Antimicrobial stewardship & healthcare epidemiology : ASHE最新文献

{"title":"Impact of masking policy on healthcare-associated acute respiratory infections in 18 hospitals in Southern Ontario.","authors":"Thomas Scheier, Anne Bialachowski, Michael Silverman, Tom Szakacs, Marianita Lampitoc, William Ciccotelli, Medina Saffie, Karim Ali, Zain Chagla, Dominik Mertz","doi":"10.1017/ash.2026.10423","DOIUrl":"10.1017/ash.2026.10423","url":null,"abstract":"<p><p>Whether continuous masking prevents healthcare-associated acute respiratory infections (HA-ARI) remains uncertain. We demonstrate that discontinuing continuous masking policies in 18 acute care facilities in Ontario was not associated with an increase in the incidence of HA-ARIs in hospitalized patients, or with ARI outbreak activity over two consecutive ARI seasons.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e160"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148159188","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 and diagnostic stewardship: opportunities for return on investment.","authors":"Tracy Zembles, Blake Buchan, Katie Ray, Michelle Mitchell, Kelly Graff","doi":"10.1017/ash.2026.10415","DOIUrl":"10.1017/ash.2026.10415","url":null,"abstract":"<p><strong>Objective: </strong>Implementation of antimicrobial and diagnostic stewardship interventions can offer substantial return on investment while enhancing patient safety and healthcare quality. Clinical benefits include a decrease in antimicrobial resistance, shorter hospital stays, fewer adverse events from unnecessary antibiotic use, and optimized treatment protocols. We aimed to estimate the annual cost savings resulting from various interventions implemented by our Antimicrobial Stewardship Program at a single free-standing children's hospital.</p><p><strong>Design: </strong>Cost analysis.</p><p><strong>Setting: </strong>Free-standing children's hospital.</p><p><strong>Patients: </strong>Hospitalized patients.</p><p><strong>Methods: </strong>We reviewed annual cost savings related to various targeted antimicrobial and diagnostic stewardship initiatives, including drug cost savings from guidelines and protocols, prevention of antimicrobial resistance, diagnostic stewardship interventions, penicillin allergy de-labeling, and sustainability efforts. Institution-level cost data were evaluated when feasible. Otherwise, cost estimates were extrapolated from the literature.</p><p><strong>Results: </strong>The Antimicrobial Stewardship Program saved an estimated $4,972,805 annually. This was a result of $1,155,405 in direct drug cost savings, $2,953,216 in savings related to a decrease in multi-drug resistant organisms, $75,000 in savings from penicillin allergy de-labeling, $689,184 in savings related to diagnostic stewardship interventions, and $100,000 in savings from sustainability efforts.</p><p><strong>Conclusions: </strong>Antimicrobial Stewardship Programs can be associated with significant cost savings, justifying the investment. Collaboration across departments, particularly with microbiology, pharmacy, infection prevention, and service providers is central to the ongoing success of stewardship efforts, underscoring the multidisciplinary strength and efficiency of the approach.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e157"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148159195","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":"Respiratory surveillance through point of care molecular testing and its impacts on nursing home RSV, influenza, and SARS-CoV-2 awareness and reporting behavior: a pilot study.","authors":"H Edward Davidson, Lisa F Han, Kevin W McConeghy, Ivis Perez, Elizabeth A Sillman, Clare Nugent, Tiffany Wallace, Laurel Holland, Evan Dickerson, David H Canaday, Stefan Gravenstein, Yasin Abul","doi":"10.1017/ash.2026.10409","DOIUrl":"10.1017/ash.2026.10409","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate feasibility of establishing syndromic respiratory virus surveillance in a network of U.S. nursing homes, using CLIA-waived point-of-care (POC) molecular PCR testing, with centrally delivered results.</p><p><strong>Design: </strong>Single-arm feasibility pilot study.</p><p><strong>Setting and participants: </strong>Twenty-three nursing homes (NHs) in six U.S. states, representing approximately 2,500 residents.</p><p><strong>Methods: </strong>A CLIA-waived POC molecular PCR testing device was implemented for on-site testing of respiratory syncytial virus (RSV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and influenza A and B from collected nasal swabs. Symptom data was entered at the time of testing. Test results were transmitted to a centralized, web-based dashboard providing near real-time surveillance from November 2023 to January 2025. Surveys of NH staff assessed device usability, workflow integration, impact on testing procedures, and infection and outbreak awareness.</p><p><strong>Results: </strong>The established syndromic respiratory virus surveillance network conducted 1,745 point-of-care tests between November 2023 and January 2025, identifying 360 infections, including 160 COVID-19, 115 influenza A and B, and 81 RSV infections. Symptom data was captured for 99.5% of tests. Implementation was associated with high data completeness and integration into facility testing workflows. Staff reported an impact on testing protocols, infection awareness, and time to diagnosis.</p><p><strong>Conclusions: </strong>Implementation of a CLIA-waived POC molecular testing device with centralized reporting was feasible across a geographically diverse NH network. The system achieved high data capture, identified substantial viral activity, and demonstrated value for clinical management using real-time diagnostic results. This approach can be adapted for local, regional, or national real-time reporting or future pragmatic interventional studies.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e155"},"PeriodicalIF":0.0,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148159273","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":"Dr. Anthony Harris on his comedy, career, and the mentorship North Star.","authors":"Anthony D Harris","doi":"10.1017/ash.2026.10407","DOIUrl":"https://doi.org/10.1017/ash.2026.10407","url":null,"abstract":"<p><p>Dr. Anthony Harris is Professor of Epidemiology and Public Health and Internal Medicine, and Head of the Division Genomic Epidemiology and Clinical Outcomes of Health Care Outcomes Research. He is an infectious disease physician and epidemiologist whose research interests include emerging pathogens, antimicrobial-resistant bacteria, hospital epidemiology/infection control, epidemiologic methods in infectious diseases, and medical informatics. He has published over 360 papers. He has current or has had funding from the NIH, CDC, VA, and AHRQ to study antibiotic resistance and hospital epidemiology. He is extremely proud of his mentoring track record.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e153"},"PeriodicalIF":0.0,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148159203","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":"Evaluation of multifaceted interventions on antibiotic prescribing in community-acquired pneumonia.","authors":"Kristen South, Stephanie Ducas, Ashley Cubillos, Elisabeth Chandler, Elena Gatskevich","doi":"10.1017/ash.2026.10333","DOIUrl":"10.1017/ash.2026.10333","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of systemwide antimicrobial stewardship interventions on antibiotic prescribing patterns for community-acquired pneumonia(CAP) in a community health system.</p><p><strong>Design: </strong>Retrospective pre-post implementation study.</p><p><strong>Setting: </strong>Adult acute care hospitals in a community health system.</p><p><strong>Patients: </strong>Adults 18 years or older admitted to an acute care hospital with a diagnosis of CAP identified by ICD-10 codes.</p><p><strong>Methods: </strong>This retrospective, pre-post implementation study was completed at four adult acute care hospitals in a community health system. Antimicrobial stewardship interventions targeted toward CAP were rolled out between July 2020 and March 2021. Data to capture prescribing habits was collected pre and postimplementation. The inclusion criteria were patients who were at least 18 years old, admitted to an adult acute care hospital, and diagnosed as CAP based on ICD-10 code, while exclusion criteria were patients who were transferred from another hospital, had a pneumonia with an onset of 48 hours or later after admission, or had a concomitant non-respiratory tract infection during receipt of antibiotics for CAP. The primary outcome was percentage of patients who received empiric anti-MRSA or antipseudomonal antimicrobial coverage for CAP in accordance with current guideline recommendations.</p><p><strong>Results: </strong>Four hundred patients were included in the analysis, with 207 patients in the preimplementation arm and 193 patients in the postimplementation arm. The percentage of patients who received appropriate empiric coverage significantly increased from 34.7% in the preimplementation group to 60.1% in the postimplementation group (<i>P</i> < .0001).</p><p><strong>Conclusions: </strong>Multifaceted antimicrobial stewardship interventions significantly improve guideline-concordant empiric MRSA and <i>P. aeruginosa</i> antimicrobial coverage.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e154"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044784","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":"Operational and data-integrity limitations of a system-wide Epic OPAT order set: a three-year cohort analysis.","authors":"M Yasser Alsafadi, Shivani Patel, Natalie Finch, Shemual Tsai, Wesley Hoffmann","doi":"10.1017/ash.2026.10402","DOIUrl":"10.1017/ash.2026.10402","url":null,"abstract":"<p><p>We evaluated an Epic-based outpatient parenteral antimicrobial therapy (OPAT) order set to assess its impact on clinical workflows and analytics. Free text, missing structured fields, and lack of microbiology linkage made it difficult to track care, monitor safety, and analyze outcomes, highlighting essential design requirements for OPAT system rebuilds.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e149"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038304","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":"Characterization of aerosols generated during suspected aerosol-generating procedures in healthcare settings.","authors":"Caroline A O'Neil, Jiayu Li, Meghan A Wallace, Ramesh Raliya, Yang Wang, Anna Leavey, Traci L Bricker, Carey-Ann D Burnham, Adrianus C M Boon, Pratim Biswas, Hilary M Babcock","doi":"10.1017/ash.2026.10413","DOIUrl":"10.1017/ash.2026.10413","url":null,"abstract":"<p><strong>Objective: </strong>To measure aerosol generation during various medical procedures that are potentially aerosol generating and determine whether these aerosols contain viral and/or bacterial pathogens that may pose a risk to healthcare personnel.</p><p><strong>Design: </strong>Observational.</p><p><strong>Setting: </strong>Tertiary care academic hospital.</p><p><strong>Patients: </strong>Convenience sample of adult patients undergoing one of the following procedures: extubation, bronchoscopy, mechanical ventilation, noninvasive ventilation, suctioning, nebulized medication administration (NMA), sputum induction, nasopharyngeal swab, or tracheostomy change.</p><p><strong>Methods: </strong>Four aerosol characterization instruments measured aerosol characteristics (particle mass, number, size); average baseline and procedure measurements were compared to identify changes in aerosolized particles associated with each type of procedure. SKC BioSamplers were used for viral and bacterial pathogen recovery. Clinical data were reviewed to examine patient characteristics that might impact pathogen recovery.</p><p><strong>Results: </strong>Among 93 sampled procedures, differences between baseline versus procedure measurements were only notable for NMA and sputum induction. Smaller increases in some particle measurements were observed for the single extubation sample. None of the 248 BioSampler specimens were positive for a respiratory virus, even though for 39 procedures, the patient had a recent clinical specimen that was positive for a respiratory virus. Thirty-two samples (13%) had positive bacterial cultures, all of which represented common skin/environmental contaminants or upper respiratory microbiota.</p><p><strong>Conclusions: </strong>In this study, significant aerosol generation was only observed during NMA and sputum induction. No viral pathogens and minimal bacteria were recovered from these medically generated aerosols. These data suggest that some procedures that are considered \"aerosol-generating\" may pose little infectious risk to healthcare personnel.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e151"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038300","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 appropriateness among patients experiencing homelessness at an interprofessional student-run free clinic.","authors":"Olivia Laster, Morgan P Stewart, Kathryn P Lin, Travis J Carlson","doi":"10.1017/ash.2026.10412","DOIUrl":"10.1017/ash.2026.10412","url":null,"abstract":"<p><p>Oral antibiotic prescribing was evaluated at a student-run free clinic serving patients experiencing homelessness. A retrospective review over a 30-month period showed 40.8% antibiotics were inappropriate and 32.7% lacked sufficient documentation for assessment. These findings revealed ambulatory stewardship gaps, underscoring the need for antimicrobial stewardship interventions in student-run free clinics.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e150"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038303","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 and attitude toward antibiotic use and self-medication with antibiotics among medical students.","authors":"Porntita Sae-Li, Sirashat Hanvivattanakul, Ruj Nana, Thana Khawcharoenporn","doi":"10.1017/ash.2026.10414","DOIUrl":"10.1017/ash.2026.10414","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate knowledge and attitude toward antibiotic use and self-medication with antibiotics.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>A Thai public university.</p><p><strong>Participants: </strong>Medical students.</p><p><strong>Methods: </strong>An anonymous online survey was conducted among pre-clinical- and clinical-year medical students between January 2023 to February 2024.</p><p><strong>Results: </strong>Of the 538 students included, 391 (65%) and 147 (35%) were in pre-clinical and clinical years, respectively, and 59% were female. Most of the students (>90%) were knowledgeable about the names of antibiotics and importance of adhering to prescribed antibiotic regimen. Less than 50% were knowledgeable about antibiotic resistance in gonorrhea and resistance transmission among humans or animals to humans. Clinical-year students had significantly higher knowledge score about antibiotic use than pre-clinical-year students (10 vs. 8 of 15; <i>P</i> < .001). Most students agreed that antibiotic resistance is mostly caused by human actions and antibiotic use and resistance should be taught early in a high school. Pre-clinical-year students were more-likely than clinical-year students to agree that alternative treatments are always available when antibiotics are ineffective. In multivariable logistic regression analysis, factors associated with higher antibiotic knowledge score were higher academic years (<i>P</i> < .001). While being pre-clinical-year students was independently associated with using antibiotics without appropriate indications (any diarrheal illnesses, upper respiratory tract infections and abrasions) and stopping antibiotic prematurely (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>Interventions to improve knowledge and practices regarding antibiotic use should be tailored to students' academic years and be guided by the study's findings.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e152"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038284","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":"Feasibility of C-reactive protein point-of-care testing for antibiotic stewardship in rural GP-pharmacy settings.","authors":"Sajal Kumar Saha, Michael Muleme, Oliver Van Hecke, Mary Lou Chatterton, Eugene Athan","doi":"10.1017/ash.2026.10401","DOIUrl":"10.1017/ash.2026.10401","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility of implementing C-reactive protein point-of-care testing (CRP-PoCT) for patients presenting with respiratory tract infections (RTIs) in primary care.</p><p><strong>Design: </strong>Feasibility study.</p><p><strong>Setting: </strong>General practice (GP) and community pharmacy in rural Victoria.</p><p><strong>Patients or participants: </strong>Five GPs and a community pharmacist used CRP-PoCT for RTI patients aged 12-65 years for two months between August and December 2023.</p><p><strong>Methods: </strong>Data on testing, prescribing, and implementation barriers and facilitators were collected from patient records and surveys of GPs and pharmacists. Feasibility outcomes were analyzed using descriptive statistics and content analysis.</p><p><strong>Results: </strong>Fifty-five patients were screened, with recruitment rates of 87.5% (35/40) in GP clinics and 67% (10/15) in community pharmacies, and a retention rate of 100%. Adherence to the testing protocol was 100% in both settings; however, adherence to the prescribing protocol was 76% in GP practices and 100% in pharmacies. Common RTI symptoms were cough (70%, n = 30), fever (58%, n = 25), and sore throat (44%, n = 19). Antibiotics were prescribed to 36.4% (12/33) of GP patients and 10% (1/10) of pharmacy patients. Pharmacists managed patients with OTC medicines (80%, 8/10) or immediate GP referral (10%, 1/10). CRP-PoCT feasibility was rated highly by GPs [median 6/7 (IQR 4-6)] and moderately by the pharmacist (4/7). Key implementation facilitators identified were nurse/technician support, medicare funding, clear workflows, and GP-pharmacy collaborative practice agreement.</p><p><strong>Conclusion: </strong>With mitigation of practical challenges, CRP-PoCT can be feasibly implemented in rural GP-pharmacy settings to enhance antibiotic stewardship for acute respiratory infections in primary care.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e148"},"PeriodicalIF":0.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038353","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}