Antimicrobial stewardship & healthcare epidemiology : ASHE最新文献

{"title":"Mindful diagnostics in culture-negative endocarditis: early noninvasive diagnosis of <i>Tropheryma whipplei</i> by plasma microbial cell-free DNA.","authors":"Ashita Jain, Sarwat Khalil, Muhammad R Sohail, Laura C Lelenwa, Enrique Garcia-Sayan, Kenneth K Liao, Ahmed Hamdi, Todd Lasco, Mayar Al Mohajer","doi":"10.1017/ash.2026.10416","DOIUrl":"10.1017/ash.2026.10416","url":null,"abstract":"<p><p><i>Tropheryma whipplei</i> was identified by plasma microbial cell-free DNA sequencing within 4 days in severe culture-negative endocarditis after antibiotics had already been started. The result supported earlier diagnostic clarification and antimicrobial de-escalation before valve pathology was available, illustrating a practical diagnostic-stewardship role for noninvasive sequencing in high-acuity endocarditis.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e179"},"PeriodicalIF":0.0,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280036","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 of early oral antibiotic transition for the treatment of uncomplicated enterococcal bacteremia.","authors":"Cecilia Li, Madeline Schultze, Carissa Tedeschi, Alex Rock, Eric Gillett, Alyssa Letourneau, Tiffany Wu","doi":"10.1017/ash.2026.10746","DOIUrl":"10.1017/ash.2026.10746","url":null,"abstract":"<p><strong>Objective: </strong>To compare clinical outcomes in adults with uncomplicated enterococcal bacteremia treated with intravenous (IV) therapy alone versus an early oral (PO) transition and evaluate treatment characteristics and safety outcomes.</p><p><strong>Design: </strong>Retrospective cohort study between January 1, 2021, and August 1, 2024. The primary outcome was clinical cure at 90 days after antibiotic completion. Secondary outcomes included treatment failure, infection-related readmission, hospital length of stay (HLOS), and 90-day mortality.</p><p><strong>Setting: </strong>Massachusetts General Hospital and Brigham and Women's Hospital, two tertiary care centers in Boston, MA.</p><p><strong>Patients: </strong>Adult patients with at least one positive blood culture with <i>Enterococcus</i> spp. Patients were excluded if they had polymicrobial or persistent bacteremia, invasive infection, incomplete source control, died before completing therapy, or received fewer than 7 days of antibiotics.</p><p><strong>Results: </strong>209 patients were included, of which 119 received IV therapy alone and 90 underwent early PO transition. Gastrointestinal (41.6%) and genitourinary (32.1%) sources were most common, and 86 patients (41.1%) had immunocompromising conditions. Clinical cure was similar between the IV and early PO transition groups (73.9% vs 82.2%; <i>P</i> = .156), with no significant differences in secondary and safety outcomes. HLOS was significantly shorter in the early PO transition group (9 days vs 20 days; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>Early PO transition appears to be a safe and effective strategy for uncomplicated enterococcal bacteremia and was associated with reduced HLOS.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e177"},"PeriodicalIF":0.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280063","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":"Antimicrobial stewardship strategies and programs in the outpatient settings: a scoping review.","authors":"Adrienne Landsteiner, Muthu Narayan, Jonathan Byrd, Steffi Yang, Kristen Ullman, Catherine Sowerby, Nicholas Zerzan, Caleb Kalinowski, Dimitri Drekonja, Timothy J Wilt, Wei Duan-Porter","doi":"10.1017/ash.2026.10741","DOIUrl":"10.1017/ash.2026.10741","url":null,"abstract":"<p><strong>Objective: </strong>To describe the evidence on antimicrobial stewardship programs (ASPs) and strategies implemented in outpatient settings.</p><p><strong>Design: </strong>We conducted a scoping review to describe the evidence published since 2013 on the effects and implementation of outpatient ASP strategies and programs.</p><p><strong>Methods: </strong>We searched Ovid MEDLINE, Embase, and Scopus from January 1, 2013 through September 3, 2024. Data were summarized in figures and tables. We categorized studies by types of ASP strategies and settings. We also summarize the reported outcomes using the RE-AIM framework.</p><p><strong>Results: </strong>Of 29,544 unique citations/abstracts, 285 primary studies and 37 systematic reviews were eligible. Most included primary studies were observational (<i>k</i> = 226) and only 59 (21%) were randomized controlled trials (RCT). Most studies were conducted in primary care (<i>k</i> = 135) or emergency room/urgent care (<i>k</i> = 79). The most commonly evaluated individual strategies were patient and/or clinician education only (<i>k</i> = 55), audit and feedback (<i>k</i> = 48), and laboratory testing (<i>k</i> = 45). Overall antimicrobial and inappropriate prescribing rates were the most frequently assessed outcomes; patient treatment outcomes and health care utilization were also commonly reported.</p><p><strong>Conclusions: </strong>There has been substantial growth in the evidence base, but this is largely from observational studies. Evidence gaps include a need for more controlled studies, and evaluation of additional outcomes. Few studies evaluated implementation costs or barriers, reach, and sustainability. Many of these additional outcomes would provide valuable insights to aid policy makers in the most feasible and appropriate strategies for implementation.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e176"},"PeriodicalIF":0.0,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280116","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":"Stakeholder perceptions of gaps in antimicrobial resistance mitigation: a multinational multisectoral survey to inform prioritization of One Health interventions.","authors":"Godwin Pius Ohemu, Howard Rodriguez-Mori, Marcelo Schmidt, Babafela Awosile","doi":"10.1017/ash.2026.10750","DOIUrl":"10.1017/ash.2026.10750","url":null,"abstract":"<p><strong>Objective: </strong>This study examined stakeholder perceptions of gaps in antimicrobial resistance (AMR) mitigation efforts across different sectors and career stages, with the goal of generating insights to support prioritization of One Health interventions.</p><p><strong>Method: </strong>We conducted a cross-sectional survey of AMR stakeholders using a structured questionnaire between October and November 2025. Stakeholders were recruited through international networks across 33 countries on 5 continents. Respondents listed the top three areas in AMR mitigation efforts that they perceived as receiving insufficient attention but require greater focus to reduce the emergence and spread of drug-resistant bacterial infections. We performed thematic analysis, calculated weighted priority scores, conducted an Impact-Effort Matrix analysis, and applied Fisher's exact tests to examine associations between themes, professional sector and career stages.</p><p><strong>Results: </strong>Among 103 respondents, participants spanned nine professional sectors and four career stages. Antimicrobial stewardship (18.8%, weighted score 119) and Environmental AMR and Waste (16.5%, weighted score 108) were the most frequently cited perceived gaps. Impact-Effort Matrix analysis identified four priority areas as Quick Wins (stewardship, IPC, surveillance, and animal health, accounting for 45.7% of impact), two Major Projects (environmental AMR, R&D), three Fill-ins (awareness, One Health, other/cross-cutting), and three Hard Slogs (access, financing, policy). No significant associations were observed between perceived mitigation gaps across professional sector and career stages.</p><p><strong>Conclusions: </strong>The emphasis on antimicrobial stewardship among stakeholders highlights a perceived disconnect between stewardship policy adoption and on-the-ground practice. The Impact-Effort Matrix provides a decision-support tool that may assist policymakers and funders in prioritizing One Health interventions.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e174"},"PeriodicalIF":0.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280107","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":"Efficacy of a transition to oral antimicrobial therapy for gram-negative bacilli bloodstream infection: systematic review and meta-analysis.","authors":"Hitoshi Honda, Toshiki Miwa, David Warren, Akane Takamatsu","doi":"10.1017/ash.2026.10742","DOIUrl":"10.1017/ash.2026.10742","url":null,"abstract":"<p><strong>Background: </strong>While the disease and economic impact of gram-negative bacilli bloodstream infections (GNB-BSI) are high, treatment strategies, including transitioning from intravenous antimicrobial therapy (IVAT) to oral stepdown antimicrobial therapy (OSAT) are still in their nascent stage of development.</p><p><strong>Methods: </strong>A systematic review and meta-analysis evaluated the clinical effectiveness of OSAT compared with IVAT for GNB-BSI. Medline and Embase were searched from January 1980 to March 2025, along with the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and reference lists of eligible studies. Randomized controlled trials and observational studies comparing OSAT with IVAT were included. Three investigators screened studies, extracted data, assessed study quality, and risk of bias, following PRISMA guidelines, ROBINS-E for observational studies and RoB 2 for randomized trials. Certainty of evidence was assessed using the GRADE framework.</p><p><strong>Results: </strong>Sixteen studies involving 4,858 patients who received OSAT and 4,961 patients who received IVAT were extracted for review. The pooled risk ratio for mortality and treatment failure in the primary analysis which included studies adjusting for confounders (n = 3) was 0.95 (95% confidence interval [CI]: 0.42, 2.14; <i>I</i> ² = 8%) and 1.11 (95% CI: 0.22, 5.51; <i>I</i> ² = 59%), respectively. The GRADE assessment for the primary analyses rated the evidence as very low to moderate certainty. Outcome definitions varied substantially across studies, potentially affecting pooled estimates.</p><p><strong>Conclusions: </strong>Although an imbalance in the baseline characteristics of patients with GNB-BSI across the studies warranted closer attention, OSAT may be as effective as IVAT for GNB-BSI without compromising clinical outcomes. Nevertheless, high-quality RCTs are needed before making definitive recommendations.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e172"},"PeriodicalIF":0.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280089","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":"Structure, personnel, and initiatives of antimicrobial stewardship programs in pediatric hospitals in the United States based on on-call participation: a cross-sectional survey.","authors":"Gustavo Rey Alvira-Arill, Samantha Brace, Taylor Morrisette, Stephen Thacker, Aaron Hamby, Rachel Burgoon, Zachary Gruss, Alexandra Mills, Richard Lueking, Krutika Mediwala Hornback","doi":"10.1017/ash.2026.10745","DOIUrl":"10.1017/ash.2026.10745","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial stewardship programs (ASPs) promote optimal antimicrobial use in pediatrics; however, data describing structure, personnel effort allocation, and activity distribution across regular and after-hours workflows remain limited.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of pediatric ASPs across the U.S. from September to October 2024 using ASP/ID-related listservs. Respondents reported institutional structure, personnel effort allocation, initiatives, and participation in an after-hours ASP on-call model, with additional details from programs reporting on-call participation.</p><p><strong>Results: </strong>Twenty-two pediatric ASP responses were included, most from academic medical centers (81.8%) and programs covering 101-250 beds (41%). Median physician full-time equivalents (FTEs) increased with institutional size, ranging from 0.1 for institutions with < 100 beds to 0.8 for those with >500 beds. Pharmacist FTEs were a median of 1 for institutions with ≤ 500 beds and increased to 2.25 for programs >500 beds. Most programs reported to Quality and Safety (45%) or discipline-specific departments (41%), with funding primarily attributed to Pharmacy (73%). During regular working hours, nearly all programs performed prospective audit and feedback (100%), responded to ASP-related inquiries (95.5%), and facilitated antimicrobial de-escalation (90.9%). Six programs (27.4%) reported participation in an ASP on-call model, most commonly providing remote coverage during evenings, weekends, and holidays. After-hours activities were largely limited to time-sensitive interventions, including preauthorization and responding to inquiries.</p><p><strong>Conclusions: </strong>Pediatric ASPs demonstrate variability in structure, personnel effort allocation, and stewardship activities. ASP on-call coverage remains uncommon and is typically focused on time-sensitive interventions, reflecting targeted deployment of stewardship resources outside regular working hours.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e173"},"PeriodicalIF":0.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280105","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":"Community-onset symptomatic urinary tract infections (SUTI) caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales: independent predictors and comparative effectiveness of oral agents.","authors":"Shani Zilberman-Itskovich, Majdi Masarwi, Eyal Levy, Moti Iflah, Inbar Levi Steinweg, Nikita Yapryntsev, Shani Mednyk, Roni Gur-Lavy, Samir Alfahel, Keren Amity, Avi Itzhaki, Dror Marchaim","doi":"10.1017/ash.2025.10267","DOIUrl":"10.1017/ash.2025.10267","url":null,"abstract":"<p><strong>Background: </strong>The incidence of community-onset (CO) symptomatic urinary tract infection (SUTI) caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales is increasing worldwide. Our study aims were to explore the independent predictors for CO-ESBL SUTI and to compare the effectiveness of several oral therapeutics, which are used for this indication in community health settings.</p><p><strong>Methods: </strong>Retrospective matched case-case-control and case-case studies, among insurers of Maccabi health maintenance organization, Shfella district, Israel (10-11/2019). Patients with CO-ESBL (<i>Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis</i>) SUTI were matched to patients with CO-non-ESBL SUTI and to uninfected controls (1:1:1). Matched analyses (logistic regressions) were used to model predictors for CO-ESBL SUTI. A composite parameter for worse SUTI outcomes was compared among patients who were managed with a single, supposedly effective (ie, in vitro), oral agent.</p><p><strong>Results: </strong>The study consisted of 1,455 patients (ie, three matched groups of 485 patients). The independent predictors for CO-ESBL SUTI were certain recent exposures: (1) hospitalization (3 months), (2) past carriage of multidrug-resistant organisms (2 years), (3) exposure to any antimicrobial (3 months), and (4) prior SUTI (6 months). Among 331 patients with CO-ESBL SUTI, resistance rates were lowest for fosfomycin (4.9%), while outcomes were worst for patients managed with oral amoxicillin-clavulanate.</p><p><strong>Conclusions: </strong>CO-ESBL SUTI independent predictors in this community region were recent hospitalization, known MDRO carriage, exposure to antimicrobials and prior SUTI. Amoxicillin-clavulanate should be avoided, even for ESBL susceptible isolates.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e15"},"PeriodicalIF":0.0,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954060","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":"Trends and risk factors of multidrug-resistant hospital-acquired infections in a Tunisian university hospital: repeated point prevalence surveys, 2023-2025.","authors":"Salma Balhi, Sameh Boughattas, Mohamed Ben Rejeb, Asma Ben Cheikh, Nihel Haddad, Abdelhalim Trabelsi, Hela Ghali, Houyem Said Laatiri","doi":"10.1017/ash.2026.10424","DOIUrl":"10.1017/ash.2026.10424","url":null,"abstract":"<p><strong>Objective: </strong>To assess temporal trends in hospital-acquired infections (HAIs) prevalence, antimicrobial resistance (AMR) patterns, and associated risk factors of multidrug resistance (MDR)-related HAI in a Tunisian hospital between 2023 and 2025.</p><p><strong>Design: </strong>Repeated point-prevalence surveys (PPSs).</p><p><strong>Setting: </strong>Sahloul University Hospital, Sousse, Tunisia.</p><p><strong>Patients: </strong>All patients hospitalized for more than 48 hours during each surveys.</p><p><strong>Methods: </strong>Data on HAI prevalence, isolated pathogens, and AMR profiles were collected through three PPSs conducted annually from 2023 to 2025. HAIs were defined according to the criteria of the Centers for Disease Control and Prevention. MDR was defined as nonsusceptibility to at least one agent in three or more antimicrobial classes.</p><p><strong>Results: </strong>From 2023 to 2025, 126 pathogens were responsible for 101 HAIs among 752 surveyed patients. The overall HAI prevalence was 10.9%, with no significant difference between the survey years (trend <i>P</i> = .430). Bloodstream infections were the most common type of HAI. Microbiological documentation was available for 94% of cases. Gram-negative bacteria predominated (72.2%) with Klebsiella pneumoniae (15%) as the leading pathogen. Overall, 41.2% of isolates were classified as MDR, with no significant trend over time (trend <i>P</i> = .068). Enterobacterales resistant to third-generation cephalosporins accounted for 14.3% (18/126) and carbapenem-resistant Enterobacterales for 7.9% (10/126).Prolonged hospital stay (>8 d) and ICU admission were independently associated with MDR-related HAIs (adjusted OR = 15.759, 95% CI: 3.691-67.285, <i>P</i> < .001 and OR = 3.612, 95% CI: 1.584-8.237, <i>P</i> = .002).</p><p><strong>Conclusions: </strong>Repeated PPSs are an effective surveillance strategy for monitoring HAIs and AMR. These findings support the implementation of targeted antimicrobial stewardship and enhanced infection control interventions in Tunisian hospitals.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e169"},"PeriodicalIF":0.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201159","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":"Implementation of two-stage testing for <i>Clostridioides difficile</i> at a tertiary referral veterans hospital.","authors":"Madeline Marker, Dimitri Drekonja","doi":"10.1017/ash.2026.10427","DOIUrl":"10.1017/ash.2026.10427","url":null,"abstract":"<p><p><i>Clostridioides difficile</i> infection is a common community and nosocomial infection. Two-stage testing (initial polymerase chain reaction (PCR) test, followed by a confirmatory toxin test for PCR+ results) has been used to help differentiate colonization from infection. We report the impact of adopting two-stage testing at a tertiary Veterans Affairs medical center.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e170"},"PeriodicalIF":0.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200849","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":"Predictors of excess length of stay among tuberculosis patients at Highland Hospital, Alameda County, California, 2018-2022.","authors":"Eliza Hollingsworth, Julie Willkom, Rachel Marusinec, Emily Yette, Amit Chitnis, Farzad Moazed","doi":"10.1017/ash.2026.10420","DOIUrl":"10.1017/ash.2026.10420","url":null,"abstract":"<p><p>All adult pulmonary tuberculosis (TB) hospitalizations (N = 66) during 2018-2022 at Highland Hospital were reviewed. Positive sputum smears were significantly associated with longer median excess length of stay (9 d). Implementing new TB infection control guidance and investing in community-based isolation facilities may reduce healthcare utilization.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e168"},"PeriodicalIF":0.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200930","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}