Antimicrobial Resistance and Infection Control最新文献

{"title":"Clinical risk factors associated with nosocomial Pseudomonas aeruginosa bacteraemia in patients within a tertiary care healthcare setting - a case control study.","authors":"Özge Yetiş, Shanom Ali, Pietro Coen, Peter Wilson","doi":"10.1186/s13756-025-01628-0","DOIUrl":"https://doi.org/10.1186/s13756-025-01628-0","url":null,"abstract":"","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"112"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205341","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":"Impact of targeted interventions on healthcare-acquired infection prevention and control of Clostridium difficile infections.","authors":"Sisi Zhang, Juping Duan, Lina Zhang, Sidi Liu, Xiujuan Meng, Xiaobei Peng, Wei Liu, Anhua Wu, Chunhui Li","doi":"10.1186/s13756-025-01616-4","DOIUrl":"https://doi.org/10.1186/s13756-025-01616-4","url":null,"abstract":"","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"113"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205368","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":"Clean Hospitals Day 2025: the human factors of healthcare environmental hygiene.","authors":"Alexandra Peters, Martina Mocenic, Pierre Parneix, Brett G Mitchell, Stephanie Dancer, David J Weber","doi":"10.1186/s13756-025-01638-y","DOIUrl":"https://doi.org/10.1186/s13756-025-01638-y","url":null,"abstract":"","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"111"},"PeriodicalIF":4.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197846","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":"The impact of central line-specific dwell-times for neonatal central line associated bloodstream infections.","authors":"Martina Buttera, Carolyn Luhmann-Lunt, Michael Buettcher, Dirk Lehnick, Martin Stocker","doi":"10.1186/s13756-025-01618-2","DOIUrl":"10.1186/s13756-025-01618-2","url":null,"abstract":"<p><strong>Background: </strong>Central line-associated bloodstream infections (CLABSIs) are among the most serious infectious complications associated with central lines in neonates. CLABSIs can be prevented by healthcare workers using \"bundles\" when inserting and managing central lines. These include prompt removal of the central line when it is no longer needed. The aim of this study was to describe and analyze neonatal CLABSIs, focusing on a minimal data set including specific catheter types and dwell times.</p><p><strong>Methods: </strong>A retrospective descriptive study reviewing the management and outcome of neonates with CLABSI admitted to the Department of Neonatology and Neonatal Intensive Care at the Children's Hospital of Central Switzerland in Lucerne from 1 January 2020 to 31 December 2023.</p><p><strong>Results: </strong>In this four-year period, a total of 27,636 neonates were born in the catchment area and 2599 neonates (9.4%) were admitted to our hospital. In total, 615 neonates (23.7%) had at least one central line with a total of 4940 catheter days. We observed an overall neonatal CLABSI rate of 2.9 per 1,000 catheter days. The rate varied significantly by catheter type: 0 per 1,000 catheter days for umbilical artery catheters (UACs), 0.9 per 1,000 catheter days for peripherally inserted central lines (PICCs), 5.6 per 1,000 catheter days for umbilical venous catheters (UVCs), and 17.9 per 1,000 catheter days for centrally inserted venous catheters (CVCs). All episodes of CLABSI were observed after a dwell time of 5 days, with increasing rates after 9 days.</p><p><strong>Conclusions: </strong>We observed a pronounced variation in CLABSI rates between different catheter types. All episodes of CLABSI were observed after a dwell time of 5 days, with increasing rates after 9 days, and the rate of CLABSI increased with longer dwell times for UVCs and CVCs. This suggests a reduction in dwell time as a potential strategy for future quality improvement programs aiming for a zero CLABSI rate and underlines the importance of reporting central-line specific dwell-times for future publications.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"106"},"PeriodicalIF":4.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172197","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":"Etiology and antimicrobial resistance patterns of sepsis in infants 0-59 days old in Jimma, Ethiopia: a longitudinal study.","authors":"Daniele Gusland, Melkamu Berhane, Mekdes Shimekit, Mulatu Gashaw, Alemseged Abdissa, Jens C Eickhoff, Dawd S Siraj, James H Conway","doi":"10.1186/s13756-025-01626-2","DOIUrl":"10.1186/s13756-025-01626-2","url":null,"abstract":"<p><strong>Introduction: </strong>In Ethiopia, empiric treatment for sepsis or possible serious bacterial infection (PSBI) in infants 0-59 days old is based on World Health Organization (WHO) guidelines. We aimed to assess the etiology, antimicrobial susceptibility and outcomes of empiric treatment in PSBI in Jimma, Ethiopia and created local antibiograms to assess empiric treatment guidelines in this setting.</p><p><strong>Methods: </strong>We prospectively enrolled 363 infants 0-59 days of age admitted to Jimma University Hospital with PSBI over 12-months. Following institutional practice, blood and cerebrospinal fluid (CSF) cultures were collected; positive cultures were identified and evaluated for antibiotic susceptibility. We compared microbiologic results to the WHO guideline based empiric treatment selections at the hospital and evaluated the clinical outcomes at discharge and 30-days of age.</p><p><strong>Results: </strong>Of 279 patients who had blood cultures obtained, 212(76.0%) were positive, yielding 216 isolates. Four CSF cultures were positive and were included in analysis of blood cultures due to the smaller number of isolates. The most common isolates were Klebsiella (31.8%), coagulase-negative Staphylococci (24.6%), and Staphylococcus aureus (11.6%). Of Klebsiella species, 87% were resistant to at least one commonly utilized antibiotic and 82% were resistant to first-line empiric antimicrobials. In-hospital mortality was 12.3% and it was highest (41%) in participants with Klebsiella. At 30-days of age, mortality for infants with positive culture was 6.6%.</p><p><strong>Conclusions: </strong>Isolates from PSBI showed high rates of antibiotic resistance to first- and second-line antimicrobials. In this setting, the WHO empiric treatment guidelines inadequately treat infants admitted with PSBI, particularly those with Klebsiella. To provide the most effective care for PSBI in 0-59 days old infants, institutionally used guidelines should be customized to reflect local epidemiology and resistance patterns.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"108"},"PeriodicalIF":4.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172387","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":"Prevalence of AmpC beta-lactamase producing Escherichia coli and Klebsiella pneumoniae in Africa: a systematic review and meta-analysis.","authors":"Saba Gebremichael Tekele, Zewudu Mulatie, Alemu Gedefie, Hussen Ebrahim, Brukitawit Eshetu, Mihret Tilahun, Habtu Debash, Agumas Shibabew, Ousman Mohammed, Ermiyas Alemayehu, Daniel Gebretsadik Weldehanna, Melaku Ashagrie Belete","doi":"10.1186/s13756-025-01578-7","DOIUrl":"10.1186/s13756-025-01578-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The emergence of AmpC beta-lactamase (AmpC) poses a significant challenge in the context of antimicrobial resistance (AMR). AmpC confers resistance to narrow- and broad- spectrum cephalosporins, beta-lactam/beta-lactamase inhibitor combinations and aztreonam making it clinically relevant and presenting a formidable threat to effective therapeutic interventions. Thus, the aim of this study was to assess magnitude of AmpC producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) in Africa.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Articles were extensively searched in bibliographic databases and grey literature using entry terms and combinations key words. Electronic databases such as PubMed, Scopus, Science Direct, Embase, and other online sources such as African Journal Online, Google Scholar, and ResearchGate were used to find relevant articles. Furthermore, the Joanna Briggs Institute quality appraisal tool was used to assess the quality of the included studies. Studies meeting eligibility criteria were extracted in MS Excel and exported to STATA version 14 software for statistical analysis. A random-effects model was used to compute the pooled prevalence of AmpC producing E. coli and K. pneumoniae. Heterogeneity was quantified by using the Cochrane Q test and I&lt;sup&gt;2&lt;/sup&gt; statistics. Publication bias was assessed using a funnel plot and Egger's test. Additionally, sensitivity analysis was conducted to assess the impact of a single study on the pooled effect size.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;Of the 2,619 studies identified, 25 studies were eligible for quantitative analysis, involving a total of 11,908 E. coli, and 4,654 K. pneumoniae isolates. The overall pooled prevalence of AmpC producing E. coli and K. pneumoniae in Africa was 18.79% (95% CI: 15.00, 22.58). The pooled prevalence of AmpC producing E. coli and K. pneumoniae were 15.32% (95% CI: 12.03, 18.61) and 17.25% (95% CI: 13.18, 21.32), respectively. There was significant heterogeneity among studies (I&lt;sup&gt;2&lt;/sup&gt; = 99.0%, p &lt; 0.001). Our study depicted that Egypt had the highest pooled prevalence of AmpC producing E. coli and K. pneumoniae with 28.91% (14.74, 43.08) and 27.84% (8.47, 47.21) respectively. Furthermore, studies conducted after 2020 showed the highest pooled prevalence of AmpC producing E. coli 28.29% (11.78, 44.80) and K. pneumoniae 29.04% (13.13, 44.85) while lowest pooled prevalence of AmpC producing E. coli 6.28% (95% CI: 2.99, 9.58) and K. pneumoniae 5.41% (95% CI: 1.73, 9.09) was observed among studies conducted before the year 2016.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study showed an increase in AmpC producing E. coli and K. pneumoniae in Africa over the past 20 years. Therefore, regular identification of AmpC, infection prevention control, strengthening of the antimicrobial resistance surveillance system and an effective antibiotic policy are required to combat the antibiotics resistance in Africa.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Pr","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"109"},"PeriodicalIF":4.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172417","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":"Neonatal infection with Staphylococcus capitis NRCS-A in Iceland: A 12-year longitudinal, retrospective study of strains from patients, staff and the environment in a neonatal intensive care unit.","authors":"Ingibjörg Hilmarsdóttir, Kristján Orri Helgason, Álfheidur Thórsdóttir, Mélanie Bonhomme, Jóhanna Dröfn Stefánsdóttir, Ásdís Elfarsdóttir Jelle, Thórdur Thórkelsson, Frédéric Laurent, Marine Butin","doi":"10.1186/s13756-025-01623-5","DOIUrl":"10.1186/s13756-025-01623-5","url":null,"abstract":"<p><strong>Background: </strong>The multidrug resistant NRCS-A clone of Staphylococcus capitis (SC) has spread globally in neonatal intensive care units (NICUs) where it causes neonatal sepsis and colonisation of infants, fomites and staff. Whole genome sequencing (WGS) of international isolates has suggested a putative origin of the clone in Norway, which is closely related to Iceland geopolitically. No data have been available about the NRCS-A clone in Iceland where a case of neonatal sepsis in 2014 suggested its presence for the first time. This study examines the epidemiology of the clone in the single Icelandic NICU over a 12-year period and its relationship to international isolates.</p><p><strong>Methods: </strong>The study involved retrospective examination of the occurrence and clinical significance of SC-NRCS-A isolated from blood cultures of infants during 2009 - 2020, and prospective screening for SC among infants, staff and the environment. WGS was done on selected isolates to verify the presence of the SC-NRCS-A clone, examine phylogenetic relationship within the Icelandic isolates, and compare them with an international collection of SC-NRCS-A.</p><p><strong>Results: </strong>SC-NRCS-A was found in blood cultures from 28 infants, of which nine with sepsis, and was a frequent coloniser of infants and diverse fomites. In staff SC-NRCS-A was detected in nares, throat and scalp. WGS of 93 isolates from blood and prospective screening specimens and comparison with international isolates revealed that the Icelandic SC-NRCS-A was distributed into two clusters, one related to Norwegian and the other to Irish SC-NRCS-A isolates. Both clusters contained isolates representing all sample sources.</p><p><strong>Conclusion: </strong>The study demonstrated interpatient transmission, widespread dissemination and persistence of the SC-NRCS-A clone in the Icelandic NICU. The close phylogenetic relationship of Icelandic isolates with those from Norway and Ireland suggests potential import to Iceland by NICU staff or infants receiving medical care in these neighbouring countries at some point before 2009 for the Irish clone and before 2014 for the Norwegian clone.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"107"},"PeriodicalIF":4.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172450","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":"Pattern and appropriateness of antimicrobial prescription for acute respiratory tract infection in primary healthcare settings in Ethiopia.","authors":"Gashaw Enbiyale Kasse, Suzanne M Cosh, Judy Humphries, Md Shahidul Islam","doi":"10.1186/s13756-025-01612-8","DOIUrl":"10.1186/s13756-025-01612-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Acute respiratory tract infections (ARTIs) are the leading cause of antimicrobial misuse, contributing to the increasing problem of antimicrobial resistance. Little information exists about the pattern and appropriateness of antimicrobial prescribing in patients with ARTIs in the study area. Therefore, this study aims to investigate antimicrobial prescriptions and their appropriateness for ARTIs in primary healthcare settings in Ethiopia, as well as to identify potential risk factors for inappropriate antimicrobial prescriptions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional study was conducted in seven selected primary health centres. Data were collected through face-to-face structured questionnaire interviews with outpatients diagnosed with ARTIs and a review of their medical charts. To be eligible for this study, patients had to be diagnosed with one of the ARTIs as diagnosed by physicians. The appropriateness of antimicrobial prescription was evaluated by two experienced physicians based on national and international guidelines. Multivariable logistic regression was used to identify the significant factors, including sociodemographic and clinical characteristics, associated with inappropriate antimicrobial prescriptions. A p-value &lt; 0.05 was considered a level of statistical significance. We used Variance Inflation Factors (VIF) to check the multicollinearity of independent variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 420 patients included in the study, 55% were female. The mean age of the participants was 45.1 years (SD ± 16.8 years) with a range of 18-90 years. The most frequent diagnoses of ARTIs were acute bronchitis (24%), common cold (22.4%), and tonsillitis (15.2%). 352 (83.8%) of patients received antimicrobial prescriptions. The most frequently prescribed antimicrobial classes were penicillin (69.1%), macrolides (20.4%), and fluoroquinolones (6.2%). Moreover, amoxicillin (36.9%) and amoxicillin-clavulanic acid (32.4%) were the most inappropriately prescribed antimicrobials. The rate of inappropriate antimicrobial prescription was 64.2%. Among these, 71.7% of patients received antimicrobials that were not indicated, while the remaining 28.3% received an inappropriate dose and frequency. Patients diagnosed with common colds, acute bronchitis and tonsillitis had a higher rate of inappropriate antimicrobial prescriptions. The presence of fever (OR = 5.42; 95% CI = 3.36-8.75; P &lt; 0.001), patients with comorbidities (OR = 1.31; 95% CI = 1.23-3.93; p = 0.001) and patient age ≥ 60 years (OR = 1.18; 95% CI = 1.08-2.48; p &lt; 0.001) were associated with a higher likelihood of inappropriate antimicrobial prescribing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Overall, the study findings highlight a high rate of antimicrobial prescriptions for ARTIs, with the majority being prescribed inappropriately. These results underscore the need for targeted interventions, including antimicrobial stewardship programs and adher","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"110"},"PeriodicalIF":4.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172397","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":"Development and evaluation of a massive open online course (MOOC) to teach medical students the prudent use of antibiotics.","authors":"Miriam Wiese-Posselt, Selin Saydan, Thiên-Trí Lâm, Alina Rörig, Clara Bergmann, Felicia Becker, Oliver Kurzai, Markus A Feufel, Petra Gastmeier, Sandra Schneider","doi":"10.1186/s13756-025-01640-4","DOIUrl":"10.1186/s13756-025-01640-4","url":null,"abstract":"<p><strong>Background: </strong>If antibiotics are used appropriately, the development of antimicrobial resistance (AMR) can be curbed. Many medical students feel that they do not receive sufficient training in this respect during their undergraduate medical education. In recent years, digital learning formats are being successfully employed in student teaching. Our aim was to develop and evaluate a massive open online course (MOOC) on appropriate antibiotic therapy and the development of AMR. The intention was to provide the MOOC as an effective learning format in medical schools and to encourage others to develop their own MOOCs on other topics.</p><p><strong>Methods: </strong>We developed a MOOC for medical students that consisted of four modules (M1-4) on bacteriology, microbiology diagnostics, pharmacology, antibiotics, AMR, the One Health approach, principles of appropriate antibiotic therapy, and transfer of knowledge to clinical practice. MOOC learners were asked to answer the same 16 knowledge and five self-assessment questions at the beginning and end of the MOOC and to give course feedback in an anonymous online questionnaire.</p><p><strong>Results: </strong>From July 1, 2021 until June 30, 2022 the MOOC was actively attended by 2061 learners. Of them, 473 (23%) completed the final exam and 389 (19%) answered the knowledge and self-assessment questions at the beginning and end of the MOOC. A significant increase in knowledge and a strengthening of competence and self-confidence was observed in these 389 learners. The median knowledge score increased significantly from 10/16 (IQR 8; 12) points before the MOOC to 16/16 (15; 16) afterwards (p < 0.001). Overall, course activity decreased from M1 (100% attendance) to M4 (38%). At the end of the MOOC, the online feedback questionnaire was completed by 304 (15%) learners, most of whom rated the MOOC positively. For example, 97% of them stated that they had increased their knowledge in relevant areas.</p><p><strong>Conclusions: </strong>A high dropout rate for voluntary MOOCs is generally reported. Therefore, a course completion rate of 23% is acceptable. The learners who completed the MOOC showed a significant increase in knowledge and self-confidence. The use of the MOOC, or parts of it, as digital learning format for undergraduate medical education appears promising.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"105"},"PeriodicalIF":4.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123947","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":"Barriers and facilitators of the implementation for the antimicrobial Social Norm Feedback (SNF) intervention strategy in primary care institutions: a qualitative study based on the Consolidated Framework for Implementation Research (CFIR).","authors":"Yuxing Yan, Junli Yang, Yun Lu, Yutong Fu, Jiao Chen, Xinchen Li, Yue Chang","doi":"10.1186/s13756-025-01617-3","DOIUrl":"10.1186/s13756-025-01617-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Although current evidence supports the effectiveness of social norm feedback (SNF) interventions, their sustained integration into primary care remains limited. Drawing on the elements of the antimicrobial SNF intervention strategy identified through the Delphi-based evidence applicability evaluation, this study aims to explore the barriers and facilitators to its implementation in primary care institutions, thereby informing future optimization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Based on the five domains of the Consolidated Framework for Implementation Research (CFIR), we developed semi-structured interview and focus group discussion guides. Employing purposive sampling, we selected health administrators, hospital managers, physicians, and pharmacists for semi-structured interviews, while patients who had received antimicrobial therapy in primary care institutions participated in focus group discussions. Data collection continued until saturation was achieved, ultimately gathering insights from 36 participants across 5 health administration departments and 7 primary care institutions in 5 locations of Guizhou Province, Southwest China. Textual data were coded and categorized using NVivo 12.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified 33 barriers, 38 facilitators, and 1 mixed determinant influencing the persistent implementation of the antimicrobial SNF intervention strategy in primary care institutions. The highest number of factors influencing implementation was found in the inner setting domain. Key barriers included insufficient available resources, insufficient accessibility of knowledge and information, lack of relative priority (referring to the perception that the intervention was less important than competing organizational tasks), organizational culture that prioritizes short-term efficiency, lack of organizational incentives and rewards, inadequate implementation climate, insufficient readiness for implementation, insufficient oversight and leadership engagement, lack of clear goals and feedback, lack of networks and communications, and absence of Pharmacist Council in organizational structure. Improving these factors would promote continuous implementation. Furthermore, facilitators within this domain also included the tension for change (stakeholders' perception that current prescribing practices urgently need improvement), excellent learning climate, excellent compatibility, and organizational structure in newly established large-scale hospitals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Long-term implementation of the antimicrobial SNF intervention strategy necessitates synergistic effects among intervention characteristics, organizational setting, characteristics of individuals, outer setting, and dynamic implementation process. The study provides critical evidence and references for the sustainable implementation of the antimicrobial SNF intervention strategy and the optimized design of complex intervent","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"104"},"PeriodicalIF":4.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028751","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}