Antimicrobial Resistance and Infection Control最新文献

{"title":"Successful termination of a multi-year wastewater-associated outbreak of NDM-5-carrying E. coli in a hemato-oncological center.","authors":"Heidrun Kerschner, Linda Jernej, Adriana Cabal, Patrick Hyden, Sigrid Machherndl-Spandl, Lucia Berning, Anna Blaimschein, Werner Ruppitsch, Petra Apfalter, Rainer Hartl","doi":"10.1186/s13756-025-01539-0","DOIUrl":"10.1186/s13756-025-01539-0","url":null,"abstract":"<p><strong>Background: </strong>In May 2018, an outbreak of NDM-5-carrying Escherichia coli (NDM-5-EC) was detected at the hemato-oncology department of a tertiary care center in Austria. This report details the outbreak investigation, control measures and the whole genome sequencing (WGS) data of the outbreak isolates.</p><p><strong>Methods: </strong>A total of 15 isolates (seven clinical isolates from allogenic stem cell transplant (SCT) recipients and eight wastewater isolates recovered from patients' toilets) were analyzed by whole genome sequencing.</p><p><strong>Results: </strong>Genome based typing identified two clusters of the high risk clones ST167/CT12607 and ST617/CT2791. Long-read sequencing of selected isolates from both clusters identified two different plasmids, however with a highly similar genetic context of the bla_NDM-5 containing region. Genomic analysis revealed the presence of additional resistance genes, including bla_CTX-M-15, and bla_OXA-1, and virulence factors. Four patients were colonized with NDM-5-EC, two patients suffered bacteremia caused by the outbreak strain and two deaths were associated with an NDM-5-EC infection. The outbreak source was traced to toilet sewage pipes, which remained persistently contaminated despite extensive cleaning and disinfection. Successful eradication of NDM-5-EC from the installations required disassembly, hot water pressure washing of the sewage pipes and complete replacement of all movable parts. Additionally, colonized patients were instructed to use wheeled commodes instead of toilets, and a pre-admission screening strategy was implemented for all patients undergoing hematologic stem cell transplantation. The outbreak was successfully terminated in November 2020.</p><p><strong>Conclusion: </strong>NDM-5-EC, especially high-risk clones such as ST167 and ST617, can persist in hospital wastewater systems despite cleaning and disinfection efforts and can cause prolonged outbreaks. Therefore, a comprehensive bundle of interventions like the ones applied in our study is essential, especially in clinical settings with heavily immunosuppressed patients.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"27"},"PeriodicalIF":4.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794547","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":"Implementation of hospital antimicrobial stewardship programmes in low- and middle-income countries: a qualitative study from a multi-professional perspective in the Global-PPS network.","authors":"Ines Pauwels, Ann Versporten, Diane Ashiru-Oredope, Silvia Figueiredo Costa, Herberth Maldonado, Ana Paula Matos Porto, Shaheen Mehtar, Herman Goossens, Sibyl Anthierens, Erika Vlieghe","doi":"10.1186/s13756-025-01541-6","DOIUrl":"10.1186/s13756-025-01541-6","url":null,"abstract":"<p><strong>Background: </strong>Hospitals in low- and middle-income countries (LMIC) face context-specific challenges in implementing antimicrobial stewardship (AMS) programmes. The Global Point Prevalence Survey (Global-PPS) project has established a network of hospitals across 90 countries, using point prevalence surveys to monitor antimicrobial use and guide AMS activities. However, little is known about AMS implementation in these hospitals. Using qualitative research, we aim to explore the implementation process in LMIC hospitals within the Global-PPS network and the factors influencing it, identify potential implementation strategies, and evaluate the role of Global-PPS in this process.</p><p><strong>Methods: </strong>A qualitative study was conducted using semi-structured online interviews with healthcare workers (HCWs) involved in AMS in LMIC hospitals within the Global-PPS network. Participants were selected using a combination of convenience and purposive sampling and included clinicians, microbiologists, pharmacists, and nurses. Interviews followed a topic guide based on the integrated checklist of determinants of practice (TICD Checklist). Transcripts were analysed using a combination of inductive and deductive thematic analyses.</p><p><strong>Findings: </strong>Twenty-two HCWs from 16 countries were interviewed. Hospitals were in different stages of the AMS implementation process at the time of the study, from pre-implementation to institutionalisation of AMS as part of the continuous quality improvement process. While the Global-PPS provided a valuable tool for education and implementation, contextual barriers often hindered the translation of findings into targeted interventions. Four themes influenced AMS implementation, \"institutional support and resource allocation\", \"AMS team functioning, roles, and expertise\", \"adoption and integration of AMS recommendations\", and \"data-driven decision-making\" as a cross-cutting theme. Key determinants included AMS team competencies, multidisciplinary teams, sustainable funding and leadership support, diagnostic capacity, and reliable data to inform interventions. We also identified various strategies employed by local AMS teams to enhance implementation.</p><p><strong>Conclusions: </strong>This study examines AMS implementation in LMIC hospitals in the Global-PPS network and identifies key determinants. AMS teams address challenges through task shifting, local engagement and ownership. While empirical evidence on the effectiveness of these strategies is limited, these insights can guide future AMS interventions and studies within LMIC hospitals. Strengthening AMS requires bridging the gap between measurement and action and expanding research on behaviour change.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"26"},"PeriodicalIF":4.8,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787501","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":"Enhancing antimicrobial resistance surveillance and research: a systematic scoping review on the possibilities, yield and methods of data linkage studies.","authors":"S A M van Kessel, C C H Wielders, A F Schoffelen, A Verbon","doi":"10.1186/s13756-025-01540-7","DOIUrl":"https://doi.org/10.1186/s13756-025-01540-7","url":null,"abstract":"<p><strong>Background: </strong>Surveillance data on antimicrobial resistance (AMR) determinants such as antibiotic use, prevalence of AMR, antimicrobial stewardship, and infection prevention and control are mostly analysed and reported separately, although they are inextricably linked to each other. The impact of surveillance and research can be enhanced by linking these data. This systematic scoping review aims to summarize the studies that link AMR data and evaluate whether they yield new results, implications, or recommendations for practice.</p><p><strong>Methods: </strong>For this review, data linkage is defined as the process of linking records, from at least two independent data sources on either (I) at least two AMR determinants or (II) one AMR determinant and one or more general population characteristics. Data linkage should be performed on the level of a certain entity which, in the context of this review, can encompass persons, healthcare institutes, geographical regions or countries. A systematic literature search was performed on February 7th 2025 in Embase.com, PubMed and Scopus to identify AMR data linkage studies.</p><p><strong>Results: </strong>Forty-eight articles were included in our review. Most data linkage studies used two data sources, and most studies were published in the last 5 years (n = 23 in 2020-2024). A predominance of studies linked data on geographical location, and thirteen studies linked data on individual patient level. Findings demonstrate that the majority of studies (43/48) had added value and provided recommendations for clinical practice and future policies or had suggestions for further research and surveillance. Additionally, data linkage studies appeared to be suitable for hypothesis generating. Several limitations were identified. Most studies had ecological designs, which are prone to ecological fallacy and unobserved confounding, making it hard to establish causality.</p><p><strong>Conclusion: </strong>This systematic scoping review showed that AMR data linkage studies are increasingly performed. They have potential to gain a more comprehensive understanding of AMR dynamics by generating hypotheses, assisting in optimisation of surveillance, and interpretation of data in the context of guideline/policy development. To increase the added value of data linkage, more studies should be performed to improve knowledge on methodological approaches, data access, data management, and governance issues.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"25"},"PeriodicalIF":4.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741850","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":"Healthcare-associated bloodstream infections caused by bacterial and fungal contamination of intravenous fluids and medicines in healthcare facilities in low- and middle-income countries: a scoping review.","authors":"Jemima Nyandwaro, Peter Hyland, Raffaella Ravinetto, Jan Jacobs","doi":"10.1186/s13756-025-01536-3","DOIUrl":"https://doi.org/10.1186/s13756-025-01536-3","url":null,"abstract":"<p><strong>Introduction: </strong>We reviewed culture-confirmed healthcare-associated outbreaks linked to bacterial and fungal contamination of intravenous fluids and medicines (further \"infusates\") in low-income countries and lower and upper middle-income countries (LIC, Lower-MIC and Upper-MIC). We assessed the scope, impact, risks, and gaps in knowledge.</p><p><strong>Methodology: </strong>Literature search including PubMed, Web of Science, Worldwide Database for Nosocomial Outbreaks, Global Health, and Google Scholar. National essential medicine lists (NEMLs) of sub-Saharan countries were searched for listing of pediatric infusates.</p><p><strong>Results: </strong>Between 1975 and 2023, 50 articles were retrieved. Median (range) number of patients affected was 12 (3-185); 74.2% (761/1025) of all patients affected were children. All patients presented with bloodstream infections; median case fatality ratio was 21.1% (0.0-87.5%). Upper-MIC, Lower-MIC and LIC accounted for 21, 25 and 4 articles, respectively. Most frequently affected wards were neonatal and adult intensive care units (19 and 6 articles). The 50 articles revealed 59 contaminated infusates: IV fluids (n = 37), including TPN (n = 10, of which 8 were from Upper-MIC), and IV medicines (n = 22), comprising amongst others propofol (n = 4) and Water for Injection (n = 3). The 63 isolates included Enterobacterales (46.0% (29/63) of isolates), non-fermentative Gram-negative bacteria (NFGNB, 47.6% (30/63)), fungi (4.8%, 3/63)) and Bacillus circulans (1.6% (1/63)). Among the Enterobacterales, the genera Serratia, Klebsiella, and Enterobacter represented 82.8% (24/29) of isolates. Burkholderia cepacia was the most frequent NFGNB (53.3% (16/30) isolates). Excluding TPN, 18 IV fluids and 7 IV medicines (representing half (51.0%, (25/49) of these infusates) were incorrectly used as multidose vial. A third (33.9%, 20/59) of infusates in 40.0% (20/50) of articles was intrinsically contaminated. In LIC and LMIC, staff in neonatology units turned to in-ward preparation of infusates because of lack of access to pediatric IV formulations and sizes. Less than a third (31.8%, 18/44) of the NEMLs listed neonatal IV premixtures.</p><p><strong>Conclusion: </strong>Infusate contamination is a serious, underreported risk especially for children in LICs and Lower-MIC. Outstanding issues are access to pediatric infusates and preventing in-ward preparation of IV medicines in LIC and Lower-MIC, and safe preparation and administration of TPN in Upper-MIC.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"24"},"PeriodicalIF":4.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741853","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 of a strain-specific PCR as a diagnostic tool for surveillance, detection, and monitoring of vancomycin-resistant Enterococcus faecium during outbreak.","authors":"Artur J Sabat, Lilli Gard, Monika A Fliss, Viktoria Akkerboom, Robin F J Benus, Mariette Lokate, Andreas Voss, Erik Bathoorn","doi":"10.1186/s13756-025-01538-1","DOIUrl":"10.1186/s13756-025-01538-1","url":null,"abstract":"<p><strong>Introduction: </strong>Vancomycin-resistant Enterococcus faecium (VREfm) poses a significant concern in healthcare settings, particularly during outbreaks. Traditional antibiotic susceptibility testing may fail to detect occult vancomycin resistance, and long culture times delay diagnosis. While whole genome sequencing (WGS) is the most accurate method for tracing infectious disease transmissions, its response times are not rapid enough to optimally support controlling of ongoing outbreaks. To address this limitation, we investigated the genomic diversity among outbreak isolates and developed outbreak-specific PCR tests for rapid VREfm carrier screening using strain-specific biomarkers identified through comparative genomics.</p><p><strong>Materials and methods: </strong>Total DNA from VREfm isolates was sequenced using Oxford Nanopore and Illumina platforms. Multi locus sequence types (MLST-ST) and core genome sequence type clusters (cgMLST-CT) were determined with Ridom SeqSphere + software. Comparative analysis of whole genomes was conducted using Lasergene software (DNASTAR).</p><p><strong>Results: </strong>A large VREfm outbreak involving 111 patients caused by E. faecium ST117-CT469 was identified in the Northern Netherlands, spanning from August 2021 to September 2024. A subset of 55 E. faecium ST117-CT469 isolates were evaluated by WGS and outbreak specific PCRs. Antibiotic susceptibility testing revealed occult vancomycin resistance in the outbreak strain. Comparative genomics identified unique markers specific to E. faecium ST117-CT469. Two PCR assays were developed for rapid outbreak detection: a traditional PCR assay distinguishing outbreak from non-outbreak strains based on amplicon size and a TaqMan real-time PCR assay. Both assays demonstrated 100% reproducibility and specificity. The TaqMan assay was able to detect as little as 5 fg of bacterial DNA in the presence of human DNA, equivalent to approximately one bacterial genomic copy. Sequence analysis of WGS data for all 55 outbreak isolates showed perfect nucleotide sequence conservation in the regions where the primers and probe hybridized. Sequence comparison against NCBI GenBank entries confirmed the perfect specificity of both PCR assays for detecting the ST117-CT469 outbreak strain.</p><p><strong>Conclusions: </strong>These PCR tests maintain the accuracy and discriminatory power of WGS for identifying the ST117-CT469 outbreak strain but are more cost-effective, faster, and easier to use compared to WGS. They enhance VREfm outbreak management by providing an efficient method for rapid screening. Application of strain-specific PCR based on WGS data is currently the most effective screening method during large, ongoing outbreaks.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"23"},"PeriodicalIF":4.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699371","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":"High incidence of multidrug-resistant organisms and modifiable risk factors associated with surgical site infections: a cohort study in a tertiary medical center in Kuala Lumpur, Malaysia from 2020 to 2023.","authors":"Anis Najwa Muhamad, Cindy Shuan Ju Teh, Mohd Rusdi Draman, Yohan Khirusman Adnan, Azlina Amir Abbas, Tak Loon Khong, Vairavan Narayanan, Soo Nee Tang, Rina Karunakaran, Norhafizah Ab Manan, Anjanna Kukreja, Siti Zuhairah Mohamad Razali, Chun Yoong Cham, Robert D Hontz, Michael J Gregory, Anca Selariu, Huy C Nguyen, Andrew G Letizia, Sasheela Sri La Sri Ponnampalavanar","doi":"10.1186/s13756-025-01537-2","DOIUrl":"10.1186/s13756-025-01537-2","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs) are a persistent challenge in healthcare, contributing significantly to patient morbidity, mortality, and healthcare costs. Despite advancements in preventive measures, SSIs remain prevalent, especially in countries like Malaysia where rates are higher than in high-income nations.</p><p><strong>Methods: </strong>A prospective, cohort study was conducted at the University Malaya Medical Center (UMMC), Malaysia, from November 2020 to May 2023. Clinical and microbiological data were collected, and logistic regression were performed to identify risk factors associated with SSIs.</p><p><strong>Results: </strong>A total of 1,815 patients undergoing orthopedic, neurosurgical, and general surgical procedures were monitored for SSIs. The incidence rate of SSIs was 3.23 per 100 procedures (n = 71) with significant associations observed between SSI occurrence and prolonged surgical duration > 100 min, extended hospitalization > 5 days, trauma-to-surgery interval > 8 days, and presence of implants. Common pathogens isolated included Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Multidrug-resistant organisms (MDROs) were identified in 42.1% of the total isolates.</p><p><strong>Conclusions: </strong>In this study, a high rate of MDRO and risk factors for SSI were identified. It emphasises the need for ongoing surveillance to guide infection prevention strategies and antimicrobial stewardship programs. Future research should prioritize evaluating the impact of targeted interventions tailored to identified risk factors to optimize surgical patient outcomes.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"22"},"PeriodicalIF":4.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622977","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":"Bodily waste management and related hygiene practices in nursing homes of Vaud: findings from a multicentre cross-sectional survey as a basis for targeted interventions.","authors":"Emmanouil Glampedakis, Marie-Catherine Snoussi, Béatrix Sobgoui, Firmino Battistella, Patricia Cuiña Iglesias, Coralie Riccio, Laetitia Qalla-Widmer, Alessandro Cassini, Marie Immaculée Nahimana Tessemo","doi":"10.1186/s13756-025-01535-4","DOIUrl":"10.1186/s13756-025-01535-4","url":null,"abstract":"<p><strong>Introduction: </strong>Bodily waste management is a critical yet frequently neglected domain of infection prevention and control. We conducted a survey to examine various aspects of bodily waste management and related hygiene practices in nursing homes (NH) based on existing recommendations.</p><p><strong>Methods: </strong>All NHs (n = 120) of canton Vaud in Switzerland were invited to participate in this cross-sectional survey between July 2022 and February 2023 using a questionnaire.</p><p><strong>Results: </strong>Eighty-seven NHs participated in the survey (72.5%). Of these, 33% had internal protocols on bodily waste management, 98% had at least a dirty utility room (median: 4 per NH) and all a bedpan washer-disinfector (WD), yet only 66% met the cantonal recommendation of bedpan WD density (1/15 beds). Separation of soiled and clean compartments was present in 51%, complete hand hygiene supplies in 73% and personal protective equipment (PPE) in 30% of utility rooms. Fifty-four percent of NHs reported having a lid for each bedpan. Systematic use of lids was reported in 33% of institutions and of gloves in 98%, for the transport of used bodily waste collection tools. All surveyed institutions reported performing automated reprocessing of bodily waste collection tools in bedpan WDs and use of manual pre-cleaning was anecdotal. Regular maintenance and validation of bedpan WDs was present in almost all participating NHs.</p><p><strong>Conclusion: </strong>Identified actionable priorities include making bodily waste management protocols accessible to staff, delineation of clean and soiled compartments in utility rooms and equipping them with PPE and hand hygiene supplies, as well as educating healthcare workers on best practices for the transport and disposal of bodily waste.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"20"},"PeriodicalIF":4.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603570","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":"Compliance with transmission-based precautions, and associated factors among healthcare providers in Cameroon: a cross-sectional study.","authors":"Leslie Tasha Mbapah, Midrelle Syntyche Tsague, Denise Georges Teuwafeu, Mbapah Tracy Ngwanui, Sandra Tabe Etaka, Fombo Enjeh Jabbossung, Brandon Carl Monika Pouekoua, Longsti Scarlet Tabot Enanga, Taljaard Jantjie","doi":"10.1186/s13756-025-01523-8","DOIUrl":"10.1186/s13756-025-01523-8","url":null,"abstract":"<p><strong>Background: </strong>Transmission-based precautions (TBP) and the proper use of personal protective equipment (PPE) are essential in preventing hospital-acquired infections (HAIs) and in controlling the emergence and spread of antimicrobial resistance (AMR). This study, therefore, aimed to determine healthcare providers' compliance with TBP and its determinants in healthcare settings to help curb the burden of HAIs and AMR.</p><p><strong>Method: </strong>This study was a cross-sectional, hospital-based research conducted among healthcare providers at four health facilities in the Fako division of Cameroon, from January 1 to May 31, 2024. A standardized observation form, adapted from the World Health Organization's checklist for hand hygiene practices, was used to assess compliance with Transmission-Based Precautions (TBP) among healthcare providers when interacting with patients known or suspected of having infectious pathogens. Multivariable logistic regression analysis was performed to identify factors independently associated with TBP compliance, with significance set at a p-value of less than 0.05.</p><p><strong>Results: </strong>The proportion of participants with good TBP compliance was 75.4% (95%CI: 67.4-82.2). Contact precaution compliance was 94.2%, while that for droplet /airborne was 12.8%. Factors independently associated with good TBP compliance were healthcare providers trained in IPC (aOR: 2.89, 95%CI: 1.16-7.22), the availability of PPE in the facility's departments (aOR: 6.00, 95%CI: 1.24-29.17), and working in the facility; Mount Mary Hospital (aOR: 22.47, 95%CI: 2.21-228.08).</p><p><strong>Conclusion: </strong>Compliance with transmission-based precautions was suboptimal. The determinants of good compliance with TBP among healthcare providers were making PPE available in the facility and training healthcare providers on IPC. Tailored public health measures should be implemented to improve and sustain healthcare providers' compliance with TBP.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"21"},"PeriodicalIF":4.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603572","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":"Establishing carbapenem resistant organism surveillance, prevention, and control in a middle-income country: implementation of a hospital-based program in Fiji.","authors":"Aneley Getahun Strobel, Savneel Shivam Kumar, Shammi Prasad, Tracey Young-Sharma, Matthew Richards, Ashlyn Datt, Alvina Lata, Sisilia Assisi Genaro, Timaima Ratusela, Ilisapeci Nabose, Alipate Vakamocea, Sanjeshni Autar, Farheen Hussein, Ravi Naidu, Ana Suka, Donna Cameron, Chantel Lin, Courtney R Lane, Alison Macintyre, Kylie Hui, Rodney James, Bernadette Kennedy, Benjamin P Howden, Kirsty Buising","doi":"10.1186/s13756-025-01534-5","DOIUrl":"10.1186/s13756-025-01534-5","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) is a major public health threat with the highest burden being estimated to be in low- and middle-income countries. Fiji is an upper-middle-income country in Oceania. Recent studies from Fiji highlighted the increasing burden of carbapenem resistant organisms (CRO) such as Acinetobacter baumannii, Pseudomonas aeruginosa and Escherichia coli. A project titled Preparing Fiji for Pathogens with Critical Antimicrobial Resistance was undertaken at the Colonial War Memorial Hospital, Fiji's main referral hospital, in 2022 and 2023. The overarching goal was to support the hospital's readiness for prompt detection, management and prevention of infections caused by pathogens with critical AMR including CRO. This paper describes the steps taken to establish CRO surveillance, prevention, and control interventions, outbreak response and healthcare workers' capacity building initiatives tailored to the hospital's need and capacity. It also shares the results, lessons learned and challenges in setting up the systems that may inform actions in other low- and middle-income countries in the Pacific Region and globally.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"19"},"PeriodicalIF":4.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555646","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":"State of infection prevention and control in Austrian hospitals: data from 81 hospitals completing the WHO Infection Prevention and Control Assessment Framework (IPCAF).","authors":"Ferenc Darius Rüther, Andrea Grisold, Agnes Wechsler-Fördös, Alexander Gropmann, Michael Behnke, Sonja Hansen, Christine Geffers, Seven Johannes Sam Aghdassi","doi":"10.1186/s13756-025-01532-7","DOIUrl":"10.1186/s13756-025-01532-7","url":null,"abstract":"<p><strong>Background: </strong>The WHO Infection Prevention and Control Assessment Framework (IPCAF) can be used for systematically evaluating infection prevention and control (IPC) practices in healthcare facilities. In 2018, a survey among Austrian hospitals using the IPCAF revealed an overall high level of IPC implementation. Here, we report the results of a second survey in Austrian hospitals with the IPCAF, to once again evaluate the state of IPC implementation and investigate potential developments since 2018.</p><p><strong>Methods: </strong>A total of 139 Austrian acute care hospitals participating in the German surveillance network \"KISS\" were invited to complete a translated online version of the IPCAF between October 2023 and January 2024. The IPCAF functions like a questionnaire, where each response is assigned a specific point value, enabling the calculation of an overall IPC score. Based on this score, hospitals were categorized into four distinct IPC levels: inadequate, basic, intermediate, and advanced. The aggregated scores were then calculated and compared with the results from 2018.</p><p><strong>Results: </strong>Complete datasets from 81 hospitals were received and analyzed. The median overall IPCAF score was 645 (interquartile range: 598-685), with 59 hospitals (72.9%) categorized as advanced, and 21 hospitals (25.9%) as intermediate. One hospital (1.2%) fell into the basic category. Questions pertaining to IPC education and training as well as the application of multimodal IPC strategies showed the lowest scores. Compared to 2018, the current median score of 645 was slightly higher (median score 2018: 620; data from 65 hospitals) and the proportion of hospitals with a full-time IPC professional per 250 beds increased markedly by 37 percentage points. However, the most pronounced decrease (median score - 5) was observed for questions on the WHO core component of IPC education and training.</p><p><strong>Conclusions: </strong>IPC standards in Austria show an overall increasing trend, especially in terms of IPC staffing. However, areas for improvement remain, and hospitals should make efforts to strengthen IPC education and training programs.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"18"},"PeriodicalIF":4.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539944","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}