Antimicrobial stewardship & healthcare epidemiology : ASHE最新文献

{"title":"Letter to the Editor regarding \"Long-term sustainability of improvements in antibiotic prescribing after implementation of a local guideline for the management of patients hospitalized with skin and soft tissue infection\" by Frappa <i>et al</i>.","authors":"Callan Bleick","doi":"10.1017/ash.2025.10116","DOIUrl":"10.1017/ash.2025.10116","url":null,"abstract":"","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e202"},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031251","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":"Early follow-up blood cultures-frequency and outcomes of repeat blood culture collection within 48 hours of emergency department workup: an observational study.","authors":"Angela Zara Hills, Jaimi Greenslade, Mercedes Ray, Julian Williams","doi":"10.1017/ash.2025.10085","DOIUrl":"10.1017/ash.2025.10085","url":null,"abstract":"<p><strong>Objective: </strong>To determine the frequency and outcomes of early follow-up blood cultures (BCs) collected within 48 hours of patients being investigated for bacteremia in the emergency department (ED), as well as the number of new pathogens isolated.</p><p><strong>Design: </strong>Retrospective observational study of patients who had BCs collected in the ED between October 2019 and July 2020.</p><p><strong>Methods: </strong>This study was conducted in a large, metropolitan ED with annual census of over 82,000 adult presentations. ED patients who had BCs collected during the study period were identified, and those who had BCs recollected within 48 hours were identified as having early follow-up BCs. The characteristics of these patients were compared to those without early follow-up BC collection. Logistic regression analyses were conducted to determine relationships between specific pathogens in EDBCs and early follow-up BC collection.</p><p><strong>Results: </strong>During the study period, 68,330 patients were treated in the ED, and BCs were collected from 1821 (2.7%). Of these, 449 (24.7%) had BCs recollected within 48 hours of their initial ED workup (early follow-up BCs) and were re-cultured 789 times across their collective stays. Five patients (1.1%) grew pathogens not isolated in EDBCs, all of which were susceptible to concurrent antimicrobials. No new pathogens were isolated in BCs taken >48 hours post ED workup.</p><p><strong>Conclusions: </strong>Collection of early follow-up BCs was common. However, the rate of new pathogen growth was low and contributed minimally to patient management. Given associated costs and patient discomfort, the practice should be discouraged unless to clarify potential false positive results in ED BC.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e200"},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031293","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":"Enhancing antimicrobial stewardship program: impact of clinical pharmacist-driven feedback in the absence of infectious diseases physicians-a multicenter quasi-experimental study.","authors":"Anup R Warrier, Nalluri Tejaswini, Hafeedha Kallarakkal, Soumya Sagar","doi":"10.1017/ash.2025.10088","DOIUrl":"10.1017/ash.2025.10088","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of clinical pharmacist-driven feedback on Antimicrobial Stewardship Program (AMSP) in the absence of infectious disease physicians across three different geographic locations.</p><p><strong>Design: </strong>Multicenter quasi-experimental study.</p><p><strong>Setting: </strong>Three private tertiary referral centers in different geographical locations in India.</p><p><strong>Participants: </strong>All consecutive prescriptions with restricted antibiotics for inpatients during the study period.</p><p><strong>Intervention: </strong>This study was conducted over 15 months from June 2022 to May 2023. The impact of mentoring clinical pharmacists by infectious disease physicians, enhancing their communication abilities for providing proactive feedback, and the impact on prescription practice were measured in terms of new prescriptions of restricted antibiotics, compliance to clinical pharmacist advice, and the duration of restricted antibiotic therapy usage, measured in terms of days of therapy (DOT) of restricted antibiotics. Gross mortality was reviewed as a balancing measure, and dose/dosing errors were considered as a secondary outcome. Data were captured in Microsoft Excel and analyzed using the SPSS software.</p><p><strong>Results: </strong>Clinical pharmacist-led antimicrobial stewardship interventions were found to have a significant impact on decreasing antibiotic prescriptions, increasing healthcare organization policy compliance, and decreasing DOT for restricted antibiotics. Culture sampling, acceptance of antimicrobial stewardship advice, dosing errors, or mortality rates were not statistically significantly related to the other study parameters.</p><p><strong>Conclusion: </strong>Clinical pharmacist-driven AMSP can be effectively implemented irrespective of the cultural and geographical setting due to their ability to improve prescription practices.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e176"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042394","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 UV-C on material degradation: a scoping literature review.","authors":"Daniel Suh, Stacey Hockett Sherlock, Kimberly C Dukes, Eli N Perencevich, Alexandre R Marra","doi":"10.1017/ash.2025.10114","DOIUrl":"10.1017/ash.2025.10114","url":null,"abstract":"<p><strong>Background: </strong>Ultraviolet-C (UV-C) radiation has emerged as a widely adopted disinfection technology in healthcare settings due to its germicidal effectiveness. However, concerns have grown regarding the potential degradation of materials, particularly polymeric surfaces, subjected to repeated UV-C exposure. Understanding the extent, mechanism, and contributing factors of UV-C-induced material degradation is essential for safe and sustainable implementation.</p><p><strong>Methods: </strong>We conducted a scoping literature review in accordance with PRISMA guidelines to evaluate evidence on UV-C-related material degradation. Multiple databases were searched for studies published between January 1, 2000, and August 30, 2024, investigating material degradation under UV-C radiation (100-280 nm) in potentially healthcare-relevant conditions. Data abstraction captured study design, UV-C exposure characteristics, material types, degradation types, and assessment methods.</p><p><strong>Results: </strong>Of the 56 studies reviewed, 14 met inclusion criteria. All employed experimental designs conducted in laboratory settings. UV-C exposure resulted in both visible and structural degradation of several polymeric materials. Polycarbonate, HDPE, and PLA were the most affected, exhibiting yellowing, surface cracking, and loss of mechanical strength. Degradation was time-, dose-, and distance-dependent, with longer exposure, higher irradiance, and shorter distance correlating with more severe damage. Detection methods included visual inspection, microscopy, spectroscopy, and nanoindentation. Some studies reported UV stabilizers and antioxidant additives as potential mitigation strategies.</p><p><strong>Conclusions: </strong>UV-C radiation can cause significant degradation of commonly used polymeric materials. These findings underscore the need for careful selection of materials in UV-C environments and support further research on mitigation strategies to enhance material longevity.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e199"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031216","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":"<i>Clostridioides difficile</i> infection and antibiotic prescribing at a regional hospital in Australia: a case-control study.","authors":"Sarah Elizabeth Alland, Bianca Mills, Michelle Bolte, Colleen Ma, Sally Munnoch, Matthew Kelly","doi":"10.1017/ash.2025.10113","DOIUrl":"10.1017/ash.2025.10113","url":null,"abstract":"<p><strong>Background: </strong><i>Clostridioides difficile</i> infections (CDI) increased at a large, regional hospital in New South Wales, Australia, in 2021, coinciding with an increase at hospitals Australia wide. We aimed to investigate the association between antibiotic prescribing practices and hospital-acquired CDI at the hospital to inform antimicrobial stewardship (AMS) programs.</p><p><strong>Methods: </strong>We conducted a retrospective case-control study for the period July 1, 2018, and June 30, 2022. Seventy hospital-acquired CDI cases were selected for the study. Cases were matched on a 1:2 basis with randomly selected controls based on date of hospitalization and age group. We conducted a multivariable analysis to explore possible risk factors for infection. We compared cases and controls who were administered antibiotics to determine if rates of inappropriate antibiotic prescriptions differed between cases and controls.</p><p><strong>Results: </strong>The multivariable model found that use of cephalosporins (third, fourth, or fifth generation) (adjusted odds ratio (aOR) 3.82, 95% confidence interval (CI) 1.35-10.84), use of penicillins (broad or extended broad spectrum) (aOR 5.79, 95% CI 2.15-15.58), and increased complexity of comorbidities (aOR 1.22, 95% CI 1.02-1.45) were independently associated with CDI. In patients who had antibiotics administered during their admission, inappropriate antibiotic prescribing (OR 5.68, 95% CI 1.95-16.48) and non-compliance with antibiotic prescribing guidelines (OR 5.01, 95% CI 1.07-14.76) were associated with CDI.</p><p><strong>Conclusions: </strong>Our study showed that antibiotic prescribing practices were associated with hospital-acquired CDI at the hospital during the study period. The results reinforce the importance of compliance with antibiotic guidelines and provide further evidence for AMS programs to reduce CDI.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e198"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031232","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":"Don't know much about geography? Decision support for the evaluation of patients with suspected high consequence infectious diseases.","authors":"Jacob E Lazarus, Michelle S Jerry, Lindsay Germaine, Chloe V Green, Jason Parente, Eileen F Searle, Erica S Shenoy","doi":"10.1017/ash.2025.10038","DOIUrl":"10.1017/ash.2025.10038","url":null,"abstract":"<p><p>EvalHCID is a clinical decision support system integrating outbreak intelligence, symptom onset, and epidemiologic risk factors to identify high consequence infectious diseases (HCIDs) (eg, Ebola). Tested among 20 emergency department (ED) providers, it significantly reduced assessment time, lowered misclassification, and scored \"excellent\" usability. EvalHCID may improve institutional preparedness and patient outcomes for emerging infectious disease threats.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e192"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031263","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":"Limited yield of SARS-CoV-2 screening in asymptomatic hematopoietic cell transplant and chimeric antigen receptor T-cell therapy patients.","authors":"Marie Hale Wilson, Elizabeth M Krantz, Steven A Pergam, Marco Mielcarek, Suni Elgar, Emily Rosen, Michelle Swetky, Catherine Liu, Joshua A Hill, Seth Cohen, Denise J McCulloch","doi":"10.1017/ash.2025.10112","DOIUrl":"10.1017/ash.2025.10112","url":null,"abstract":"<p><p>Early in the COVID-19 pandemic, screening was initiated in several settings to mitigate asymptomatic transmission of SARS-CoV-2. However, this practice was later discouraged by the Society for Healthcare Epidemiology of America. This single-center retrospective study demonstrates limited utility of SARS-CoV-2 screening tests in asymptomatic HCT and CAR T-cell patients.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e195"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031279","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 awareness: exploring knowledge among culturally and linguistically diverse patients.","authors":"Kylie Tran, Vinushan Kuganathan, Jessica Lam, Aqsa Rana, Serine Yau, Katherine Lee, Ravindra Dotel, Chin-Yen Yeo, Ronald L Castelino","doi":"10.1017/ash.2025.10108","DOIUrl":"10.1017/ash.2025.10108","url":null,"abstract":"<p><strong>Background: </strong>Effective antimicrobial stewardship (AMS) programs must address the needs of culturally and linguistically diverse (CALD) patients who often experience language barriers and varying cultural beliefs regarding antibiotics. They are at greater risk of receiving suboptimal or inappropriate care, yet guidance to support AMS practices for this population remains limited.</p><p><strong>Aim: </strong>To investigate antibiotic knowledge, perspectives, and experiences of CALD patients.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted between May to November 2023 at a Western Sydney tertiary hospital. Adult patients of CALD background on systemic antibiotics for more than 72 hours under surgical, respiratory, and geriatric specialties were surveyed on their understanding of their antibiotic treatment.</p><p><strong>Results: </strong>Of the 177 patients, median age was 70 years old (21-99 years), and 95/177 (53.7%) were males. Of the 177 patients, 171/177 (96.6%) reported speaking a language other than English at home. While 160/177 (90.4%) patients were told that they were treated with antibiotics, only 67/177 (37.9%) were told about duration, 35/177 (19.8%) were told about the side effects, and 27/177 (15.3%) were given written information. Information was provided by doctors to 125/177 (70.6%) patients, 72/177 (40.7%) by nurses, and 3/177 (1.7%) by pharmacists. Patients preferred to have received information from their doctor 79/177 (44.6%) or any healthcare professional 91/177 (51.4%).</p><p><strong>Conclusion: </strong>Improving antibiotic education for CALD patients is essential to address communication gaps. Enhancing knowledge will support appropriate use, improved adherence and outcomes, and promote shared decision-making. Strengthening health literacy in CALD populations should be a priority for AMS programs.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e193"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031256","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":"A nationwide survey of antimicrobial stewardship infrastructure and CDC core elements in the Dominican Republic.","authors":"Elianet Castillo, Rita Rojas-Fermin, Claudia Blanco, Antonio Villegas, Yeison Reyes, Arzina Aziz-Ali, Alfredo J Mena Lora","doi":"10.1017/ash.2025.10120","DOIUrl":"10.1017/ash.2025.10120","url":null,"abstract":"<p><p>Antimicrobial resistance is a global threat, and antimicrobial stewardship programs (ASP) are vital to curb resistance. A survey of 20 Dominican Republic hospitals revealed ASPs were absent in 50% and compliance with CDC core elements varied, highlighting significant challenges and areas of opportunity in implementing effective stewardship in resource-limited settings.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e196"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042245","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":"Outcomes in uncomplicated β-hemolytic Streptococcal bloodstream infections transitioned from IV to oral antimicrobial therapy.","authors":"Mackenzie R Keintz, Cristina Torres, Molly M Miller, Trevor C Van Schooneveld, Bryan T Alexander, Elizabeth Lyden, Jihyun Ma, Jasmine R Marcelin","doi":"10.1017/ash.2025.10109","DOIUrl":"10.1017/ash.2025.10109","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate clinical outcomes in patients with uncomplicated β-hemolytic <i>Streptococcus</i> spp. bloodstream infections (BSI) transitioned to oral antimicrobial therapy (OAT) compared with those that remain on intravenous antimicrobial therapy.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary academic hospital.</p><p><strong>Methods: </strong>This retrospective cohort study included adult patients hospitalized between 1/1/2013 and 12/31/2019 diagnosed with uBSI due to β-hemolytic streptococci. Patients were excluded if BSI was due to endovascular, central nervous system, or bone/joint infection or patient was immunosuppressed or died within 72 hours of identification of BSI. We compared outcomes including: 30-day mortality, antimicrobial therapy, BSI relapse, 30-day rehospitalization, adverse drug events, and reversion to IV therapy. Fisher's exact test was used for categorical variables; Mann - Whitney test and Independent T-test for continuous variables.</p><p><strong>Results: </strong>232 BSIs were included. OAT was used in 152 (65%). Cohort demographics were similar. Mortality was also similar between cohorts (2% vs 6% <i>P</i> = .13). Hospital length of stay was shorter in the OAT cohort with a median of 5 days (interquartile range 4.00, 8.00) versus 8 (5.00, 16.00) in the IV group (<i>P</i> < .0001). Patients transitioned to OAT were more likely to finish antibiotics outpatient (93% vs 62% <i>P</i> < .001).</p><p><strong>Conclusion: </strong>For β-hemolytic <i>Streptococcus</i> uBSI, OAT was associated with decreased length of stay without adverse clinical outcomes. Opportunities exist to modify clinical management of uBSI.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e194"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042410","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}