Antimicrobial stewardship & healthcare epidemiology : ASHE最新文献

{"title":"Gut check: antimicrobial stewardship opportunities in intra-abdominal infections.","authors":"Ritika Prasad, Radhika Arya, Natalie Medvedeva, David Ha, Marisa Holubar","doi":"10.1017/ash.2025.10169","DOIUrl":"10.1017/ash.2025.10169","url":null,"abstract":"<p><p>Intra-abdominal infections (IAIs) are common in both the inpatient and outpatient setting but are not often a target for antimicrobial stewardship programs (ASP). However, IAIs provide ASPs an opportunity to translate evidence into practice while also addressing empiric broad-spectrum antibiotic use and establishing relationships with surgical stakeholders. In this review, we analyze five areas of emerging evidence within this heterogeneous field that merit close attention from ASPs, including spontaneous bacterial peritonitis prophylaxis, antibiotic management of appendicitis and biliary tract infections, and optimal amoxicillin-clavulanate and metronidazole dosing.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e37"},"PeriodicalIF":0.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12877908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144805","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 infection prevention and control in behavioral health settings: barriers, facilitators, and tailored strategies.","authors":"Isabelle V Boullier, Kevin M Gibas","doi":"10.1017/ash.2025.10290","DOIUrl":"10.1017/ash.2025.10290","url":null,"abstract":"<p><p>This review examines barriers and facilitators to implementing infection prevention and control (IPC) practices in behavioral health settings. Among 63 studies identified, environmental design, staffing/training limitations, patient behaviors, and therapeutic conflicts were common barriers. Facilitators included targeted training, collaboration, and adaptable IPC policies, underscoring the need for tailored interventions.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e36"},"PeriodicalIF":0.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108539","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":"Incidence and risk factors for hospital-attributable central line-associated bloodstream infections in adult inpatients in a tertiary hospital.","authors":"Shalvi Arora, Pinhong Jin, Aung Myat Oo, May Kyawt Aung, Edwin Philip Conceicao, Yong Yang, Jean Xiang Ying Sim, Molly Kue Bien How, Ismail Bin Sazali, Lai Chee Lee, Indumathi Venkatachalam, Moi Lin Ling","doi":"10.1017/ash.2025.10149","DOIUrl":"10.1017/ash.2025.10149","url":null,"abstract":"<p><strong>Background: </strong>Hospital-attributable central line-associated bloodstream infections (HA-CLABSI) are associated with severe patient outcomes. Published data on HA-CLABSI epidemiology in hospitals locally remains limited. This study aimed to determine the HA-CLABSI incidence and risk factors to inform targeted infection prevention practices.</p><p><strong>Methods: </strong>Retrospective, nested case-control study was performed at Singapore General Hospital from January 2018 to December 2020, involving 127 cases and 252 controls. HA-CLABSI cases developed CLABSI ≥ 3 calendar days of hospitalization. Controls had central line inserted but did not develop CLABSI. Cases and controls were matched on 1:2 ratio for central line insertion date. Multivariable conditional logistic regression was performed to identify independent risk factors for HA-CLABSI, with adjusted odds ratio (aOR), 95% confidence intervals (CI) and <i>p</i>-values reported. Variables with <i>p</i>-value < 0.05 were statistically significant. HA-CLABSI incidence rate was calculated per 1,000 central line-days.</p><p><strong>Results: </strong>HA-CLABSI incidence rate during the study period was 8.4/1,000 central line-days. Independent risk factors for HA-CLABSI were transfer to high-risk areas (aOR: 2.03, 95% CI: 1.05-3.92), immunocompromised health status (aOR: 4.62, 95% CI: 2.20-9.69), antibiotic administration (aOR: 7.41, 95% CI: 3.24-16.92), and total parenteral nutrition (aOR: 3.61, 95% CI: 1.49-8.77) being included as indications for central line insertion, insertion of PICC (aOR: 13.61, 95% CI: 3.12-55.53), presence of non-tunneled central lines (aOR: 2.95, 95% CI: 1.48-5.87) and prior MRSA acquisition (aOR: 3.41, 95% CI: 1.83-6.35).</p><p><strong>Conclusion: </strong>HA-CLABSI remains a significant concern despite on-going infection prevention efforts. Risk factors identified facilitate development of targeted, evidence-based interventions.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e27"},"PeriodicalIF":0.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108571","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":"Spatial pattern and risk factors of resistance to important antibiotics among <i>E. coli</i> from veterans in seven U.S. Midwest states.","authors":"Zhuo Tang, Qianyi Shi, Shinya Hasegawa, Margaret Carrel, Jacob Oleson, Michihiko Goto","doi":"10.1017/ash.2025.10292","DOIUrl":"10.1017/ash.2025.10292","url":null,"abstract":"<p><strong>Background: </strong>Effective antibiotic stewardship programing in clinical settings necessitates a good understanding of local prevalences of antimicrobial resistance and important patient and community risk factors. However, most studies are limited in sample size and geographic coverage.</p><p><strong>Methods: </strong>This study utilized phenotypic resistance data of <i>Escherichia coli</i> from the Veteran's Health Administration of the United States (U.S.), incorporating 126,777 unique cultures from veteran outpatients from seven Midwest states from 2010 to 2023, to examine the spatial pattern and important individual- and county-level risk factors for resistance to four important classes of antibiotics. We utilized Bayesian conditional autoregressive zero-inflated Poisson regression models to generate smoothed rates of resistance in each county and multilevel logistic regression models to detect risk factors for resistance.</p><p><strong>Results: </strong>High overall rates of resistance were seen for fluoroquinolone (29%) and TMP-SMX (22%). Geographic variation was seen among and between antibiotic classes. Certain urban regions in the southern parts of Illinois, Indiana, and Ohio had higher local resistance rates for fluoroquinolone and TMP-SMX. Being male, having diabetes, and previous exposure to antibiotics are significant risk factors for all classes of antibiotics while the significance of other risk factors varied across classes.</p><p><strong>Conclusion: </strong>Diverse geographic patterns of resistance level may reflect differences in local prescribing practices, while the differential correlations with risk factors likely reflect their clinical indications and prescribing patterns in clinical settings. The local resistance rates and risk factors for different classes of antibiotics should provide important guidance in practicing empirical prescribing and antibiotic stewardship in clinical settings.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e35"},"PeriodicalIF":0.0,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108546","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":"APSIC guidelines for environmental hygiene: surface cleaning air and water quality in hospitals: 2025 update.","authors":"Anucha Apisarnthanarak, Moi Lin Ling, Namita Jaggi, Patricia Ching, Lily Liang, Zhiyong Zong","doi":"10.1017/ash.2025.10288","DOIUrl":"10.1017/ash.2025.10288","url":null,"abstract":"<p><strong>Objective: </strong>To describe the revised APSIC Environmental Hygiene Guidelines for prevention of healthcare-associated infections inclusive of surface cleaning, air and water quality.</p><p><strong>Design: </strong>The revised guideline was developed by Infection Prevention and Control key opinion leaders from Asia Pacific.</p><p><strong>Setting: </strong>This guideline emphasizes on practical implementation of environmental hygiene for prevention of healthcare-associated infections inclusive of surface cleaning, air and water quality relevant to Asia Pacific settings.</p><p><strong>Patients or participants: </strong>Any patients hospitalized in healthcare setting.</p><p><strong>Interventions: </strong>Literature search was done for recent international updates in environmental hygiene inclusive of surface cleaning, air and water quality. Recommendations were evaluated for practical and feasible recommendation in low-resourced settings in Asia Pacific.</p><p><strong>Results: </strong>The key recommendations are listed in the best practices for cleaning patient care areas. Additional measures are recommended to improve the air and water quality in healthcare settings.</p><p><strong>Conclusions: </strong>Implementation of environmental hygiene in Asia Pacific should take into consideration of the air and water quality in addition of surface cleaning. Measures to assess the cleanliness should be performed using conventional visual assessment, environmental cleaning and disinfection checklist, auditing, and additional measures (e.g., environmental culture or fluorescence).</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e34"},"PeriodicalIF":0.0,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108543","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":"Can implementation of a complex outpatient antimicrobial therapy program reduce readmissions for patients with bone and joint infections?","authors":"Elizabeth Thottacherry, Marten Hawkins, Jallisae Nedi, Susan Ellen Turley, Patrick Facelo, Timothy Pierce, Noah Fang, Daisuke Furukawa","doi":"10.1017/ash.2025.10274","DOIUrl":"https://doi.org/10.1017/ash.2025.10274","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate whether a complex outpatient antimicrobial therapy (COpAT) program led by advanced practice providers (APPs) conducting transition-of-care (TOC) services improves post discharge patient follow-up and reduces hospital readmission.</p><p><strong>Design: </strong>Pre- and postimplementation cohort study comparing outcomes 6 months before and 5 months after COpAT launch.</p><p><strong>Setting: </strong>706-bed tertiary university teaching hospital.</p><p><strong>Patients: </strong>Adult patients admitted to the hospital with bone and joint infections, seen by our inpatient infectious disease consultation service and discharged with at least fourteen days of antimicrobial therapy, with follow-up at our specialized musculoskeletal infectious diseases clinic.</p><p><strong>Intervention: </strong>The APP led pilot COpAT program was launched on March 1^st, 2024, with a multidisciplinary team including an infectious diseases physician, APP, nurse, medical assistant, and TOC pharmacists. Patients enrolled at hospital discharge and were scheduled for APP-led TOC visits within fourteen days, followed by a physician visit.</p><p><strong>Results: </strong>The pre- and post-intervention groups included 100 and 135 patients, respectively. Mean postdischarge follow-up time decreased from 20.1 to 9.1 days (<i>P</i> < .001), and patients seen within fourteen days increased from 42% to 83% (<i>P</i> < .001). Readmission rates and emergency room visits did not change significantly. TOC pharmacy engagement rose from 8% to 42% (<i>P</i> < .001), and both TOC pharmacy and APP interventions frequently addressed medication errors, side effects, and treatment modifications.</p><p><strong>Conclusion: </strong>A structured, COpAT program with APP and TOC pharmacy involvement optimizes postdischarge follow-up, strengthens antimicrobial outpatient monitoring, and supports timely intervention for patients with complex infections.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e32"},"PeriodicalIF":0.0,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094943","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":"Routine admission urinalysis has low clinical utility in psychiatric hospitalizations.","authors":"Tri Pham, Devanshi Patel, Ana Berce, Alice Bewley, Sena Sayood","doi":"10.1017/ash.2025.10291","DOIUrl":"https://doi.org/10.1017/ash.2025.10291","url":null,"abstract":"<p><p>We examined the diagnostic utility of urinalyses (UAs) in psychiatric admissions. Admission UAs led to diagnosis of clinical urinary tract infections in 1.7% of cases. Among those treated with antibiotics, inappropriate prescriptions occurred in 71.3% of cases, with increased odds in older age, female sex, positive cultures, and certain psychiatric diagnoses.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e33"},"PeriodicalIF":0.0,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146095020","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":"Erratum: Infection prevention behaviors and perceptions of nurses in a medical intensive care unit - CORRIGENDUM.","authors":"Frank A Drews, Jeanmarie Mayer, Molly Leecaster, Lindsay Visnovsky, Tavis Huber, Matthew H Samore","doi":"10.1017/ash.2026.10301","DOIUrl":"https://doi.org/10.1017/ash.2026.10301","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1017/ash.2025.10231.].</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e30"},"PeriodicalIF":0.0,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094965","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":"Erratum: Institutional readiness to provide critical care to patients with viral hemorrhagic fever (VHF) in the United States after the COVID-19 pandemic - CORRIGENDUM.","authors":"Madeline A DiLorenzo, Anthony LoPiccolo, Wael ElRayes, Jocelyn J Herstein, Radu Postelnicu, Angela Vasa, Vikramjit Mukherjee","doi":"10.1017/ash.2026.10302","DOIUrl":"https://doi.org/10.1017/ash.2026.10302","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1017/ash.2025.10167.].</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e31"},"PeriodicalIF":0.0,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146095039","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":"Fantastic stewards and where to find them: a descriptive study of the heterogeneous disparity in physician-pharmacist-nurse distribution among the infectious disease workforce.","authors":"Yuuka Uesugi, Satoshi Kitaura, Koh Okamoto","doi":"10.1017/ash.2025.10287","DOIUrl":"10.1017/ash.2025.10287","url":null,"abstract":"<p><strong>Background: </strong>Infectious disease (ID) care involves a diverse range of professionals, yet the shortage and geographical disparity of ID physicians, among other professionals, remain underexplored. This cross-sectional descriptive study aimed to elucidate the distribution of ID physicians, infection control (IC) pharmacists, and IC nurses in Japan, focusing on the interrelations among the ID workforce within medically relevant geographical units.</p><p><strong>Methods: </strong>Publicly available data from 335 secondary medical areas (SMAs) in Japan, with a population of 125 million, were analyzed. Workforce distribution was assessed using the Gini index to quantify inequalities and spatial clustering across the SMAs per capita, per hospital bed, and per unit area. χ2 test was used to assess the association of hospital characteristics with the presence of each professional.</p><p><strong>Findings: </strong>The research subjects were 1,729 ID physicians, 1,371 IC pharmacists, and 2,657 IC nurses, whose workplace data were available in Japan as of 2023. The Gini coefficients for the densities of ID physicians, IC pharmacists, and IC nurses per 100,000 people were 0.46, 0.34, and 0.28, respectively. The density of the ID workforce per unit area (1,000 km²) showed a positive correlation ( > 0.8) with any combination of ID physicians, IC pharmacists, and IC nurses. A total of 186 SMAs (56%) had at least one member from each professional group and 13 (3.9%) lacked staff from all three.</p><p><strong>Conclusions: </strong>The substantial variation in ID workforce composition across SMAs suggests opportunities for both regional and national policy and identifies new avenues for improving access to ID care.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e29"},"PeriodicalIF":0.0,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108576","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}