Antimicrobial Resistance and Infection Control最新文献

{"title":"Prevalence of fungi and their antifungal and disinfectant resistance in hospital environments: insights into combating nosocomial mycoses.","authors":"Soudabeh Ghodsi, Mahnaz Nikaeen, Shima Aboutalebian, Rasoul Mohammadi, Hossein Mirhendi","doi":"10.1186/s13756-025-01558-x","DOIUrl":"https://doi.org/10.1186/s13756-025-01558-x","url":null,"abstract":"<p><strong>Background: </strong>Fungal infections are increasingly recognized as a global health concern, contributing to considerable morbidity and mortality in hospital settings. This underscores the urgent need for infection prevention and control in healthcare facilities to protect vulnerable patients from the risk of acquiring invasive fungal diseases (IFDs). Given the critical role of transmission-based precautions in limiting the spread of filamentous fungi responsible for IFDs, this study was conducted to explore the potential role of the hospital environment in the dissemination of these infections.</p><p><strong>Methods: </strong>A total of 83 samples were collected from the air and surface of exhaust vents in the intensive care units (ICUs) of hospitals in Isfahan, Iran, to assess the presence and diversity of fungal species. Susceptibility testing against antifungal agents, including commonly used drugs and disinfectants, was performed on the identified fungal isolates. Furthermore, the antifungal resistance profiles of isolates from clinical IFD cases were compared with those of environmental isolates.</p><p><strong>Results: </strong>Fungi were detected in 45% of air samples and 100% of exhaust vent samples, with Aspergillus species being the most commonly identified genus. Mucorales were also found in 17% of exhaust vent samples. Aspergillus spp. and Rhizopus spp. showed the highest resistance to Amphotericin B, and a considerable proportion of these isolates exhibited simultaneous resistance to disinfectants. A similar antifungal resistance profile was noted between A. flavus and some R. arrhizus isolates from both environmental and clinical samples.</p><p><strong>Conclusions: </strong>The findings of this study indicate that the hospital environment, particularly exhaust vents, may act as a significant reservoir for causative agents of IFDs. This highlights the importance of environmental surveillance in preventing and controlling nosocomial fungal infections.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"37"},"PeriodicalIF":4.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954068","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 bedding hygiene in long-term care facilities: investigating the impact of multilevel antimicrobial polymers (MAP-1) on bacterial and MDRO reduction.","authors":"Awais Farid, Wei Han, Joseph K C Kwan, King Lun Yeung","doi":"10.1186/s13756-025-01555-0","DOIUrl":"https://doi.org/10.1186/s13756-025-01555-0","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the bactericidal efficacy of Multilevel Antimicrobial Polymer (MAP-1) on standard bedsheets in Long-term care facility (LTCF). The research quantifies total viable bacteria and MRSA counts and evaluates the percentage difference between treated and control bedding material over a one-week period.</p><p><strong>Design: </strong>A double-blind interventional, double cross-over study.</p><p><strong>Setting: </strong>Haven of Hope Woo Ping Care and Attention Home in Sai Kung, Hong Kong.</p><p><strong>Methods: </strong>Over an 8-week period, bedding materials from residents' rooms were sampled, totalling 288 samples from 96 bedsheets, with half treated with MAP-1 and the remaining serving as controls. MAP-1, developed at The Hong Kong University of Science and Technology, incorporates USFDA and USEPA-approved polymers. Sampling procedures adhered to standardized protocols, and bacterial counts were determined using culture methods. Data analysis employed t-tests and ANOVA to compare microbial loads between the control and treatment groups, with statistical significance set at p < 0.05.</p><p><strong>Results: </strong>The study revealed a significant reduction in total viable bacteria and MRSA counts on bedsheets treated with MAP-1. Noteworthy reductions of 80.37% for total bacteria and 87.31% for MRSA at the end of seven-day use, in the intervention group compared to the control. These reductions were statistically significant across all four observation periods and among both male and female residents.</p><p><strong>Conclusion: </strong>The study establishes the bactericidal efficacy of MAP-1 on standard bedsheets, showcasing its potential in diminishing total bacterial counts and MRSA contamination. These results hold promise for enhancing infection control practices and promoting improved sanitary conditions within healthcare settings.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"36"},"PeriodicalIF":4.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959614","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":"Use of a national repository of Fourier-transform infrared spectroscopy spectra enables fast detection of silent outbreaks and prevention of spread of new antibiotic-resistant sequence types.","authors":"Mor N Lurie-Weinberger, Elizabeth Temkin, Ophir Kastel, Moshe Bechor, Darya Bychenko-Banyas, Reut Efrati-Epchtien, Gabrielle D Levi, Nadya Rakovitsky, Alona Keren-Paz, Yehuda Carmeli","doi":"10.1186/s13756-025-01546-1","DOIUrl":"https://doi.org/10.1186/s13756-025-01546-1","url":null,"abstract":"<p><strong>Background: </strong>The reference microbiology laboratory of Israel's National Institute for Antibiotic Resistance and Infection Control has established a national repository of isolates analyzed by Fourier-transform infrared (FTIR) spectroscopy and their spectra. Healthcare institutions send antibiotic-resistant isolates as part of outbreak investigation, periodic nation-wide collection of specific species, or point prevalence studies. Here, we describe the use of a national FTIR repository to detect the emergence and spread of new sequence types and resistance mechanisms.</p><p><strong>Methods: </strong>Using FTIR, we produced dendrograms of outbreaks and periodic country-level dendrograms of isolates from selected species. When FTIR identified new clusters that were distinct from previously characterized clusters, they were investigated further by whole genome sequencing.</p><p><strong>Results: </strong>FTIR analysis uncovered two clones new to Israel: NDM-5-producing E. coli ST650 harboring a novel plasmid, and NDM-producing K. pneumoniae ST307.</p><p><strong>Conclusions: </strong>Establishing regional or national FTIR repositories could serve as a simple and effective tool for early detection of new antibiotic-resistant clones.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"34"},"PeriodicalIF":4.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956736","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":"Evaluation of the feasibility, appropriateness, and acceptability of an environmental cleaning program improvement toolkit at a tertiary care hospital in Nigeria.","authors":"Cori Dennison, Matthew Hudson, Damilola Adeniyi, Folasade Ogunsola, Hanako Osuka, Lisa P Oakley, Paul Malpiedi, Amber Vasquez, Molly Patrick","doi":"10.1186/s13756-025-01550-5","DOIUrl":"https://doi.org/10.1186/s13756-025-01550-5","url":null,"abstract":"<p><strong>Background: </strong>Environmental cleaning is a key infection prevention and control (IPC) intervention in healthcare settings. The U.S. Centers for Disease Control and Prevention (CDC), with Infection Control Africa Network (ICAN), developed best practices for global healthcare environmental cleaning in resource-limited settings to help fill gaps in guidance in low- and middle-income countries (LMICs). We aimed to evaluate the feasibility, appropriateness, and acceptability of a quality improvement toolkit developed to assist with implementing the CDC/ICAN best practices at Lagos University Teaching Hospital in Nigeria.</p><p><strong>Methods: </strong>A mixed-methods approach was used to evaluate the implementation of the toolkit from March through September of 2021. A monitoring checklist assessed feasibility after three defined steps within the toolkit. Key informant interviews and electronic surveys were conducted with toolkit team members at three time points during implementation to assess appropriateness and acceptability. A deductive analytic process was used to code and analyze interview data based on constructs of appropriateness and acceptability. Additional codes and sub-themes that emerged during analysis followed an inductive process.</p><p><strong>Results: </strong>Within the interviews and surveys, themes identified for the appropriateness included concern related to (1) time commitment for the toolkit activities and (2) resources required to sustain improvements. Themes identified for acceptability included (1) perceived challenges with time commitment and resource requirements, (2) perceived effectiveness of toolkit structure and usability, (3) perceived benefits and success associated with knowledge gained about environmental cleaning and environmental cleaning staff, (4) perceived benefits and success associated with the training for cleaning staff undertaken during toolkit implementation, and (5) perceived benefits and success associated with the multidisciplinary team approach with the inclusion of facility leadership and a project coordinator.</p><p><strong>Conclusions: </strong>The results showed that the toolkit materials were feasible within the local context and highlighted perceived effectiveness, benefits, and success of the toolkit process and experience contributing to a high level of acceptability. Challenges relating to time commitment and concern for sustainability have implications for the appropriateness of this toolkit, similar approaches to quality improvement, and the need for strengthening support for IPC improvements at the facility and national levels in resource-limited healthcare settings in LMICs.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"33"},"PeriodicalIF":4.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061951","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":"Integrated assessment of antimicrobial stewardship in carbapenem resistant Klebsiella pneumoniae prevalent hospitals in China: a multidisciplinary surveillance network-based survey.","authors":"Haishaerjiang Wushouer, Weibin Li, Junxuan Yu, Lin Hu, Xiaodong Guan, Xiaolin Liu, Anhua Wu, Xiaoqiang Yang, Minggui Wang, Yingchun Xu, Yanping Luo, Xun Huang, Luwen Shi","doi":"10.1186/s13756-025-01545-2","DOIUrl":"https://doi.org/10.1186/s13756-025-01545-2","url":null,"abstract":"<p><strong>Background: </strong>China has established an extensive multidisciplinary surveillance network encompassing antimicrobial utilisation, antimicrobial resistance, and nosocomial infections. We aimed to identify challenges and barriers in antimicrobial stewardship (AMS) development based on this national multidisciplinary surveillance network.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in 15 hospitals across China from July 2021 to April 2023. Purposeful sampling was employed to select the hospitals based on the rising prevalence of carbapenem-resistant Klebsiella pneumoniae. The survey consisted of three parts: a testing questionnaire was used to assess the awareness of clinical physicians regarding AMS; a scoring table was developed through the Delphi method to assess the hospitals' multidisciplinary management covering antibacterial usage surveillance, resistance surveillance, fungal surveillance, infectious disease management, and infection prevention and control; an on-site investigation based on case review and field inspection. Pearson correlation tests were used to examine the relationship between resistance levels and scores for various items. Theme analysis was applied to highlight key areas of focus in hospital multidisciplinary AMS from the on-site investigation.</p><p><strong>Results: </strong>Findings revealed that physicians of respiratory, infectious disease, and critical care were the top 3 specialists in AMS awareness scores, with an average of 70 points, 65 points and 62.5 points, respectively (a full mark of 100 points). Performance in infectious disease management, antibacterial surveillance, and infection prevention and control showed a scoring rate over 70%, with relatively low scores in resistance surveillance (49.1%) and fungal surveillance (36.0%). No significant correlation was found between any single scoring item and the resistance levels of focused drug-resistance pathogens. Five key areas were identified for improving multidisciplinary AMS: organizational structure, staffing and training, drug formulary and prescription management, laboratory testing and quality control, and clinical sampling and data reporting.</p><p><strong>Conclusions: </strong>The prevalence of focused drug-resistance pathogens could not attribute to any single factor. The following AMS activities should emphasise the establishment of sophisticated communication and collaboration mechanisms within multidisciplinary teams.</p><p><strong>Trial registration: </strong>Approval for this study was granted by the Ethics Committee of Peking University (reference number IRB00001052-22100).</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"32"},"PeriodicalIF":4.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962726","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":"Investigation of an outbreak of carbapenem resistant Acinetobacter baumannii in an intensive care unit during the COVID-19 epidemic.","authors":"Yi Kong, Ting Liu, Yanru Zhang, Hui Wang, Hongyi Lin","doi":"10.1186/s13756-025-01547-0","DOIUrl":"https://doi.org/10.1186/s13756-025-01547-0","url":null,"abstract":"<p><strong>Background: </strong>During the Coronavirus Disease 2019 (COVID-19) epidemic, the strain on intensive care units (ICUs) has increased, which made them more vulnerable to the threat of multidrug-resistant organism (MDRO).</p><p><strong>Aim: </strong>This study aims to investigate an outbreak of carbapenem resistant Acinetobacter baumannii (CRAB) infection in a general adult ICU of a tertiary hospital in China during the COVID-19 epidemic and evaluate the effectiveness of intervention measures.</p><p><strong>Methods: </strong>Demographic and clinical data of 37 patients were collected, and 230 environmental samples were collected. Whole genome sequencing (WGS) analysis was performed on clinical and environmental isolates. An evolutionary tree was constructed based on the WGS data. The infection control team implemented a bundle of MDRO interventions, including a termination of COVID-19 infection control measures and implementation of 'three-step' cleaning and disinfection method.</p><p><strong>Findings: </strong>There were 37 patients found to have CRAB infection or colonization in the ICU from December 2022 to April 2023, of whom 35 were hospital-acquired. 12 CRAB isolates were obtained from the environment and medical equipment. Through WGS analysis, the CRAB strains from the medical environment and bronchoscopes were found to be highly homologous to those from patients' clinical specimens. This demonstrated that the infection outbreak was caused by the lack of MDRO prevention and control measures. Following intervention, the CRAB detection rate gradually declined, with no positive samples for CRAB found in the ICU environment or on bronchoscopes.</p><p><strong>Conclusion: </strong>The infection control measures for COVID-19 conflicted with basic MDRO prevention and control strategies, likely contributing to the outbreak. Therefore, established infection prevention and control measures should be consistently followed, as they represent the most effective approach to preventing MDRO.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"30"},"PeriodicalIF":4.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967166","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":"Assessing barriers and opportunities for the improvement of laboratory performance and robust surveillance of antimicrobial resistance in Nigeria- a quantitative study.","authors":"Obiageli J Okolie, Sanda U Ismail, Uzoma Igwe, Emmanuel C Adukwu","doi":"10.1186/s13756-025-01530-9","DOIUrl":"https://doi.org/10.1186/s13756-025-01530-9","url":null,"abstract":"<p><strong>Background: </strong>Good quality data is essential in optimising containment strategies for antimicrobial resistance, a global public health threat estimated to cause around 10 million deaths yearly and up-to 5% loss in GDP by 2050 if left unaddressed. The laboratory system plays an important role in the collection of high-quality data as well as ensuring validity, reliability and timeliness of data. However, in many low-medium income countries including Nigeria, the technical capacity of the laboratory for fulfilling these responsibilities is unknown. This paucity of information limits piloting of strategies to complement existing surveillance and planning improvement of subsequent laboratory iterations into the surveillance system. The focus of this study was to assess the gaps, vulnerabilities and enablers of laboratory strengthening processes in the scope of technical capacity for clinical and public health functions and to provide a roadmap for improved surveillance of antimicrobial resistance in Nigeria.</p><p><strong>Methods: </strong>A cross-sectional study design utilising structured questionnaire administered online via Qualtrics and reported in accordance with strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Data analysis involved descriptive and inferential statistics as well as bivariate and multivariate logistics to test predictive analysis of relationship between variables.</p><p><strong>Results: </strong>A total of 302 laboratories completed the questionnaire, 107 (53.4%) government laboratories and 195 (64.6%) private sector laboratories. 18.2% reported excellent knowledge, 25.5% has excellent capacity, 7.3% are fully ready for surveillance, 12.3% are participating in some surveillance, and 1.0% record important microbiological data that correlates with epidemiological information.</p><p><strong>Conclusion: </strong>Tertiary laboratories reported highest performance across all surveillance quality indicators (SQIs). AMR surveillance is skewed toward government and tertiary laboratories, leaving lower-level and rural facilities underutilized despite their potential. This results in missing community-level data and undermines the representativeness of surveillance. The study identifies gaps in recruitment, assessment, and oversight but also offers strategies to address these issues.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"29"},"PeriodicalIF":4.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061949","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":"Clarithromycin-resistant Helicobacter pylori in Africa: a systematic review and meta-analysis.","authors":"Komla Mawunyo Dossouvi, Tchilabalo Bouyo, Simon Sognonnou, Ephraim Ehidiamen Ibadin, Lu-Chao Lv, Bissoume Sambe Ba, Abdoulaye Seck, Sika Dossim, Fábio Parra Sellera, Makhtar Camara, Amr El Kelish, Stella Ifeanyi Smith","doi":"10.1186/s13756-025-01533-6","DOIUrl":"10.1186/s13756-025-01533-6","url":null,"abstract":"<p><strong>Background: </strong>In 2022, approximately 56.5% of adults and 47.1% of children and adolescents were affected by Helicobacter pylori (H. pylori) infection in Africa, and clarithromycin-resistant H. pylori (CRHp) strains have become global priority pathogens. Therefore, this study aimed to conduct the first comprehensive systematic review and meta-analysis of CRHp in Africa.</p><p><strong>Methods: </strong>This investigation was conducted according to the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (The PRISMA 2020). Literature search of electronic databases (Google Scholar, African Journals Online, ResearchGate, PubMed, Embase, and Scopus) was performed using keywords \"clarithromycin\", \"Helicobacter pylori\", \"African country name\", \"mutation in the 23S rRNA\".</p><p><strong>Results: </strong>Sixty-five studies involving 5,313 H. pylori strains isolated over 26 years (1997-2022) from 23 African countries were included in this study. The samples from which CRHp was isolated included gastric biopsy (60/63; 95%), and stool (4/63; 6%). The pooled prevalence of CRHp in Africa was 27% (95% CI: 22, 33). There was a steady trend in the prevalence of CRHp isolated in Africa over the 26 years (R² = 0.0001, p = 0.92, slope coefficient of -0.05x). Ten types of 23S rRNA mutations (conferring clarithromycin resistance) were identified, and included mainly A2143G (465 H. pylori strains out of 1178 tested) and A2142G (344 H. pylori strains out of 1027).</p><p><strong>Conclusion: </strong>To enhance the accuracy and validity of surveillance data for H. pylori in Africa, there is an urgent need for implementing standardized microbiological methods for resistance detection. The prevalence of CRHp reported in this study was very similar to the overall global prevalence and there is a need for more representative studies on CRHp in Africa. While waiting for this, the treatment of H. pylori infections must be based on the guidelines of the AHMSG first Lagos consensus.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"31"},"PeriodicalIF":4.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962394","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":"Associations between hospital structure, infection control and incidence of hospital-acquired viral respiratory infections: a 10-year surveillance study.","authors":"Costa Salachas, Quentin Le Hingrat, Skerdi Haviari, Audrey Valdes, Vincent Mackiewicz, Isabelle Lolom, Nadhira Fidouh, Benoît Visseaux, Donia Bouzid, Diane Descamps, Jean-Christophe Lucet, Charlotte Charpentier, Solen Kernéis","doi":"10.1186/s13756-025-01543-4","DOIUrl":"https://doi.org/10.1186/s13756-025-01543-4","url":null,"abstract":"<p><strong>Background: </strong>Protecting patients from hospital-acquired viral respiratory infections is a major challenge, but the hierarchy of measures to achieve this is not yet completely clear.</p><p><strong>Aim: </strong>To describe the epidemiology of hospital-acquired viral respiratory infections and associations with structural hospital factors and adherence to infection control protocols.</p><p><strong>Methods: </strong>Retrospective cohort study conducted over 10 consecutive years (2014-2023) within 27 hospital wards in a 900-bed university hospital in Paris, France. All hospitalized adult patients who were tested for at least one virus on a respiratory sample during their stay were included. Structural factors (percentage of double occupancy rooms) and adherence to infection control protocols by healthcare workers (measured by consumption of alcohol-based hand sanitizer and of facemasks) were included as predictors in the model.</p><p><strong>Main outcome and measure: </strong>Incidence of hospital-acquired viral respiratory infections, defined by a positive PCR test for at least one respiratory virus, performed at least 5 days after hospital admission. Data were analyzed on ward-year aggregated data, with a linear mixed-effects model.</p><p><strong>Findings: </strong>Overall, 183 994 viral PCR tests were performed over the study period. Incidence of hospital-acquired viral respiratory infections was 0.57/1000 hospital-days. After adjustment on other factors (mean length of stay, use of PCR testing), incidence of hospital-acquired viral respiratory infections in a given ward was significantly associated with: the incidence of community-acquired viral respiratory infections among patients admitted to the ward (+ 0.10/1000 hospital-days per each additional point of incidence; P < 0.001), the number of double-occupancy rooms (+ 0.04/1000 hospital-days per each 10%-increase of double-occupancy rooms; P = 0.03) and masks consumption (+ 0.33/1000 hospital-days per 10 additional masks used per day; P = 0.04). Similar results were found for double-occupancy rooms (+ 0.01/1000 hospital-days per each 10%-increase of double-occupancy rooms; P = 0.012) in the sub-group analysis of influenza cases.</p><p><strong>Conclusion: </strong>In a given hospital ward, the incidence of community-acquired cases and the proportion of double-occupancy rooms are independently associated with the incidence hospital-acquired viral respiratory infections.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"28"},"PeriodicalIF":4.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957771","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":"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}