American journal of infection control最新文献

{"title":"Standardization of color change interpretation for sterilization chemical indicators: A multicenter analysis aligned with international safety color standards.","authors":"Yao Shen, Shan Zhong, Jiaxin Lv, Zhuoya Yao, Youhao Tian, Jiaxin Liu, Tao Song, Mengjie Chang, Jingjing Du, Haiqun Ban, Xianzhao Zheng","doi":"10.1016/j.ajic.2026.08.010","DOIUrl":"10.1016/j.ajic.2026.08.010","url":null,"abstract":"<p><strong>Background: </strong>To establish a standardized framework for interpreting color changes in chemical indicators (CIs) in sterilization, and improve accuracy and clinical feasibility.</p><p><strong>Methods: </strong>A questionnaire was administered to 902 health care professionals to evaluate their interpretation difficulties, confusion rates, and support for a unified color standard. In addition, pre- and post-sterilization CI color data were collected across 4 sterilization modalities: steam (n = 74), hydrogen peroxide plasma (n = 63), ethylene oxide (n = 38), and formaldehyde (n = 28). Data were compared with ISO 11140-1:2014 and GB/T 18282.1-2025.</p><p><strong>Results: </strong>Among clinical staff, 32.71% reported interpretation difficulties, with the main reasons being ambiguous color changes (58.3%) and non-uniform standards (41.7%), and 25.17% had confused indicators for different sterilization modalities. Notably, 87.36% supported a unified color standard. Post-sterilization color changes varied markedly across and within modalities: steam predominantly turned black, plasma predominantly turned yellow, ethylene oxide predominantly turned green/blue, and formaldehyde predominantly turned green.</p><p><strong>Conclusions: </strong>The current lack of cross‑manufacturer harmonization in CI color‑change schemes leads to confusion and misinterpretation risks among clinical staff. A unified, intuitive color‑change standard, preferably based on an international safety color system, is urgently needed to improve the accuracy and practicality of sterile package assessment, thereby ensuring patient safety and reducing clinical risks.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786963","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":"Risk factors associated with surgical site infections following hip arthroplasty among patients served by a large safety net hospital system.","authors":"Nana Osei-Tutu, Alison Bradbury, Tamara Nawar, Briana Episcopia, Mary Fornek, John Quale","doi":"10.1016/j.ajic.2026.08.009","DOIUrl":"10.1016/j.ajic.2026.08.009","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs), including prosthetic joint infections (PJI), are one of the many complications that can occur after total hip arthroplasty. In this report, we examined risk factors associated with SSI following hip arthroplasties among patients in a 10-hospital safety network in New York City.</p><p><strong>Methods: </strong>Data were obtained from the National Healthcare Safety Network (NHSN) on patients who underwent hip arthroplasty between 2015 and 2023. Surgical site infections were defined per NHSN criteria. Propensity score matching using NHSN risk adjustment variables was used to create a closely matched control group.</p><p><strong>Results: </strong>Over the 8 years, 3,679 hip arthroplasties were performed across the 10 hospitals, which resulted in 54 SSIs (1.5%). Patients with SSIs had significantly higher body mass indexes (BMIs) and ASA scores (both P < .05). When examining the socioeconomic differences between our cases and controls, we found higher rates of infections occurred in geographical areas of higher poverty (P < .001). Lastly, Hispanic or Black patients had higher occurrences of SSIs compared to other races (P < .05).</p><p><strong>Conclusion: </strong>Our report demonstrated the association of poverty level with SSIs following hip arthroplasty. This underscores the need for comprehensive and aggressive post-discharge programs in under resourced communities in the prevention of SSI following hip arthroplasty.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787022","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":"Protective performance of medical fabrics used in protective clothing and masks against viral particles smaller than severe acute respiratory syndrome coronavirus 2.","authors":"Noriko Shimasaki, Katsuaki Shinohara, Hideaki Morikawa, Kaoru Wakatsuki, Junko Ishii, Hiromu Yoshida","doi":"10.1016/j.ajic.2026.08.005","DOIUrl":"10.1016/j.ajic.2026.08.005","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic prompted proactive infection control measures, including improved hand hygiene and mask-wearing; however, viral respiratory infections, such as those caused by rhinoviruses, were not fully controlled by such public health measures during the pandemic. Because rhinovirus, a member of the Picornaviridae family, has a smaller particle size compared with coronaviruses, we investigated the protective performance of personal protective equipment (PPE), including protective clothing and masks, against picornaviruses.</p><p><strong>Methods: </strong>We analyzed the protective performance of 4 medical fabrics used in commercially available PPE, categorized by International Organization for Standardization (ISO) grades, under realistic viral aerosol and liquid conditions. The evaluation experiments were conducted using a newly developed test device with inactivated poliovirus (IPV), Picornaviridae family, and quantitative real-time polymerase chain reaction (qPCR).</p><p><strong>Results: </strong>Woven and nonwoven fabrics of higher ISO grades provided substantial resistance to IPV aerosols. Testing via qPCR showed that resistance to IPV-aerosol penetration differed significantly, even between fabrics within the same ISO category. In contrast, the fabrics in the lower ISO grades did not exhibit lower resistance to liquid drops than those in higher grades.</p><p><strong>Conclusions: </strong>Our findings may serve to inform optimal PPE selection by healthcare workers.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763033","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":"Needlestick and sharps injuries among healthcare workers: An 8-year infection control perspective on preventable occupational exposure.","authors":"Sudem Mahmutoğlu Çolak, Aybegüm Özşahi̇n, Tuba İlgar, İlknur Esen Yildiz, Uğur Kostakoğlu, Ayşe Ertürk","doi":"10.1016/j.ajic.2026.08.006","DOIUrl":"10.1016/j.ajic.2026.08.006","url":null,"abstract":"<p><strong>Background: </strong>Needlestick and sharps injuries (NSIs) are a major occupational hazard among healthcare workers, yet data on preventability, recurrent events, and COVID-19-related temporal trends remain limited.</p><p><strong>Methods: </strong>This retrospective study analyzed NSI events reported between 2018 and 2025 at a tertiary-care hospital. Injury mechanisms were classified from narrative reports, and preventability was assessed using predefined criteria. Incidence per 100 person-years was calculated. Poisson and multinomial logistic regression models were used for risk and preventability analyses.</p><p><strong>Results: </strong>A total of 354 NSI events were included. Median age was 25 years, and 72.6% were female. Nurses had higher incidence than physicians (IRR 1.84; 95% CI 1.28-2.64). Hollow-bore needles accounted for 83.6% of injuries, and procedural injuries were most common (48.0%). Overall, 42.4% of injuries were preventable and 48.0% partially preventable based on study-specific predefined criteria. Cleaning staff had higher odds of preventable injuries. NSI incidence declined over time, with higher rates in the pre-pandemic period compared with the post-pandemic period. Recurrent injuries occurred in 4.5%, and only 11.3% adhered to follow-up.</p><p><strong>Conclusion: </strong>Mechanism-based classification identified a substantial proportion of preventable NSIs, suggesting that a considerable fraction of occupational exposures may be reduced through targeted infection control interventions. These findings highlight the importance of focusing on modifiable procedural and waste-management-related factors to improve healthcare worker safety.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719463","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":"Towards early detection: Expanding screening protocols for HCIDs.","authors":"Sarah Brown, Terra Menier, Kari Gand, Marie Betancourt, Melissa Thone, Syra Madad, Eileen Searle","doi":"10.1016/j.ajic.2026.08.007","DOIUrl":"10.1016/j.ajic.2026.08.007","url":null,"abstract":"<p><p>This pilot study evaluates the implementation of a High Consequence Infectious Disease (HCID) screening process using the \"identify, isolate, and inform\" (III) framework across 3 emergency departments in Minnesota. The study compares adherence rates from a COVID-19-specific screening baseline to broader, disease-nonspecific screenings. Findings indicate stable adherence rates, suggesting that incorporating HCID protocols into regular hospital operations can sustain compliance and streamline enhanced infection prevention processes. The screening tool guidance is available for public use.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719864","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":"Oral colonization by hospital-associated bacterial pathogens among intensive care unit patients: Association with ventilatory support.","authors":"Maria Eduarda Cia Antoniassi, Laura Veiga Oliveira, Sarah Ferreira Mattos Alcântara, Luciano José Pereira, Isadora Cota Carvalho, Cássio Vicente Pereira, Natália Galvão Garcia","doi":"10.1016/j.ajic.2026.08.003","DOIUrl":"10.1016/j.ajic.2026.08.003","url":null,"abstract":"<p><strong>Background: </strong>The oral cavity may serve as a reservoir of hospital-associated bacterial pathogens in critically ill patients. However, the prevalence of oral colonization and associated clinical factors remain incompletely characterized.</p><p><strong>Methods: </strong>This multicenter cross-sectional study included 120 adult ICU patients from two Brazilian hospitals. Oral samples collected from the dorsal surface of the tongue were analyzed using conventional culture-based microbiological methods. Patients were classified according to ventilatory support (without invasive ventilation, endotracheal tube ventilation, or tracheostomy). Factors associated with oral colonization were evaluated using univariable and multivariable logistic regression analyses.</p><p><strong>Results: </strong>Oral colonization by hospital-associated bacterial pathogens was identified in 77 patients (64.2%). Prevalence differed according to ventilatory support, affecting 42.5%, 60.0%, and 90.0% of patients without invasive ventilation, receiving endotracheal tube ventilation, and with tracheostomy, respectively (P < .001). Klebsiella pneumoniae (46.8%), Pseudomonas aeruginosa (28.6%), and Acinetobacter spp. (22.1%) were the predominant bacterial pathogens identified. Longer ICU stays were observed among colonized patients than non-colonized patients (17.7 ± 13.0 vs 9.4 ± 10.6 days, mean ± SD; P < .001). Tracheostomy remained independently associated with oral colonization (adjusted OR, 7.77; 95% CI, 2.18-27.75; P = .002).</p><p><strong>Conclusions: </strong>Oral colonization by hospital-associated bacterial pathogens was highly prevalent and more frequent with increasing invasiveness of ventilatory support. Tracheostomy was independently associated with colonization, supporting systematic oral assessment and evidence-based oral healthcare within multidisciplinary ICU infection prevention strategies.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711034","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":"Characterizing measles IgG-related seroprevalence in the US veteran population during the 2025 West Texas outbreak.","authors":"Chris A Gentry, George Kurdgelashvili, Robert H Scofield","doi":"10.1016/j.ajic.2026.08.004","DOIUrl":"10.1016/j.ajic.2026.08.004","url":null,"abstract":"<p><strong>Background: </strong>The 2025 United States (US) measles outbreak supports concerns that measles may have significant resurgences. The study's objectives were to characterize measles serologic testing rates, estimate measles IgG seronegativity rates, and determine independent variables associated with seronegativity across the US Veterans Health Administration (VHA).</p><p><strong>Methods: </strong>A nationwide retrospective, observational study was conducted, collecting data from veterans with measles IgG antibody testing performed from January through June in 2024 (preoutbreak) and 2025 (outbreak). Endpoints included determining independent variables associated with 1) measles IgG testing within the outbreak period vs the preoutbreak period, and 2) measles IgG seronegativity within the outbreak period.</p><p><strong>Results: </strong>In total, 16,446 veterans had measles IgG testing in the outbreak period, a 60.3% increase in the testing rate compared with the nonoutbreak period. Seronegativity was found in 1,220 (11.9%) veterans in the nonoutbreak period and 1,509 veterans (9.18%) in the outbreak period (P < .0001). Independent variables associated with seronegativity included age 64 years or below (OR 5.65, 95% CI 4.59-6.94), Janus kinase inhibitor use (OR 3.54, CI 1.24-10.1), and immunodeficient condition (OR 3.10, CI 2.34-4.11).</p><p><strong>Conclusions: </strong>As measles re-emerges, certain populations were identified that may be at higher risk of infection and transmission, particularly those with immune compromise.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711066","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":"Diagnostic architecture of healthcare-associated infection surveillance definitions: A comparative methodological analysis of international surveillance frameworks.","authors":"Ahmad Sabbah, Atif Amin Baig, Naveed Ahmed, Assem Al-Hayajneh","doi":"10.1016/j.ajic.2026.08.002","DOIUrl":"10.1016/j.ajic.2026.08.002","url":null,"abstract":"<p><strong>Background: </strong>Healthcare-associated infection (HAI) surveillance relies on standardized case definitions, yet variation in diagnostic criteria across surveillance frameworks may affect interpretation and comparability of infection indicators.</p><p><strong>Methods: </strong>Official surveillance manuals and guidance documents from 13 international, regional, and national HAI surveillance frameworks were reviewed. Seven systems with sufficiently detailed diagnostic criteria were included in a structured comparative analysis. Four infection categories (CLABSI, CAUTI, pneumonia, and surgical site infection) were evaluated across 4 diagnostic domains: clinical criteria, microbiological evidence, device/procedure association, and temporal thresholds.</p><p><strong>Results: </strong>Seven surveillance systems yielded 52 surveillance definitions and 208 coded diagnostic elements. Comparative analysis identified variation in how surveillance frameworks operationalized clinical criteria, microbiological evidence, device/procedure association, and temporal thresholds. Device/procedure association and temporal thresholds were consistently specified, whereas microbiological requirements varied across infection types and surveillance contexts. Pneumonia definitions demonstrated the greatest heterogeneity in diagnostic specification across surveillance frameworks.</p><p><strong>Discussion: </strong>Structural differences in surveillance definitions may influence how infections are identified and reported within surveillance systems, potentially affecting interpretation of benchmarking data and cross-system comparisons.</p><p><strong>Conclusions: </strong>Structural variation in HAI surveillance definitions should be considered when comparing infection indicators, implementing automated surveillance systems, or adapting surveillance frameworks across healthcare settings.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688394","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":"The visibility window of point-prevalence surveys: Interpreting prolonged surgical antimicrobial prophylaxis indicators.","authors":"Luca Bresciano, Lorenzo Ramondetti, Marta Castagnotto, Roberta Bussolino, Costanza Vicentini","doi":"10.1016/j.ajic.2026.07.017","DOIUrl":"10.1016/j.ajic.2026.07.017","url":null,"abstract":"<p><p>Point-prevalence surveys (PPSs) support antimicrobial stewardship, but surgical antimicrobial prophylaxis (SAP) estimates may be shaped by visibility windows. Using PPS and prospective surgical site infection surveillance (SNICh) data, we compared crude procedure-level, visibility-weighted PPS-like, and PPS-observed estimates of prolonged SAP. The crude SNICh estimate was 12.44%, increasing to 40.86% after visibility weighting, close to the PPS-observed 39.87%, supporting visibility-sensitive interpretation of PPS SAP indicators.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683038","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":"Antibiotic overuse for never-appropriate acute respiratory tract infections among older adults presenting to United States emergency departments, 2013-2025: Interrupted time series analysis across national stewardship milestones.","authors":"Mayar Al Mohajer, Kasim Allel, David Slusky, David E Nix, Catia Nicodemo","doi":"10.1016/j.ajic.2026.07.013","DOIUrl":"10.1016/j.ajic.2026.07.013","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic overuse for acute respiratory tract infections (ARTIs) remains common in emergency departments (EDs), but national trends among older adults are not well described.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of US ED encounters in Epic Cosmos (January 2013-December 2025) among adults aged 65 years or older with never-appropriate ARTI diagnoses. Monthly antibiotic overuse (ED administration and/or discharge prescription) was evaluated with segmented regression around Centers for Disease Control and Prevention (CDC) Core Elements (November 2016), The Joint Commission (TJC) ambulatory stewardship standard (January 2020), COVID-19 onset (March 2020), and Centers for Medicare & Medicaid Services (CMS) interpretive guidance (July 2022).</p><p><strong>Results: </strong>Among 838,929 encounters, antibiotic overuse occurred in 38.5%. In the primary model, estimated 12-month changes were -5.0 percentage points (95% CI, -7.1 to -3.0; P < .001) around the CDC milestone and -15.7 percentage points (95% CI, -31.3 to -0.1; P = .049) around TJC. Estimates around COVID-19 and CMS were less stable.</p><p><strong>Discussion: </strong>Declines were most consistent around the CDC milestone; later estimates were limited by closely spaced interruptions and pandemic disruption.</p><p><strong>Conclusions: </strong>ED-focused outpatient stewardship remains needed for older adults with never-appropriate ARTIs.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648167","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}