American journal of infection control最新文献

{"title":"Persistent carbapenem resistance in mechanically ventilated ICU patients: A before-and-after analysis of the COVID-19 surge.","authors":"Bianca B P Antunes, Leonardo S L Bastos, Pedro Kurtz, Letícia M Sant'Anna, Pedro F Del Peloso, Claudia A Espanha, Silvio Hamacher, Fernando A Bozza","doi":"10.1016/j.ajic.2024.10.014","DOIUrl":"10.1016/j.ajic.2024.10.014","url":null,"abstract":"<p><strong>Background: </strong>The evolution of antimicrobial resistance among critically ill patients before, during, and after the COVID-19 surge remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed critically ill mechanically ventilated adult patients admitted to 8 Brazilian hospitals from Jan 1, 2018 to Apr 30, 2023. We stratified the patients into 3 periods: pre-surge (Jan 01, 2018-Mar 01, 2020), surge (Mar 01, 2020-Oct 01, 2021), and post-surge (after October 01, 2021). Positive cultures, pathogen prevalence, and resistance rates were analyzed using rate ratios (RR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Among 9,780 patients (3,718 pre-surge, 3,815 surge, 2,247 post-surge), those in surge period were younger (median: 70 vs 74 pre-surge vs 75 post surge) and had longer invasive mechanical ventilation duration (median 7 vs 5 days). Blood and respiratory cultures increased across periods (56.9 pre-surge vs 69.4 surge vs 70.4 patients/1,000 patient-days post-surge). Isolation of carbapenem-resistant gram-negatives increased during the surge (RR [95% CI]: 1.8 [1.5-2.2], decreased in post-surge (0.72 [0.6-0.9]), and remained higher than pre-surge (1.3 [1.0-1.6]). Resistance rates for Pseudomonas aeruginosa reduced in post-surge, whereas Klebsiella pneumoniae doubled during the surge, and remained elevated.</p><p><strong>Conclusions: </strong>Carbapenem resistance increased during the surge period. Although it decreased post-surge, it remained higher than pre-pandemic rates.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455936","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":"APIC Masthead","authors":"","doi":"10.1016/S0196-6553(24)00727-2","DOIUrl":"10.1016/S0196-6553(24)00727-2","url":null,"abstract":"","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":"52 11","pages":"Page A8"},"PeriodicalIF":3.8,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535222","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":"Facility-level antibiotic prescribing rates and the use of antibiotics among nursing home residents.","authors":"Quynh T Vo, Farzad Noubary, Brandon Dionne, Shira Doron, Benjamin Koethe, Becky A Briesacher","doi":"10.1016/j.ajic.2024.10.007","DOIUrl":"10.1016/j.ajic.2024.10.007","url":null,"abstract":"<p><strong>Background: </strong>The high frequency of antibiotic use in US nursing homes is a public health concern. Facility-level prescribing patterns may provide a measure for antibiotic stewardship targeting.</p><p><strong>Methods: </strong>An analysis of 2018-2019 data from linked files from the Centers for Medicaid and Medicare was conducted. Multilevel generalized linear models were used to calculate odds ratios for antibiotic receipt for calendar year 2019 using the 2018 facility prescribing rate.</p><p><strong>Results: </strong>In 2019, 186,274 (19%) residents were prescribed an antibiotic. The most frequently prescribed class of antibiotics was cephalosporins (26%), and the average duration of antibiotic use was 9 days. Residents who were dually eligible for Medicare and Medicaid had 37% increased odds of antibiotic receipt (all adjusted odds ratio (aOR): 1.37, 95% confidence interval [CI]: 1.35, 1.39). The 2018 facility prescribing rate was associated with 14% increased odds of antibiotic receipt in 2019 in NHs in the medium (11.9%-20.2%) prescribing category (all aOR: 1.14, 95% CI: 1.11, 1.17) and 36% increased odds of antibiotic receipt in NHs in the high (> 20.3%) prescribing category (all aOR: 1.36, 95% CI: 1.32, 1.40) when compared with the lowest (0%-11.8%) prescribing category.</p><p><strong>Conclusions: </strong>Antibiotic stewardship strategies should target nursing homes with high antibiotic prescribing rates and high populations of dually eligible patients to improve care in this population.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455933","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":"Comparative analysis of hospital-acquired and community-acquired infections at a tertiary hospital in China before and during COVID-19: A 7-year longitudinal study (2017-2023).","authors":"Xiang Su, Jianing Niu, Fang Wang, Ling Sun","doi":"10.1016/j.ajic.2024.10.009","DOIUrl":"10.1016/j.ajic.2024.10.009","url":null,"abstract":"<p><strong>Background: </strong>This 7-year longitudinal survey (2017-2023) assessed the point prevalence of hospital-acquired infections (HAIs) and community-acquired infections (CAIs) at a first-class tertiary hospital in China, both prior to and during the Corona Virus Disease 2019 (COVID-19) pandemic.</p><p><strong>Methods: </strong>Patients were stratified into prepandemic and pandemic periods, as well as into stringent and relaxed infection prevention and control (IPC) phases, to compare the point prevalence of HAIs and CAIs.</p><p><strong>Results: </strong>The overall point prevalence of HAIs was 1.50% (95% confidence interval [CI], 1.32%-1.71%), showing a significant downward trend (P = .021). Among patients receiving pathogen testing, the point prevalence of HAIs significantly declined during the pandemic (6.26% vs 9.89%, P < .001). The point prevalence of CAIs demonstrated a notable increase in 2023 compared with 2020 to 2022 among pathogen-tested patients (81.37% vs 74.18%, P = .001). Multivariate analysis identified hospitalization during the pandemic as a protective factor against HAIs (adjusted odds ratio 0.49, 95% CI, 0.36-0.67).</p><p><strong>Conclusions: </strong>The comprehensive IPC strategy implemented during the COVID-19 pandemic at this tertiary hospital significantly reduced the point prevalence of HAIs. However, CAIs exhibited a rising trend following the relaxation of COVID-19 IPC measures.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456030","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 patterns of antifungal use and risk factors associated with mortality in patients with invasive candidiasis and aspergillosis infections among patients who were received infectious disease specialist consultation prior to and during the COVID-19 pandemic in a resource-limited setting: A retrospective cohort study.","authors":"Supavit Vaivoothpinyo, Kittiya Jantarathaneewat, David J Weber, Bernard C Camins, Piyaporn Apisarnthanarak, Sasinuch Rutjanawech, Anucha Apisarnthanarak","doi":"10.1016/j.ajic.2024.10.013","DOIUrl":"10.1016/j.ajic.2024.10.013","url":null,"abstract":"<p><strong>Background: </strong>Limited data is available concerning the patterns of antifungal use and Invasive fungal infection (IFI)-associated mortality risk factors in patients with IFI prior to and during the Coronavirus disease 2019 (COVID-19) pandemic in resource-limited settings.</p><p><strong>Methods: </strong>A single-center retrospective cohort study was conducted. All patients age >18 years diagnosed with IFIs were prospectively followed during a 3-year pre-COVID-19 pandemic period and a 3-year during COVID-19 pandemic period. Patient characteristics, the patterns of antifungal use, IFI-associated mortality risk factors, and adverse drug events were collected.</p><p><strong>Results: </strong>There was a total of 133 patients in this study: 60 (45.1%) were in period 1 and 73 (54.9%) were in period 2. Pre-emptive antifungal therapy was commonly practiced in period 2 (21.7% vs 37%, P = .05). The presence of a central venous catheter (aOR 3.19, P = .007), hematologic adverse drug events (aOR 17.9, P = .008) were preventable risks for the overall IFI mortality in both periods. Appropriate antifungal use was protective against the overall IFI mortality in period 2 (aOR 0.09, P = .009).</p><p><strong>Conclusions: </strong>Several preventable risk factors associated with mortality were identified and served as a key for improvement of infection prevention, national policy to access antifungal agents, and antifungal stewardship in resource-limited settings.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455938","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":"Efficiency and simulation of Thailand's Chiang Mai University Model for COVID-19 mass vaccination hub (CMU-MVH model).","authors":"Amornphat Kitro, Danuphon Tippong, Wachiranun Sirikul, Natthanaphop Isaradech, Apiradee Kosai, Pimprapas Saengoa, Jiraporn Thammasarot, Penprapa Siviroj, Chaiy Rungsiyakull, Kriengkrai Srithanaviboonchai","doi":"10.1016/j.ajic.2024.10.005","DOIUrl":"10.1016/j.ajic.2024.10.005","url":null,"abstract":"<p><strong>Background: </strong>Mass vaccination is crucial for achieving herd immunity and controlling pandemics. Simulation models predict vaccination outcomes. This study evaluates efficiency and designs a tailored vaccination plan for Thailand.</p><p><strong>Methods: </strong>Data were derived from a coronavirus disease-19 mass vaccination hub in Chiang Mai, Thailand. It was taken between June 2021 and December 2021. The discreet event simulation model is developed in Arena Simulation Enterprise Suite version 14.0.</p><p><strong>Results: </strong>The operational efficiency of Chiang Mai University Mass Vaccination Hub (CMU-MVH) was 1,073 vaccinations per 8 hours with 38 service staff. The average processing times were 2.5 minutes for the registration station, 12.2 minutes for the assessment station, 8.3 minutes for vaccination, and 28.2 minutes for observation. With 100% staff availability and staff utilization ranging from 0.5 to 0.7, the CMU-MVH could handle 180 to 230 vaccinees per hour or 1,227 to 1,527 vaccinees per day. Reduced staff availability leads to an increase in average processing time, especially when staff availability is lower or equal to 60%.</p><p><strong>Conclusions: </strong>The CMU-MVH could handle approximately a thousand vaccinations within 8 working hours. This capability could assist policymakers in developing more effective strategies and planning for future mass vaccinations.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456032","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":"Elimination of an outbreak of carbapenem-resistant Acinetobacter baumannii in a burn unit.","authors":"Nancy L Havill, Monique Samuels, Anjali Poudyal, Vineetha Sujanan, Christina Murdzek, Michael J Aniskiewicz, Meghan Maloney, Jacqueline Laird, Alisa Savetamal","doi":"10.1016/j.ajic.2024.10.002","DOIUrl":"10.1016/j.ajic.2024.10.002","url":null,"abstract":"<p><p>Carbapenem-resistant Acinetobacter baumannii is an opportunistic pathogen which has caused numerous health care-associated outbreaks particularly in intensive care and burn units. We describe an outbreak in a burn unit where 3 patients were identified as being colonized or infected with carbapenem-resistant Acinetobacter baumannii. A multifaceted approach and rapid implementation of infection prevention measures were effective in identification and removal of potential environmental reservoirs resulting in the prevention of further transmission.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142405819","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":"Analysis of an expanded admission screening protocol for Candida auris at a New York City hospital.","authors":"Aaron Cheng, Karen Brody, Jordan Ehni, Zachary Gallate, Scott Lorin, Bernard Camins, Waleed Javaid","doi":"10.1016/j.ajic.2024.08.027","DOIUrl":"https://doi.org/10.1016/j.ajic.2024.08.027","url":null,"abstract":"<p><strong>Background: </strong>Candida auris (C auris) is an emerging global infectious disease threat, and screening practices for identification of C auris are inconsistent across healthcare facilities. This study describes the utility of expanding a C auris admission screening protocol at an acute care hospital to screen all patients presenting from any skilled nursing facility.</p><p><strong>Methods: </strong>A retrospective review identified all patients screened on admission for C auris from January 2022 through September 2023. Patients were identified for risk potential, and those deemed high risk were placed on transmission-based precautions while awaiting culture results.</p><p><strong>Results: </strong>Of the 591 patients screened, 14 cases were identified (2.4%). Nine cases presented with tracheostomies or were ventilator-dependent and classified as high risk. Five cases were considered low risk at the time of screening. Eight of these newly identified cases would not be screened under the prior criteria.</p><p><strong>Discussion: </strong>This study's findings support prior studies that patients with tracheostomies or were ventilator-dependent have greater risk for C auris colonization. Adopting an expanded admission screening program has allowed the hospital to detect more cases earlier to prevent nosocomial transmissions.</p><p><strong>Conclusions: </strong>Healthcare facilities should consider initiating or expanding admission screening programs for C auris based on community prevalence rates of C auris.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563759","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":"Impact of COVID-19 pandemic on reusable device precleaning training for front-line staff.","authors":"Josephine Fox, Lydia Grimes-Jenkins, Heather Gasama, Ashley Lloyd, Helen Wood, Satish Munigala, David K Warren","doi":"10.1016/j.ajic.2024.10.003","DOIUrl":"10.1016/j.ajic.2024.10.003","url":null,"abstract":"<p><p>High-level disinfection and sterilization are complex processes, requiring initial and ongoing training of frontline staff.¹ A key component of appropriate disinfection and sterilization is point-of-use precleaning performed by front-line staff. Our facility implemented an annual hospital-wide education and competency program for staff that perform precleaning of reusable medical devices.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455935","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":"Health care workers' perceptions about infection prevention and control in Latin America.","authors":"Valeria Fabre, Carolyn Herzig, Lucy Anchiraico Galarza, Bowen Aquiles, Ana Belen Arauz, Maria Del Carmen Bangher, Marisa L Bernan, Sol Burokas, Iris L Cazali, Angel Colque, Marisabel Comas, Rosa Verónica Contreras, Maria Gabriela Cordoba, Silvia Mabel Correa, Gustavo Costilla Campero, Aura Chiroy, Gabriela De Ascencao, Carlos Cruz García, Cecilia Ezcurra, Leandro Falleroni, Johana Fernandez, Sandra Ferrari, Veronica Freire, Maria Isabel Garzón, José Anel Gonzales, Lucrecia Guaymas, Fausto Guerrero-Toapanta, Sandra Lambert, Diego Laplume, Paola Romina Lazarte, Herberth Maldonado, Diego M Maurizi, Sandra Miriam Manami, Florencia Mesplet, Cristina Moreno Izquierdo, Yanina Nuccetelli, Argelis Olmedo, Belén Palacio, Florencia Pellice, Carla Lorena Raffo, Carolina Ramos, Fanny Reino, Viviana Rodriguez, Federico Romero, Juan José Romero, Graciela Sadino, Nancy Sandoval, Ines Staneloni, Mariana Suarez, Maria Victoria Suayter, Maria Alejandra Urueña, Marisol Valle, Silvia Vera Amate Perez, Hugo Videla, Silvina Villamandos, Olmedo Villarreal, Maria Alejandra Viteri, Eduardo Warley, Clare Rock, Elizabeth Bancroft, Rodolfo E Quiros","doi":"10.1016/j.ajic.2024.10.004","DOIUrl":"10.1016/j.ajic.2024.10.004","url":null,"abstract":"<p><strong>Background: </strong>Limited information exists regarding health care workers' (HCWs) perceptions about infection prevention and control (IPC) in Latin America.</p><p><strong>Methods: </strong>We conducted an electronic voluntary anonymous survey to assess HCWs' perceptions toward IPC in 30 hospitals in Latin America during August to September 2022. Nurses, physicians, and environmental cleaning (EVC) staff were prioritized for recruitment.</p><p><strong>Results: </strong>Overall, 1,340 HCWs completed the survey. Of these, 28% were physicians, 49% nurses, 8% EVC staff, and 15% had \"other\" roles. Self-compliance with hand hygiene and prevention bundles was perceived to be high by 95% and 89% of respondents, respectively; however, ratings were lower when asked about compliance by their peers (reported as high by 81% and 75%, respectively). Regular training on IPC and access to health care-associated infections (HAI) rates were more limited among physicians than other HCWs (eg, 87% of EVC staff and 45% of physicians reported training upon hiring and thereafter, 60% of nurses and 51% of physicians reported regular access to HAI rate reports).</p><p><strong>Conclusions: </strong>We identified several opportunities to strengthen IPC practices in Latin American hospitals, including improving HCW education and training on IPC and their awareness of HAI rates and compliance with prevention measures.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455934","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}