Antimicrobial Resistance and Infection Control最新文献

{"title":"Assessment of dry-fogged hydrogen peroxide as an \"untact\" room disinfection automation system for rapid terminal decontamination of a single isolation room in a healthcare institution.","authors":"Jin Woong Suh, Jeong Yeon Kim, Jang Wook Sohn, Sung Eun Lee, Hyeon Jeong Kim, Woo Jin Chi, Mi Na Lee, Young Kyung Yoon","doi":"10.1186/s13756-025-01613-7","DOIUrl":"10.1186/s13756-025-01613-7","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the efficacy of dry-fogged hydrogen peroxide (dHP) as an \"untact\" room disinfection automation system (URDAS) for rapid terminal room decontamination.</p><p><strong>Methods: </strong>This prospective study was conducted at a university-affiliated hospital in Korea. After patient discharge, dHP technology was used to decontaminate single rooms. Environmental cultures were collected from inanimate surfaces and room air before and after the decontamination process. Routine manual cleaning and disinfection were performed only after environmental sampling during terminal decontamination.</p><p><strong>Results: </strong>After applying URDAS using dHP, culture positivity in the surface samples decreased from 20.5% (16/78) to 5.1% (4/78). Particularly, bed-removable tables and bedsheets used by patients often remain contaminated even after disinfection. Thirty-six species were isolated from the air cultures before disinfection, which decreased to 23 species after disinfection, representing a 36.1% reduction. The most frequently isolated pathogens after disinfection were S. aureus on fabric materials from surface samples and Aspergillus species from air samples.</p><p><strong>Conclusion: </strong>Our findings demonstrate that URDAS using dHP is an effective tool for disinfecting contaminated environmental surfaces and spaces in single isolation rooms with minimal risk of exposure to medical staff. However, further optimization is required to address the material- and pathogen-specific disinfection challenges.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"92"},"PeriodicalIF":4.4,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717333","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":"Risk factors and economic burden of healthcare-associated infections among patients supported by extracorporeal membrane oxygenation in the ICU: a cohort study from China.","authors":"Zhenyu Hu, Minjin Peng, Chen Dong, Li Li, Qiao Hu, Hanlin Liao, Haining Jiang, Xianglan Fang, Qifei Zhang, Binbin Fu, Tingyu Lan, Kun Meng, Yijun Tang, Duoshuang Xie","doi":"10.1186/s13756-025-01611-9","DOIUrl":"10.1186/s13756-025-01611-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Extracorporeal Membrane Oxygenation (ECMO) is a critical life-support technology widely used for managing patients with cardiopulmonary failure. However, ECMO patients are particularly susceptible to healthcare-associated infections (HAIs) due to their critical illness and the invasive procedures. These infections not only reduce patients' quality of life but also increase healthcare resource utilization. Therefore, understanding the characteristics and risk factors of HAIs in ECMO patients and establishing/implementing targeted preventive strategies are essential.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to analyze the epidemiological characteristics of HAIs, investigate associated risk factors, and assess the economic impact on patients receiving ECMO support.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cohort study included patients who received ECMO support at Taihe Hospital, Hubei University of Medicine, from February 2017 to September 2023. Patients were categorized into an infection group and a non-infection group based on the occurrence of HAIs. Collected data included basic patient information, infection sites, pathogen distribution, and economic burden. Risk factors for ECMO-related HAIs were analyzed using both univariate and multivariate methods, with statistical significance defined as p &lt; 0.05. Multivariate competing risk regression analysis was performed to identify independent risk factors significantly associated with ECMO-related HAIs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included 97 eligible ECMO patients, predominantly male (77, 79.38%), with a mean age of 46.7 ± 16.5 years. The total ECMO support duration across all patients was 467.3 days, with a median hospital stay of 12.5 days (range: 4.4-25.5 days). Of note, 86.60% of the patients received venoarterial (VA) ECMO support. Among these patients, 14.43% developed ECMO-related HAIs, resulting in 17 HAI events among 14 patients. These events comprised 10 respiratory tract infections (RTIs), 4 bloodstream infections (BSIs), 2 surgical site infections (SSIs), and 1 urinary tract infection (UTI). The rate of ECMO-related HAIs was 36.4 cases per 1,000 ECMO days. A total of 29 pathogenic microbial strains were identified, including 21 multidrug-resistant bacteria (72.41%; 72.41% Gram-negative, 20.69% Gram-positive), and 2 fungal strains (6.90%). Independent risk factors for ECMO-related HAIs included tracheostomy (odds ratio [OR] = 28.6, p = 0.003) and decreased platelet count (OR = 0.975, p = 0.004). Median total hospitalization expenses were significantly higher in the infection group (US$100,270.4 vs. US$32,108.6; p &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Patients receiving ECMO support are at a heightened risk of developing HAIs, with respiratory tract infections (RTIs) and bloodstream infections (BSIs) being the most prevalent types. The study identified tracheostomy and decreased platelet count as independent risk factors for ECMO-","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"91"},"PeriodicalIF":4.4,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717334","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":"Broad-spectrum and Watch antimicrobials are commonly used to treat hospital-acquired infections in German acute care hospitals: results from the 2022 national point prevalence survey.","authors":"Seven Johannes Sam Aghdassi, Selin Saydan, Frieder Pfäfflin, Miriam Songa Stegemann, Anja Theloe, Michael Behnke, Luis Alberto Peña Diaz, Alexander Gropmann, Christine Geffers, Brar Piening, Sonja Hansen","doi":"10.1186/s13756-025-01608-4","DOIUrl":"10.1186/s13756-025-01608-4","url":null,"abstract":"<p><strong>Background: </strong>Hospital-acquired infections (HI) and associated antimicrobial use (AU) significantly contribute to antimicrobial resistance. We aimed to analyse AU patterns for HI treatment in German acute care hospitals.</p><p><strong>Methods: </strong>We analysed data from the German 2022 point prevalence survey (PPS) on AU and healthcare-associated infections, using the European Centre for Disease Prevention and Control protocol across 252 hospitals. Analyses focused on key infection prevention and control (IPC), antimicrobial stewardship (AMS) indicators and AU for HI, categorised by the World Health Organisation AWaRe classification. Comparisons were made to the previous national PPS in 2016 and 2011.</p><p><strong>Results: </strong>A total of 22 422 antimicrobial prescriptions were recorded in 66 586 patients. HI treatment accounted for 20% of AU. Penicillins with beta-lactamase inhibitors, carbapenems and third-generation cephalosporins accounted for over 50% of AU for HI treatment. Watch antimicrobials dominated HI treatment prescriptions, accounting for around 62% of use, particularly in respiratory infections, while use of Access antimicrobials was limited (24%). Skin and soft tissue as well as bone and joint infections, respiratory infections, and urinary tract infections were the most commonly treated HI. Over time, IPC indicators, such as alcohol-based hand rub consumption and IPC staffing, improved significantly, yet AMS staffing remained low and comprehensive hospital-wide post-prescription reviews were limited to around a quarter of hospitals.</p><p><strong>Conclusions: </strong>The findings underscore the importance of reducing HI to curb the use of broad-spectrum antimicrobials in German hospitals. IPC should be included in AMS strategies, alongside aspects like improving AMS staffing and establishing post-prescription review programmes.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"90"},"PeriodicalIF":4.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658179","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":"Non-adherence to surgical antibiotic prophylaxis guidelines: findings from a mixed-methods study in a developing country.","authors":"Noha Ali, Ranim Hamouda, Rana Tarek, Menna Abdelhamid, Abdullah Lashin, Rania Hassan, Rania Gamal, Mourad Elfaham, Aya Attia, Ahmed Abdelaleem, Noha Sakna, Amgad Gamal, Sally Aboelenin, Rahma AbdelHafez, Sara Abdelkader, Ashraf Nabhan","doi":"10.1186/s13756-025-01607-5","DOIUrl":"10.1186/s13756-025-01607-5","url":null,"abstract":"<p><strong>Objectives: </strong>The effectiveness of surgical antibiotic prophylaxis in reducing the risk of post-operative infectious morbidity, depends on its appropriate use. We aimed to assess adherence to surgical antibiotic prophylaxis guidelines and to explore the factors contributing to non-adherence.</p><p><strong>Methods: </strong>This mixed-methods study comprised a cross-sectional survey and qualitative analysis. The cross-sectional survey included all surgical procedures performed in Ain Shams University Hospital of Obstetrics and Gynecology from November 1 2024 to December 31 2024. Trained medical interns collected routine data in real-time in the operative theater and in the wards by observing and documenting three key variables namely the antibiotic prescribed, timing of administration, and the duration of use. The overall adherence rate was calculated as the proportion of cases meeting all three criteria. The survey was followed by a qualitative research through synchronous online focus group of eight participants. Following transcription of the audio-recorded discussion, three researchers used a deductive approach to content analysis of the focus group discussion.</p><p><strong>Results: </strong>Two hundred and eighty surgical procedures were analyzed, with cesarean sections accounting for 48.6% (136/280). Full adherence to surgical antibiotic prophylaxis guidelines was observed in 0% of cases. The appropriate antibiotic was prescribed in 62.5% (175/280) of procedures. Timely administration within the recommended 60-minute pre-incision window occurred in 38.2% (107/280). In contrast, 61.4% (172/280) of procedures had delayed antibiotic administration post-incision. The recommended single-dose or ≤ 24-hour regimen was administered in only 6.1% (17/280), whereas 93.9% (263/280) had prolonged parenteral antibiotic use beyond 24 h, with 98.9% (277/280) transitioning to oral antibiotics upon discharge. Key barriers to adherence included knowledge gaps, workflow inefficiencies, inadequate monitoring, limited antibiotic availability, financial constraints, and weak enforcement of surgical antibiotic prophylaxis guidelines.</p><p><strong>Conclusions: </strong>Non-adherence to surgical antibiotic prophylaxis guidelines is high, particularly regarding timing and duration. Addressing systemic barriers and enforcing guideline compliance is essential to improving antibiotic stewardship in surgical settings.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"89"},"PeriodicalIF":4.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635999","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 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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256002/pdf/","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":"OA","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}