Jeannie P Cimiotti, Yin Li, Yu Jin Kang, Edmund R Becker, Peter Joski, Patti E Landerfelt, Omid R Razmpour, Scott K Fridkin
{"title":"Registered nurse workload and hospital-onset methicillin-resistant Staphylococcus aureus bloodstream infections.","authors":"Jeannie P Cimiotti, Yin Li, Yu Jin Kang, Edmund R Becker, Peter Joski, Patti E Landerfelt, Omid R Razmpour, Scott K Fridkin","doi":"10.1016/j.ajic.2025.06.008","DOIUrl":"10.1016/j.ajic.2025.06.008","url":null,"abstract":"<p><p>The prevention of methicillin-resistant Staphylococcus aureus (MRSA) is a national priority. Data from the American Hospital Association Survey and the Centers for Medicare & Medicaid Services show that each additional registered nurse hour per patient day was associated with a 3% decrease in the rate of hospital-onset MRSA bloodstream infection.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robin Otchwemah, Dominik Sons, Christoph Senges, Heide Niesalla, Marieke Stolte, Swetlana Herbrandt, Frauke Mattner
{"title":"Observing is influencing: How hand disinfection compliance observations affect hand disinfection rates; specifics derived from an electronic monitoring system.","authors":"Robin Otchwemah, Dominik Sons, Christoph Senges, Heide Niesalla, Marieke Stolte, Swetlana Herbrandt, Frauke Mattner","doi":"10.1016/j.ajic.2025.06.020","DOIUrl":"https://doi.org/10.1016/j.ajic.2025.06.020","url":null,"abstract":"<p><strong>Background: </strong>Monitoring hand disinfection (HD) with direct observation is considered the gold standard but is flawed by the Hawthorne effect (HE). In our project in a German university hospital, we quantified the HE and evaluated possible room-specific differences.</p><p><strong>Methods: </strong>Data were collected on an intensive care unit (ICU), an intermediate care unit (IMC), and a normal ward (NW) each categorized into 'patient', 'utility/waste' and 'other' rooms. While dispensers were monitored by sensors of a full-time active electronic monitoring system (EMS), the infection prevention and control staff performed step-by-step observations according to the WHO '5 Moments'. Periods with and without direct observations were compared regarding the number of HDs performed per patient-day (HD/PD) using descriptive evaluation and a linear mixed model.</p><p><strong>Results: </strong>The HE was detected in 'patient' rooms on the NW and ICU (+31.4%, +27.4% HD/PD; both p < 0.01) during observation periods. Opposite effects, expressed by significant decreases in HD/PD during observations, occurred in 'utility/waste' rooms on the NW (-57.7%), IMC (-99.4%) and ICU (-32.9%).</p><p><strong>Discussion & conclusion: </strong>In our setting, the HE varied considerably between wards and room-types. As HE occurred in patient rooms, the usual HD compliance during patient care may be lower than directly observed.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lyn-Li Lim, Stephanie K Tanamas, Leon J Worth, Ann Bull, N Deborah Friedman, Sanne Peters, Sarah Bird, Nick Wilson, Noleen Bennett
{"title":"Vaccination coverage outcomes and healthcare organisation program implementers' experiences after introduction of a healthcare worker influenza vaccination mandate in Victoria, Australia, 2022-2023.","authors":"Lyn-Li Lim, Stephanie K Tanamas, Leon J Worth, Ann Bull, N Deborah Friedman, Sanne Peters, Sarah Bird, Nick Wilson, Noleen Bennett","doi":"10.1016/j.ajic.2025.06.021","DOIUrl":"https://doi.org/10.1016/j.ajic.2025.06.021","url":null,"abstract":"<p><strong>Background: </strong>In 2022, the Victorian government, Australia, introduced a seasonal influenza vaccination mandate for specified healthcare workers (HCW). We describe implementation of the mandate's requirements in healthcare organisations by METHODS: An analysis was undertaken of annual organisational surveillance data routinely reported by healthcare organisations to the coordinating centre from 2018 to 2023. Focus group interviews with program implementers were conducted.</p><p><strong>Results: </strong>Annual vaccination coverage increased from a median of 85.4% (2018-2021) to 93.6% (2022-2023). Those with 'unknown status' and declinations decreased from a median of 8.2% to 5.1%, and 5.0% to 1.1% respectively. Implementers described increased leadership support and accountability for program delivery, and a focus on educating HCWs on the mandate and how to provide evidence of vaccination. New challenges included interpreting the mandate and applying pragmatic consequences. Implementers described increased administrative burden and seeking technological solutions.</p><p><strong>Conclusions: </strong>Introduction of the mandate coincided with an increase in HCW influenza vaccination coverage and changes to program delivery. Investment in technological solutions can support surveillance by reducing the administrative burden and potentially increasing reporting accuracy of number of HCWs with 'unknown status'.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Opioid Use and Risk of Clostridioides difficile Infection in Hospitalized Patients: A Systematic Review and Meta-Analysis.","authors":"Pooja Gokhale, Lorenzo Villa Zapata","doi":"10.1016/j.ajic.2025.06.019","DOIUrl":"https://doi.org/10.1016/j.ajic.2025.06.019","url":null,"abstract":"<p><strong>Objective: </strong>Clostridioides difficile infection (CDI) is a leading cause of nosocomial infections, particularly in immunocompromised individuals. Emerging evidence suggests that opioid use may increase the risk of CDI in hospitalized patients. The aim of this systematic review and meta-analysis is to assess the association between opioid use and CDI among hospitalized patients.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted from inception to January 2024 across PubMed/MEDLINE, Web of Science, and the Cochrane Library. The search was supplemented by hand-searching reference lists of included articles. Observational studies comparing adult opioid users with non-users in a hospital setting were included. The meta-analysis employed a restricted maximum likelihood (REML) random-effects model using R Statistical Software, version 4.3.2.</p><p><strong>Results: </strong>From 1,521 articles initially retrieved, four met the inclusion criteria, comprising 119,145 patients. Of these, 42,794 were opioid users, and 76,351 were non-users. There were 13,399 cases of CDI among opioid users, compared to 13,184 among non-users. The meta-analysis revealed an odds ratio (OR) of 1.98 (95% CI: 1.54-2.56), indicating a significantly higher risk of CDI in opioid users.</p><p><strong>Conclusion: </strong>The findings underscore the need for further research to explore the impact of opioid use on the severity of CDI. Clinicians should consider alternatives to opioids or enhance monitoring strategies to mitigate infection risks in vulnerable populations, particularly elderly and immunocompromised.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Haillie C Meek, Stacey Konkle, Belinda Ostrowsky, Eli S Rosenberg, Karen Southwick, Sarah Kogut, Monica Quinn, Ernest J Clement, Emily Lutterloh
{"title":"Characterization of patients with Candida (Candidozyma) auris before and during the COVID-19 pandemic in New York, 2017-2022.","authors":"Haillie C Meek, Stacey Konkle, Belinda Ostrowsky, Eli S Rosenberg, Karen Southwick, Sarah Kogut, Monica Quinn, Ernest J Clement, Emily Lutterloh","doi":"10.1016/j.ajic.2025.06.016","DOIUrl":"https://doi.org/10.1016/j.ajic.2025.06.016","url":null,"abstract":"<p><strong>Background: </strong>Candida (Candidozyma) auris, a multidrug resistant organism, can cause severe, invasive infections. We characterized C. auris epidemiology in New York before and during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Multiple statewide databases were linked to assess demographic and clinical characteristics and outcomes among C. auris screening cases (patients tested for colonization screening) and clinical cases (patients tested to diagnose disease). Cases diagnosed during 2017-2022 were divided into four phases and compared, including pre-COVID-19, first wave, ongoing mitigation, and vaccine era. Joinpoint analysis was used to assess monthly percentage change (MPC) and significant temporal trends among clinical cases.</p><p><strong>Results: </strong>During the first wave, higher proportions of C. auris cases were among Black and Hispanic patients (clinical and screening), patients from high social vulnerability index neighborhoods (clinical), and patients aged <60 years (screening), compared with pre-COVID-19. Increased proportions of Hispanic patients and those aged <60 years among screening cases persisted through ongoing mitigation and vaccine era. MPC of clinical cases was stable throughout the analysis period at 1.97%, and no significant joinpoints were observed.</p><p><strong>Conclusions: </strong>The influx of COVID-19 hospitalizations might have driven shifts in characteristics of clinical and screening C. auris cases. Clinical C. auris incidence increased during 2017-2022, but the incidence slope did not increase during or after the onset of COVID-19.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
María Carolina Gutiérrez Galvis, Edimerk Mauricio Gil Güiza, Maicol Andrés Avellaneda Arciniegas, Olga Marcela Medina Pérez, Angélica Yurley Ramírez Vásquez, Laura Juliana Ortiz García, Claudia Ivonne García González, Sindy Fernanda Macías Duarte, Luz Helena Sánchez Rodríguez, Marisela Márquez Herrera, Agustín Vega Vera, Yeny Zulay Castellanos-Dominguez, Laura Viviana Herrera Sandoval, Clara Inés Sánchez Suárez
{"title":"First report of Lodderomyces elongisporus identification in Intensive Care Unit patients in Colombia.","authors":"María Carolina Gutiérrez Galvis, Edimerk Mauricio Gil Güiza, Maicol Andrés Avellaneda Arciniegas, Olga Marcela Medina Pérez, Angélica Yurley Ramírez Vásquez, Laura Juliana Ortiz García, Claudia Ivonne García González, Sindy Fernanda Macías Duarte, Luz Helena Sánchez Rodríguez, Marisela Márquez Herrera, Agustín Vega Vera, Yeny Zulay Castellanos-Dominguez, Laura Viviana Herrera Sandoval, Clara Inés Sánchez Suárez","doi":"10.1016/j.ajic.2025.06.018","DOIUrl":"https://doi.org/10.1016/j.ajic.2025.06.018","url":null,"abstract":"<p><p>Lodderomyces elongisporus, a yeast commonly associated with environmental sources, is emerging as a human fungal pathogen. This report presents the first documented case of L. elongisporus colonization in two Intensive Care Unit patients in Colombia. Our findings emphasize the need for accurate identification and enhanced surveillance to evaluate its clinical impact in hospital infections.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karin Granqvist, Linda Ahlstrom, Jon Karlsson, Birgitta Lytsy, Annette Erichsen
{"title":"Digital feedback to improve adherence to hand hygiene: a longitudinal study on the effects of an electronic monitoring system.","authors":"Karin Granqvist, Linda Ahlstrom, Jon Karlsson, Birgitta Lytsy, Annette Erichsen","doi":"10.1016/j.ajic.2025.06.017","DOIUrl":"https://doi.org/10.1016/j.ajic.2025.06.017","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the impact of digital feedback from an electronic monitoring system to healthcare workers at both the group and individual levels on the adherence to hand hygiene.</p><p><strong>Method: </strong>An electronic monitoring system was installed in a surgical ward at a tertiary hospital and adherence rates among healthcare workers (n = 15) were measured from October 2018 to December 2019. After an initial baseline period (2 months), digital feedback was given to the healthcare workers first at the group level (2 months), and then at both the group and individual levels (2 months). Adherence rates were then measured over an additional follow-up period of 9 months.</p><p><strong>Result: </strong>Digital feedback for 9 months at both the individual and group levels significantly increased adherence to hand hygiene compared with the baseline (37.9% vs 52.5%). The mean increase in adherence rates was 14.5%. Feedback over a shorter period (2 months) had the same effect at neither the group level nor the individual level.</p><p><strong>Conclusion: </strong>Follow-up long-term studies are crucial to evaluate the effect of digital feedback. As research on innovations monitoring hand hygiene adherence is still in its infancy, this study contributes with valuable findings on the use of an electronic monitoring system, an innovation with the ultimate objective of improving hand hygiene among healthcare workers, to increase patient safety.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rodrigo Reghini, Ivan Leonardo Avelino França E Silva, Silvia Figueiredo Costa, Thaís Guimarães
{"title":"Impact of empowerment of onco-hematological patients on the incidence of catheter-related bloodstream infections.","authors":"Rodrigo Reghini, Ivan Leonardo Avelino França E Silva, Silvia Figueiredo Costa, Thaís Guimarães","doi":"10.1016/j.ajic.2025.06.015","DOIUrl":"https://doi.org/10.1016/j.ajic.2025.06.015","url":null,"abstract":"<p><strong>Background: </strong>Patients with hematologic malignancies and hematopoietic stem cell transplant recipients (HSCT) are at high risk of central venous catheter-related bloodstream infections (CLABSI). Global actions have encouraged patient training and empowerment as a strategy to reduce these infections.</p><p><strong>Objective: </strong>To evaluate the impact of patient empowerment in reducing the incidence density (ID) of CLABSI.</p><p><strong>Methods: </strong>Prospective, pre- and post-intervention, quantitative study of development, validation and application of an instrument to assess good practices in CVC handling, consisting of six questions and answers by hospitalized patients who had a CVC in two units of an oncological hospital.</p><p><strong>Results: </strong>Fifty-three patients participated in the study, totaling 1290 evaluations. In the post-intervention period, a significant increase (p<0.001) was observed in three practices: hand hygiene after handling the CVC (92.1% vs. 98.8%), salinization with pulsatile movements after administering medications and collecting laboratory tests (86.8% vs. 96.7%) and daily CVC assessment (97.4% vs. 99.8%). The ID of CLABSI decreased in the HSCT unit (4.4 vs. 0 CLABSI/1,000 CVC-days), though without statistical significance (p=0.066).</p><p><strong>Discussion: </strong>Increased adherence to good practices highlights the potential of patient involvement as a complementary strategy for CLABSI prevention.</p><p><strong>Conclusion: </strong>Actions aimed at patient participation can contribute to improving processes and reducing the ID of CLABSI.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mary Lou Manning, Julia Kay, Susan Egger, Mariann Kerr, John Renzi
{"title":"Infection Prevention Pre-licensure Nursing Education: Exploring Graduating Student and Preceptor Experiences.","authors":"Mary Lou Manning, Julia Kay, Susan Egger, Mariann Kerr, John Renzi","doi":"10.1016/j.ajic.2025.06.014","DOIUrl":"https://doi.org/10.1016/j.ajic.2025.06.014","url":null,"abstract":"<p><p>Nurses play a vital role in infection prevention and control (IPC) practice, monitoring, and surveillance. To prepare future nurses, Bachelor of Science in Nursing (BSN) programs must prioritize IPC education. This study aims to assess the IPC perceptions and experiences of final-semester BSN students and their clinical preceptors. Infection preventionists can actively partner with nursing school faculty to help shape and empower the next generation of nurses, ensuring they're not only knowledgeable, but also confident and resilient in applying IPC practices on the frontlines.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara M Reese, Albert Shackelford, Katreena Merrill, Frances Nicholson, Ehssan Baghagho, Brenna Doran, Heather Stoltzfus, Rebecca Crapanzano-Sigafoos
{"title":"Why do infection preventionists leave a job? A qualitative evaluation of infection preventionist attrition in healthcare.","authors":"Sara M Reese, Albert Shackelford, Katreena Merrill, Frances Nicholson, Ehssan Baghagho, Brenna Doran, Heather Stoltzfus, Rebecca Crapanzano-Sigafoos","doi":"10.1016/j.ajic.2025.06.011","DOIUrl":"10.1016/j.ajic.2025.06.011","url":null,"abstract":"<p><strong>Background: </strong>Infection preventionists (IPs) importance has increased over the years for various reasons. IP attrition results in risks to both patients and staff. The goal of this project was to determine the drivers of IP attrition and retention through focus groups.</p><p><strong>Methods: </strong>Focus groups comprised of IPs who have been in the same role for >5 years (Tenured IPs), IPs who have left one IP role for another IP role in the last 3 years (Transitional IPs), IPs who have left the field of infection prevention (Former IPs) and IP leaders discussed drivers of attrition and retention. A thematic analysis was performed to determine themes and subthemes.</p><p><strong>Results: </strong>Twelve focus groups (Tenured: n=24, Transitional: n=23, Former: n=10, Leaders: n=25) identified major themes related to attrition and retention: professional development and growth, organizational culture, recognition and value, workload and quality of work-life balance, leadership support, team dynamics, and the impact of Coronavirus 2019 pandemic.</p><p><strong>Conclusions: </strong>IP attrition and retention are complex, and numerous factors impact an IP's decision to stay in their role. Healthcare leaders and leaders of IPs need to evaluate retention strategies for this role. Future studies should determine the correlation between retention strategies and turnover rates.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}