Antimicrobial Resistance and Infection Control最新文献

{"title":"The evolving epidemiology of Carbapenemase-producing Enterobacterales in Canadian acute care facilities, 2010-2023.","authors":"Robyn Mitchell, Laura Mataseje, Joëlle Cayen, Erin McGill, Kristine Cannon, Ian Davis, Tamara Duncombe, Chelsey Ellis, Jennifer Ellison, Jennifer Happe, Susy S Hota, Kevin C Katz, Pamela Kibsey, Santina Lee, Jerome A Leis, Xena Li, Allison McGeer, Jessica Minion, Sonja Musto, Connie Patterson, Ewa Rajda, Stephanie W Smith, Jocelyn A Srigley, Kathryn N Suh, Nisha Thampi, Jen Tomlinson, Joseph Vayalumkal, Kristen Versluys, Titus Wong, Yves Longtin","doi":"10.1186/s13756-025-01602-w","DOIUrl":"10.1186/s13756-025-01602-w","url":null,"abstract":"<p><strong>Background: </strong>Carbapenemase-producing Enterobacterales (CPE) are associated with substantial morbidity and mortality with limited treatment options and have an ability to spread rapidly in healthcare settings. We analyzed surveillance data from the Canadian Nosocomial Infection Surveillance Program to describe trends and the epidemiology of CPE from 2010 to 2023.</p><p><strong>Methods: </strong>Participating acute-care hospitals submitted eligible isolates to the National Microbiology Laboratory for detection of carbapenemase genes. Trained infection control professionals applied standardized definitions to collect epidemiological data by chart review from 30-97 hospitals from 2010 to 2023.</p><p><strong>Results: </strong>The national incidence of CPE infection (0.03 to 0.14 per 10,000 patient days; R² = 0.76) and colonization (0.02 to 0.78 per 10,000 patient days; R² = 0.83) increased exponentially from 2010 to 2023. We identified rapidly rising rates of healthcare-associated (HA) CPE infections from 2019 to 2023 (0.05 to 0.09 per 10,000 patient-days, p = 0.04), attributed to select hospitals (7/97) which accounted for half (53%) of all HA-CPE infections in 2023. Similarly, we identified that 2023 HA-CPE colonization rates were highest in medium (201-499 beds) and large (≥500 beds) hospitals in the Central region. Most patients did not report international travel (66%) nor receipt of medical care abroad (74%). Travel and receipt of medical care were less commonly reported among bla_KPC associated cases (7.1% and 5.3% respectively) compared to bla_NDM (55% and 45% respectively) and bla_OXA-48 (57% and 39%) associated cases. Furthermore, bla_KPC was the predominant carbapenemase among all HA-CPE isolates (62%, 950/1,534).</p><p><strong>Conclusions: </strong>Surveillance data from a national network of Canadian acute care hospitals indicates that while the incidence of CPE in Canada remains low, it is accelerating at an exponential rate. Our findings suggest that nosocomial transmission is driving the recent increase in CPE incidence in Canada. Improved infection control measures and antimicrobial stewardship as well as access to newer antimicrobials are all urgently needed.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"88"},"PeriodicalIF":4.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity versus clonality in carbapenem-resistant A. baumannii: a two-year surveillance study in four intensive care units at a large teaching hospital in Rome, Italy.","authors":"Mariateresa Ceparano, Valerio Capitani, Giuseppe Migliara, Silvia Rondón, Valentina Baccolini, Alessandra Carattoli, Paolo Villari, Carolina Marzuillo","doi":"10.1186/s13756-025-01605-7","DOIUrl":"10.1186/s13756-025-01605-7","url":null,"abstract":"<p><p>Multidrug-resistant (MDR) Acinetobacter baumannii is a major cause of healthcare-associated infections, which showed a significant increase during the SARS-CoV-2 pandemic, particularly in intensive care units (ICUs). The spread of A. baumannii in these environments is facilitated by contact with contaminated surfaces or infected patients, particularly via the hands of healthcare workers. This study analysed the spread and emergence of specific MDR A. baumannii clusters in four ICUs at the Umberto I teaching hospital in Rome, Italy, between January 2020 and January 2022. Genetic relatedness among A. baumannii isolates was determined by pulsed- field gel electrophoresis (PFGE) and whole- genome sequencing (WGS) performed on representative isolates. A total of 178 A. baumannii isolates, collected from 129 SARS-CoV-2-positive and 49 SARS-CoV-2-negative patients, were classified into 17 PFGE pulsotypes. Overall, 117 isolates belonged to clone A and exhibited an MDR phenotype; all of them belonged to international clonal lineage II. WGS analysis confirmed the presence of outbreaks within and between wards. Reconstruction of the evolutionary distances among isolates identified two locally circulating lineages (LCLs), two distinct clusters, and four outbreaks. Transmission between wards designated for SARS-CoV-2-positive patients and ICUs restricted to SARS-CoV-2-negative patients was also observed. All isolates showed resistance to carbapenems, mainly attributed to the bla_OXA-23 gene, and resistance to aminoglycosides, mediated by the armA gene. The study traced epidemic and sporadic infections, yielding valuable information on the implementation of preventive strategies and highlighting the importance of infection control measures to limit the spread of A. baumannii in hospital environments.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"84"},"PeriodicalIF":4.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The status of infection prevention and control structures in secondary and tertiary hospitals in Northwest China: findings from WHO Infection Prevention and Control Assessment Framework (IPCAF).","authors":"Yafei Jin, Wen Xu, Fangfei Liu, Shanhong Fan, Yao Suo","doi":"10.1186/s13756-025-01598-3","DOIUrl":"10.1186/s13756-025-01598-3","url":null,"abstract":"<p><strong>Background: </strong>Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) pose significant challenges to healthcare institutions worldwide. Implementing effective infection prevention and control (IPC) measures is crucial for reducing the risk of HAIs. However, limited research has been conducted on the current status of IPC in secondary and tertiary hospitals in Shaanxi Province, China. This study aims to comprehensively and quantitatively evaluate the IPC practices in these hospitals using the IPC Assessment Framework (IPCAF).</p><p><strong>Methods: </strong>A cross-sectional study was conducted in Shaanxi Province, China, from February to April 2024, in collaboration with the Provincial Center for Nosocomial Infection Control and Quality Improvement (NICQI) and 10 regional NICQIs. Using a stratified multistage sampling approach, secondary and tertiary hospitals were selected. Data were collected via electronic questionnaires distributed through WeChat groups. To ensure data quality, a pilot survey was performed, and standardized training was provided to all investigators.</p><p><strong>Results: </strong>A total of 171 hospitals participated in the survey, with 108 secondary hospitals (63.16%) and 63 tertiary hospitals (36.84%). The overall median IPCAF score was 642.5 (inter-quartile range [IQR]: 545-710), with secondary hospitals scoring 600 (IQR: 507.5-682.5) and tertiary hospitals 705 (IQR: 637.5-755), indicating significant differences between hospital grades (P < 0.05). According to WHO criteria, 106 hospitals (61.99%) achieved an \"advanced\" IPC level. Among core component (CC) scores, CC5 (Multimodal strategies) and CC7 (Workload, staffing and bed occupancy) had the lowest median scores (75), while CC8 (Built environment, materials and equipment for IPC at the facility level) and CC2 (IPC guidelines) had the highest median score.</p><p><strong>Conclusions: </strong>Secondary and tertiary hospitals in Shaanxi Province have demonstrated a relatively high level of IPC. However, resource allocation and facility upgrades in secondary hospitals require enhancement. The identified strengths and areas for improvement are in accordance with those observed in other upper-middle income countries, particularly with respect to multimodal strategies.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"85"},"PeriodicalIF":4.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Source-tracking Klebsiella outbreaks in premature infants using a novel amplicon fingerprinting method.","authors":"Adam P Matson, Katrin Unterhauser, Karim Rezaul, Stephanie Lesmes, Yanjiao Zhou, Ian C Michelow, Naveed Hussain, Mark D Driscoll","doi":"10.1186/s13756-025-01609-3","DOIUrl":"10.1186/s13756-025-01609-3","url":null,"abstract":"<p><strong>Background: </strong>Even with state-of-the-art infection control practices, premature infants can develop life-threatening infections in the neonatal intensive care unit (NICU). The precise sources of most NICU-associated infections frequently remain unknown and, therefore, are difficult to address. In this study, we used a novel microbiome sequencing approach to source-track lethal sepsis-causing Klebsiella, opportunistic pathogens, and commensal bacterial strains colonizing the gut of hospitalized premature infants.</p><p><strong>Methods: </strong>An exploratory-methods, case series was at performed Connecticut Children's Medical Center NICU in 2021. Long-read 16-23 S rRNA gene sequencing was used to analyze fecal samples, mother's milk, and clinical bacterial isolates derived from a cluster of Klebsiella-infected, and concurrently hospitalized non-infected, premature infants who were simultaneously enrolled in a neonatal microbiome study. Distinct groups of amplicons comprising a unique fingerprint pattern for a given strain were compared among the samples to ascertain relatedness.</p><p><strong>Results: </strong>We confirmed 100% amplicon identity between lethal Klebsiella quasipneumoniae from milk, gut, blood and trachea during sepsis in twins, while differentiating other infecting and colonizing Klebsiella strains in concurrently hospitalized premature infants. The method also successfully discriminated between multiple Klebsiella strains within the gut microbiota of a non-infected infant. Additionally, we showed that human milk is the source of many early intestinal colonizers, including Klebsiella, Enterococcus, Veillonella, and Bifidobacterium strains.</p><p><strong>Conclusions: </strong>Amplicon fingerprinting can be utilized as a high-throughput high-resolution test to assist in the investigation of nosocomial outbreaks. Additional applications such as routine monitoring of various reservoirs for potential pathogens could inform infection prevention and control strategies in the NICU.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"83"},"PeriodicalIF":4.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the implementation of the Italian National action plan to combact antimicrobial resistance (PNCAR) 2017-2021 through SPiNCAR-1: results for the Piedmont Region, 2022.","authors":"Stefania Di Giacomo, Luca Bresciano, Lorenza Ferrara, Sabina Pederiva, Carla Maria Zotti, Fortunato Paolo D'Ancona, Costanza Vicentini","doi":"10.1186/s13756-025-01604-8","DOIUrl":"10.1186/s13756-025-01604-8","url":null,"abstract":"<p><strong>Background: </strong>The Italian National action plan to contrast antimicrobial resistance (PNCAR) was adopted in Italy with the aim of reducing antimicrobial resistance (AMR) rates through a \"One Health\" approach. The project \"Support for the National Plan to Combat Antimicrobial Resistance (SPiNCAR)\" was developed to evaluate the level of implementation of actions outlined by the PNCAR, through a self-assessment tool, addressed to regional and local health authorities. This study presents the findings of the first use of the SPiNCAR tool in the Region of Piedmont, detailing the level of implementation as of 31 December 2022.</p><p><strong>Methods: </strong>The self-assessment questionnaire is divided into 7 central \"areas\" representing the main actions against AMR: governance, surveillance and monitoring, appropriate use of antimicrobials, healthcare-associated infection (HAI) control and prevention, education and training, alliance among stakeholders, evaluation of the impact and implementation of the program. Areas are structured into two or more items called \"standards\", subdivided into \"criteria\". Different questionnaires were developed for Regional and Local Authorities. Scores were calculated as the percentage of criteria met within each area, aggregated at both regional and local levels.</p><p><strong>Results: </strong>By analysing results at the regional level, it was possible to identify domains of strength in the areas of Governance (79%), Appropriate use of antimicrobials (70%), HAI Control and Prevention (68%) and areas for improvement in Alliance among Stakeholders (18%), Training (33%) and Surveillance (41%). Local authorities showed encouraging median results in Surveillance (37%), Appropriate Use of Antimicrobials (22,5%), and HAI Control and Prevention (21,5%), whereas Implementation (10,5%), Education and Training (8%) and Alliance among Stakeholders (2,5%) need to be improved.</p><p><strong>Conclusions: </strong>The first SPiNCAR assessment offered valuable insights to enhance healthcare quality; the evaluation identified stakeholder engagement and training as priority areas for improvement and targeted interventions for AMR containment.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"86"},"PeriodicalIF":4.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can chlorhexidine gluconate baths reduce fungal colonisation in intensive care unit patients?","authors":"Teresa Nascimento, João Inácio, Daniela Guerreiro, Patrícia Patrício, Luís Proença, Cristina Toscano, Priscila Diaz, Helena Barroso","doi":"10.1186/s13756-025-01606-6","DOIUrl":"10.1186/s13756-025-01606-6","url":null,"abstract":"<p><strong>Background: </strong>Chlorhexidine Gluconate (CHG) bathing is widely used in Intensive Care Units (ICUs) to reduce bacterial colonisation, yet its efficacy against fungal skin colonisation, particularly Candida spp., is not well understood. This study aimed to evaluate the impact of daily CHG bathing on Candida colonisation among ICU patients.</p><p><strong>Methods: </strong>From 2020 to 2022, axillary/inguinal swabs were collected from 675 ICU patients across three units on admission (Day 1, D1), Day 5 (D5) and Day 8 (D8). Patients received daily CHG bathing (either 2% impregnated wipes or 4% liquid solution) from D1 to D5, followed by soap-and-water bathing from Day 6 to D8. Standard and molecular microbiological methods were used to identify fungal species, and colony-forming units (CFUs) were quantified. Colonisation rates and fungal burden were compared across time points and bathing protocols.</p><p><strong>Results: </strong>A total of 988 swabs from 675 patients were collected, 675 on D1, 203 on D5 and 110 on D8. CHG bathing had no significant impact on Candida burden at individual time points, (D1, p = 0.223; D5, p = 0.939 and D8, p = 0.669). No significant differences in colonisation or fungal burden were observed between the use of 4% CHG solution and 2% CHG-impregnated wipes upon ICU admission. However, in the subgroup of 89 patients monitored longitudinally, a transient reduction in colonisation was observed during the CHG bathing period (D1-D5), followed by a significant increase during the soap-and-water period (D6-D8) (p = 0.005; between periods: p < 0.001). Among the 329 positive swabs, 274 yielded > 100 CFU/ml. High colony counts of C. albicans (> 1000 CFU/mL) were observed, with no significant association between colonisation levels and specific Candida species (p = 0.940).</p><p><strong>Conclusions: </strong>CHG bathing demonstrated only a limited and transient impact on Candida colonisation in ICU patients. Colonisation rates rebounded after cessation of CHG use, suggesting ongoing acquisition during ICU stay. These findings highlight the need for additional or alternative infection control measures targeting fungal pathogens in critical care settings.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"87"},"PeriodicalIF":4.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the risk of aerosol transmission of CRKP during bronchoscopy in the intensive care unit.","authors":"Junlin Yang, Zhuhong Zha, Lingzhu Li","doi":"10.1186/s13756-025-01603-9","DOIUrl":"10.1186/s13756-025-01603-9","url":null,"abstract":"<p><strong>Background: </strong>The potential for aerosol generation during bronchoscopy to facilitate the transmission of multidrug-resistant bacteria remains incompletely understood. This study aimed to assess the risk of carbapenem-resistant Klebsiella pneumoniae (CRKP) transmission via aerosols during bronchoscopy in an intensive care unit (ICU).</p><p><strong>Methods: </strong>We collected eight samples from the ICU of a tertiary general hospital, including bronchoalveolar lavage fluid (BALF) samples from one patient with community-acquired pneumonia and one patient with hospital-acquired CRKP infection, as well as air samples collected at 1, 2, and 3 m from the patients' bedsides. The gene sequences of the isolates were determined using Sanger sequencing, and the sequence type (ST) of the strains was identified through multilocus sequence typing (MLST). Phylogenetic and evolutionary analyses were performed using the MEGA program to construct maximum likelihood trees.</p><p><strong>Results: </strong>All samples tested positive for CRKP, with consistent antibiotic susceptibility profiles showing resistance to first-line antibiotics commonly used in clinical practice. All isolates were identified as ST11-type CRKP, and phylogenetic analysis revealed high homology among the eight CRKP isolates.</p><p><strong>Conclusions: </strong>This study demonstrates that CRKP can be transmitted through aerosols up to 3 m during bronchoscopy in the ICU, leading to hospital-acquired infections in patients in adjacent beds. These findings underscore the need for enhanced infection control measures during aerosol-generating procedures in high-risk settings.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"81"},"PeriodicalIF":4.8,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adequacy and implications of antimicrobial prophylaxis for elective surgeries in a tertiary hospital: a cross sectional and retrospective cohort study (ADEQUAP).","authors":"Marco Piscaglia, Dolores Martín Sierra, Antonio Huelva Millán, Maria Teresa Garcia Poo, Jesús Rodríguez Baño, Maria Dolores Del Toro López","doi":"10.1186/s13756-025-01601-x","DOIUrl":"10.1186/s13756-025-01601-x","url":null,"abstract":"<p><strong>Background: </strong>Surgical antimicrobial prophylaxis (SAP) is essential for preventing surgical site infections (SSI) but is often improperly administered. This study assessed SAP adequacy and its association with SSI and other nosocomial infections (NI) to identify areas for improvement.</p><p><strong>Methods: </strong>This cross-sectional and retrospective cohort study included adults undergoing elective cardiovascular, orthopaedic, colorectal surgeries and cystectomy in 2022 at a teaching hospital. SAP was considered adequate if it met all local guideline criteria: indication, drug, dose, timing of administration, redosing and duration. Associations between SAP adequacy and SSI were analyzed using generalized mixed models.</p><p><strong>Results: </strong>Among 723 patients included (median age 68 years; 57.7% male), 714 (98.8%) received SAP. Overall multidomain adherence to SAP guidelines was 34.6%, with high compliance for regimen (92.8%), dose (97.5%), and timing (98.3%), but lower compliance for redosing (63.4%) and duration (53.9%). Regimen adequacy was significantly lower in patients with beta-lactam allergies (55.6% vs. 94.8%, p < 0.001) and in cystectomy cases compared to other procedures (41.2% vs. 94.1%, p < 0.001). Non-compliant regimens were independently associated with a higher SSI rate (adjusted OR 3.4; 95% CI: 1.8-8.3; p = 0.003), but not with non-SSI NIs. Inadequate SAP was also associated with a length of stay (LOS) exceeding 10 days (RR 4.61; p < 0.001) and higher 90-day mortality (RR 3.37; p = 0.007). Patients who developed an SSI were significantly more likely to develop additional non-SSI NIs (adjusted OR 6.1; 95% CI: 2.8-13.4; p < 0.001). Median LOS was longer in patients with SSI (16.5 vs. 7 days, p < 0.001), and SSI was also associated with increased 90-day mortality (14.7% vs. 2.7%; RR 5.42; p < 0.001).</p><p><strong>Conclusion: </strong>Non-adherence to SAP guidelines was associated with an increased risk of SSI, prolonged LOS, and greater crude mortality. Key areas for improvement include regimen selection, appropriate redosing, and limiting SAP duration. Patients with beta-lactam allergies were specially at risk of receiving inadequate SAP. Although SAP non-compliance was not independently associated with other NIs, SSIs significantly increased their occurrence.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"82"},"PeriodicalIF":4.8,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An economic evaluation of a hospital-wide bundle intervention to reduce hospital-acquired infections and bladder distension among hip fracture patients in Sweden.","authors":"Sneha Abdul Jabbar, Maria Frödin, Ewa Wikström, Brigid M Gillespie, Hanna Gyllensten, Annette Erichsen","doi":"10.1186/s13756-025-01573-y","DOIUrl":"10.1186/s13756-025-01573-y","url":null,"abstract":"<p><strong>Background: </strong>A theory-driven knowledge translation program was established to co-create and implement evidence-based practices to prevent urinary catheter-associated urinary tract infections (UC-UTIs) and bladder distension (BD). This study investigates the cost-effectiveness of implementing the Safe Hands and Safe Bladder bundle intervention compared to standard care for patients undergoing hip fracture surgery in Sweden.</p><p><strong>Method: </strong>The study included outcomes from a quality register of patients who underwent hip fracture surgery at a Swedish hospital from 2015 to 2020. Adopting a healthcare perspective, estimates for the implementation cost were derived using activity-based costing, while the bundle's cost-effectiveness was estimated using a decision tree model. Health outcomes were evaluated based on adverse events, specifically UC-UTI and BD. Analyses included calculating the incremental cost-effectiveness ratio (ICER), which denotes the incremental cost per added infection rate expressed as a percentage. Additionally, sensitivity analyses were conducted to test the robustness of the results under alternative cost assumptions.</p><p><strong>Results: </strong>The likelihood of avoiding BD or UC-UTI increased from 50 to 87% over the course of the intervention year. The discounted implementation cost was SEK 890,389 (corresponding to Int$ 102,721). However, the implementation cost was offset by costs for a prolonged hospital stay due to these adverse events, resulting in an overall cost savings of SEK - 7,334 per patient (Int$ -846) in 2020 compared to before the intervention was introduced. Consequently, the intervention proved to be cost-effective, leading to savings and a decrease in the occurrence of adverse events.</p><p><strong>Conclusion: </strong>Implementing the bundle intervention in units providing care for patients with acute hip fractures proved cost-effective. This offers decision makers valuable insights and demonstrates that implementation programs incorporating collaboration, facilitation and co-creation processes can effectively use limited resources. Further research should determine the generalizability of the findings to other settings and populations.</p><p><strong>Clinicaltrials: </strong></p><p><strong>Gov registration: </strong>NCT02983136 and ISRCTN 17,022,695, retrospectively registered after data collection were completed.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"80"},"PeriodicalIF":4.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Farmer field schools as interventions to reduce the need for antimicrobials in agrifood systems: a longitudinal analysis of layer farmer field school graduates and non-graduates in Kenya.","authors":"Mark A Caudell, Stella Kiambi, Tabitha Kimani, Anica Buckel, Ruth Omani, Junxia Song, Markus Lipp, Emmanuel Kabali","doi":"10.1186/s13756-025-01580-z","DOIUrl":"10.1186/s13756-025-01580-z","url":null,"abstract":"","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"79"},"PeriodicalIF":4.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}