The primary outcome was concordance with institutional guidelines, including drug selection, dose/frequency, and duration. Secondary outcomes included rate of repeat healthcare contact for UTI within 14 days and total duration of therapy.</p><p><strong>Results: </strong>793 randomly selected patient encounters (397 panel and 396 non-panel) were included. Prescribing was guideline adherent in 79.3% and 64.9% (<i>P</i> < 0.001) of panel and non-panel encounters, respectively. There were more 3- and 5-day treatment courses in the panel cohort; however, inappropriate duration of therapy was the most common reason for non-concordance in both cohorts. There was no significant difference between groups in repeat 14-day healthcare contact for UTI (13.4% panel vs 11.1% no panel, <i>P</i> = 0.34).</p><p><strong>Conclusion: </strong>Use of a pre-populated ambulatory order panel for the treatment of cystitis was associated with greater concordance with institutional guidelines, without adversely impacting repeat healthcare contact for UTI.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e96"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061130","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":"Low- versus high-dose trimethoprim-sulfamethoxazole for the treatment of <i>Stenotrophomonas maltophilia</i> pneumonia.","authors":"Bradley Taranto, Lynn C Wardlow, Kelci Coe, Jose A Bazan, Jessica Leininger","doi":"10.1017/ash.2025.64","DOIUrl":"https://doi.org/10.1017/ash.2025.64","url":null,"abstract":"<p><strong>Objective: </strong>To compare outcomes of patients treated with low-dose (LD) versus high-dose (HD) trimethoprim-sulfamethoxazole (TMP-SMX) for <i>Stenotrophomonas maltophilia</i> pneumonia.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Large academic tertiary-care center.</p><p><strong>Patients: </strong>Hospitalized adult patients who received at least 8 mg/kg/day of TMP-SMX for at least 96 hours for treatment of <i>S. maltophilia</i> pneumonia between October 2012 and September 2022. Patients were included if they were diagnosed with pneumonia based on clinical and radiographic findings at the time of initiation of antibiotics.</p><p><strong>Methods: </strong>The primary outcome was clinical success at the end of therapy among patients treated with LD (8-12 mg/kg/day) versus HD (>12 mg/kg/day) TMP-SMX. Secondary outcomes included microbiological success, all-cause and infection-related inpatient mortality, infection recurrence, development of TMP-SMX resistance, and incidence of acute kidney injury (AKI) and hyperkalemia.</p><p><strong>Results: </strong>95 patients were included (LD, <i>n</i> = 20 versus HD, <i>n</i> = 75). There was no difference in the primary outcome of clinical success at the end of therapy between groups (LD 57% versus HD 65%, <i>P</i> = 0.53). Secondary outcomes, including inpatient infection-related mortality (<i>P</i> = 0.56), AKI (<i>P</i> = 0.61), and hyperkalemia (<i>P</i> = 0.34) also did not differ significantly between the LD and HD groups.</p><p><strong>Conclusions: </strong>No differences in clinical success or adverse events were observed in patients with <i>S. maltophilia</i> pneumonia treated with either LD or HD TMP-SMX.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e95"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055113","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":"Healthcare workers' attitudes and practices around environmental sustainability in infection prevention.","authors":"Ashley L Lin, Michelle E Doll, Rachel J Pryor, Elizabeth A Monsees, Priya Nori, Gonzalo M Bearman","doi":"10.1017/ash.2025.68","DOIUrl":"https://doi.org/10.1017/ash.2025.68","url":null,"abstract":"<p><p>We assessed healthcare workers' knowledge, attitudes, and practices around disposable personal protective equipment (PPE) use. We observed that healthcare workers are interested in sustainable policies and identified areas for policy changes to reduce PPE waste.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e94"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042241","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":"Antibiotic use and financial impact of a comprehensive beta-lactam allergy management program.","authors":"Karan Raja, Lakhini Vyas, Susan Morrison, Donald Beggs, Mitesh Patel, Mona Philips","doi":"10.1017/ash.2025.36","DOIUrl":"https://doi.org/10.1017/ash.2025.36","url":null,"abstract":"<p><strong>Objective: </strong>A multidisciplinary beta-lactam allergy management program was implemented at our community medical center to facilitate allergy documentation, conduct penicillin skin testing (PST), and decrease non-beta-lactam (NBL) use. This study measures PST-associated antibiotic use and financial outcomes.</p><p><strong>Design: </strong>Cohort study.</p><p><strong>Setting: </strong>Non-teaching, urban, community medical center within a multi-hospital health system.</p><p><strong>Patients: </strong>Adult inpatients who underwent PST and received antibiotic therapy during a 5-year period at our facility.</p><p><strong>Methods: </strong>Demographics, allergies, laboratory results, PST outcome, and antimicrobial regimens were assessed. Actual NBL days of therapy (DOT) were collected from the electronic medical record. NBL DOT that patients would have received without PST were modeled by forecasting the original regimen to end of inpatient treatment. Difference between actual and forecasted DOT was deemed DOT avoided (DOT-A) for each consecutively enrolled patient. The financial analysis evaluated cumulative NBL cost avoided. PST outcomes and average time from antibiotic initiation to PST were assessed.</p><p><strong>Results: </strong>The study included 600 patients who underwent PST an average of 3.7 days into treatment. The most common indication was acute bacterial skin and skin structure infections (23.9%). PST results were negative in 98% of patients. NBL DOT-A was 944.8/1000DT (8.8 DOT-A per intervention) accounting for an estimated cost savings of $206,500 ($344.10 per intervention), driven primarily by aztreonam avoidance.</p><p><strong>Conclusions: </strong>This study highlights significant avoidance of NBL DOT in one of the largest identified cohort of inpatients undergoing PST. Associated cost avoidance contributes to the sustainability and longevity of the allergy management program.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e83"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042365","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-time biofluorescent particle counting compared to conventional air sampling for monitoring airborne contamination in orthopedic implant surgery.","authors":"Frans Stålfelt, Josefin Seth Caous, Karin Svensson Malchau, Camilla Björn, Maziar Mohaddes","doi":"10.1017/ash.2025.61","DOIUrl":"https://doi.org/10.1017/ash.2025.61","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infection (SSI) following orthopedic surgery is a complication associated with morbidity and economic burden. Transmission of airborne bacteria that settle into surgical wounds constitutes a risk factor for SSIs. However, monitoring microbial contamination inside operating rooms with conventional methods is resource and time-consuming.</p><p><strong>Aim: </strong>This study aimed to assess correlation between a biofluorescent particle counter (BFPC) and conventional air sampling, to enable real-time monitoring of airborne contamination. Additionally, the study aimed to analyze correlation between particles near the surgical site and particles 1 meter away, to evaluate the feasibility of distance-based measurements.</p><p><strong>Methods: </strong>Correlation analysis was conducted to compare colony-forming units (CFU) collected using a Sartorius MD8 air sampler with biofluorescent viable particles detected by BioTrak 9510-BD, both positioned near the surgical site. Additionally, correlation between particle counts measured by AeroTrak 6510, positioned 1 meter away, and total particle counts measured by the BioTrak near the surgical site was evaluated. Sampling took place in two operating rooms: one with turbulent mixed airflow (TMA) and one with unidirectional airflow (UDAF).</p><p><strong>Results: </strong>Negligible to low correlation between biofluorescent particles and CFU was observed, both in UDAF (n = 100) and TMA (n = 22). However, strong correlation was found between BFPC and particle counter measurements of total numbers of particles (R_p = 0.634-0.769, <i>P</i> < .001).</p><p><strong>Conclusion: </strong>While BFPCs offer real-time monitoring of airborne contamination, their predictive ability for CFU levels remains uncertain. Yet, the strong correlation between particles in the surgical site and particles measured 1 meter away suggests feasibility to conduct future studies with larger cohorts.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e93"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059763","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":"Revisiting restricted reproductive rights in 2025: what do we need to know now?","authors":"Pamela Bailey, Amy Crockett, Julie Ann Justo, Priya Nori","doi":"10.1017/ash.2025.56","DOIUrl":"https://doi.org/10.1017/ash.2025.56","url":null,"abstract":"<p><p>In the aftermath of the 2022 <i>Dobbs v Jackson Women's Health Organization</i> decision on access to reproductive healthcare, we published a commentary in this journal to inform the infectious diseases (ID) community about anticipated worsening of maternal and neonatal sepsis outcomes and relevant stewardship and healthcare associated infection issues. Three years later, we seek to keep the ID community engaged with important updates and intensify their commitment to providing high-quality care and reduce disparate health outcomes in this vulnerable population.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e92"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029211","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}