Antimicrobial stewardship & healthcare epidemiology : ASHE最新文献

{"title":"Hand hygiene on gloved hands: is glove integrity compromised by repeated disinfections?","authors":"Michelle Doll, Tiffany Zhao, Ian Langford, Barry Rittmann, Patrick R Ching, Pamela Bailey, Gonzalo Bearman","doi":"10.1017/ash.2025.167","DOIUrl":"10.1017/ash.2025.167","url":null,"abstract":"","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e111"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103412","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 broad-spectrum anti-Pseudomonal beta-lactam antibiotics versus targeted therapy for neutropenic patients with methicillin-susceptible <i>Staphylococcus aureus</i> bloodstream infections.","authors":"Lauren C Russell, Jeff Klaus, Miguel A Chavez, Erik R Dubberke, Tamara Krekel","doi":"10.1017/ash.2025.179","DOIUrl":"10.1017/ash.2025.179","url":null,"abstract":"<p><p>The safety of the utilization of methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA)-targeted therapy for the treatment of MSSA bloodstream infections in the setting of neutropenia is not well studied. This single-center, retrospective cohort study of 40 patients found no significant difference in clinical outcomes between broad-spectrum anti-Pseudomonal and MSSA-targeted beta-lactam therapy.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e108"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103393","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":"Scientific Integrity Under Threat: The Role of the IDSA, PIDS, and SHEA Journals in an Evolving Political Landscape.","authors":"","doi":"10.1017/ash.2025.165","DOIUrl":"https://doi.org/10.1017/ash.2025.165","url":null,"abstract":"","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e103"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043582","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":"Untapped potential: exploring clinical pharmacists as antibiotic stewardship ambassadors.","authors":"Esther Esadah, Hayden T Schwenk, Laura L Bio","doi":"10.1017/ash.2025.69","DOIUrl":"https://doi.org/10.1017/ash.2025.69","url":null,"abstract":"<p><strong>Objective: </strong>To describe inpatient clinical pharmacists' interventions on injectable antibiotics and assess their impact on prospective audit and feedback (PAF) by the antimicrobial stewardship program (ASP).</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Freestanding, quaternary-care, pediatric and obstetric hospital.</p><p><strong>Methods: </strong>We identified all clinical pharmacist interventions (iVents) documented on injectable antibiotics from November 1, 2020, through October 31, 2022. PAF performed on injectable antibiotics during the same timeframe was captured. We reported characteristics of clinical pharmacist iVents on injectable antibiotics. We also compared the incidence of PAF recommendations (PAFR) between PAF cases with prior iVent documentation for the same patient and antibiotic and those without preceding iVent documentation.</p><p><strong>Results: </strong>A total of 5,277 iVents were documented on injectable antibiotic orders. Cefazolin had the highest volume of iVents (13%). Antibiotic dose optimization was the most frequent iVent type (34%). A total of 5,152 PAF were documented by ASP pharmacists on injectable antibiotics during the study period, with 1,782 (34%) resulting in a PAFR. A total of 999 PAF (19%) had a prior iVent; 4,153 PAF did not. Comparing the two groups, the incidence of a PAFR was significantly higher in the PAF with prior iVent group compared to the PAF without prior iVent group (383/999, 38% vs 1,399/ 4,153, 34%; <i>P</i> = 0.006). Antibiotic discontinuation was the most common type of PAFR in both groups.</p><p><strong>Conclusions: </strong>Clinical pharmacists serve as ASP ambassadors, intervening on injectable antibiotic orders to improve prescribing. Future efforts to expand and incorporate clinical pharmacists in ASP initiatives are warranted.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e104"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059643","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":"Exploring oral antibiotics for antibiotic stewardship in nonoperative management of complicated appendicitis in pediatric patients.","authors":"Rebecca John, Alvaro E Galvis, Robert F T Bucayu, John Schomberg, Yigit Guner, Antonio Arrieta, Delma Nieves","doi":"10.1017/ash.2025.74","DOIUrl":"https://doi.org/10.1017/ash.2025.74","url":null,"abstract":"<p><strong>Introduction: </strong>Culture data may help determine antibiotic administration options for nonoperative complicated appendicitis. Variability exists in treatment strategies, from solely using intravenous therapy, including outpatient parenteral antibiotic treatment (OPAT), to transitioning to oral (PO) antibiotics. We hypothesize that most patients have an oral antibiotic option based on culture results and that there is no increased rate of readmission due to treatment failure with oral antibiotics.</p><p><strong>Methods: </strong>This was a single-center retrospective cohort study reviewing antibiotic treatment of pediatric patients treated with nonoperative management for complicated appendicitis with abscesses percutaneously drained by Interventional Radiology (IR). We compared case-mix demographic variables, choice and route of antibiotic therapy, culture data, and clinical outcomes between those who exclusively received parenteral antibiotics therapy (PAT) and those who were switched to oral therapy (PO).</p><p><strong>Results: </strong>We identified 54 cases of nonoperative complicated appendicitis who underwent IR abscess drainage from 2014 to 2019. Forty-five [83%] patients completed therapy with PAT and 9 with PO; forty-six of 54 patients (85%) patients had an oral antibiotic(s) option based on sensitivities. Readmissions and complications included 6 (11%) patients. Three (50%) patients were readmitted due to antibiotic treatment failure with worsening of abscess formation, 2 due to PICC (peripherally inserted central catheters) issues, and 1 due to a drug reaction.</p><p><strong>Conclusions: </strong>Most patients with nonoperative complicated appendicitis can be transitioned to oral antibiotic options based on the culture susceptibility profiles.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e101"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055236","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":"Identification and validation of a risk assessment scoring tool for extended-spectrum beta-lactamase-producing Enterobacterales bacteremia at a tertiary teaching hospital.","authors":"Victoria Gavaghan, Jessica L Miller, Maureen Shields, Jennifer Dela-Pena","doi":"10.1017/ash.2025.70","DOIUrl":"https://doi.org/10.1017/ash.2025.70","url":null,"abstract":"<p><strong>Objective: </strong>To identify institution-specific risk factors for extended-spectrum beta-lactamase (ESBL) bloodstream infections (BSI) to develop and validate a risk assessment scoring tool that can be utilized for hospitalized patients.</p><p><strong>Design: </strong>Single-center, retrospective, case-control study.</p><p><strong>Setting: </strong>Tertiary teaching hospital.</p><p><strong>Patients: </strong>Hospitalized adult and pediatric patients with <i>E. coli</i> or <i>Klebsiella</i> spp. BSI were stratified based on ESBL production between August 2019 to July 2021. Exclusion criteria included patients < 28 days old, a positive blood culture resulting prior to admission/after discharge or a polymicrobial and/or carbapenem-resistant BSI.</p><p><strong>Methods: </strong>Multivariable logistic regression assessed predictors of ESBL in a derivation cohort. Predictors were applied to a novel validation BSI cohort using area under the receiver-operator characteristics curve (ROC AUC) to assess the reliability of identifying patients likely to harbor ESBL at the time of organism identification.</p><p><strong>Results: </strong>A total of 238 patients in the derivation cohort met inclusion criteria stratified as ESBL (n = 68) or non-ESBL (n = 170). Multivariable logistic regression demonstrated diabetes, 30-day history of invasive procedure or antibiotic use, and/or history of ESBL as independent predictors of ESBL. After creation of an ESBL risk assessment tool, the results were applied to a validation cohort of 170 patients. This model displayed good calibration and discrimination with a strong predictive power (Hosmer-Lemeshow χ²= 4.66, p = 0.19; ROC AUC = 0.88, 95% CI = 0.7909 - 0.974).</p><p><strong>Conclusions: </strong>A validated ESBL risk assessment tool reliably identified hospitalized patients likely to harbor ESBL <i>E. coli</i> or <i>Klebsiella</i> spp. BSI upon organism identification.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e102"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042353","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":"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}