Antimicrobial Resistance and Infection Control最新文献

{"title":"Impact of a multimodal hand hygiene intervention on methicillin-resistant Staphylococcus aureus carriage among healthcare workers in Libya: a quasi-experimental pre-post study.","authors":"Mohanned Mohamed Alwashaish","doi":"10.1186/s13756-026-01721-y","DOIUrl":"10.1186/s13756-026-01721-y","url":null,"abstract":"<p><strong>Background: </strong>Healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) remains a major threat in low-resource settings, where interventional evidence linking improvements in hand hygiene (HH) to changes in MRSA carriage among healthcare workers (HCWs) is limited. We evaluated the association between implementation of a multimodal HH program and MRSA carriage in a tertiary-care hospital in Libya.</p><p><strong>Methods: </strong>We conducted a quasi-experimental pre-post study (January-December 2024) across four hospital units (intensive care unit, neonatal intensive care unit, surgical ward, and radiology department). Paired anterior nares swabs were collected from HCWs at baseline and one year after intervention implementation. MRSA was identified using cefoxitin disk diffusion according to CLSI 2024 guidelines. Antimicrobial susceptibility testing was performed by the Kirby-Bauer method, and vancomycin minimum inhibitory concentrations were determined using E-test. HH compliance was assessed using WHO observational methods. The primary analysis used McNemar's test and generalized estimating equation (GEE) logistic regression, while multidrug resistance was summarized using the multiple antibiotic resistance (MAR) index.</p><p><strong>Results: </strong>Among 318 paired HCWs, MRSA carriage decreased from 31.1 (99/318) at baseline to 19.5% (62/318) post-intervention (absolute reduction of 11.6 percentage points; p < 0.001). The adjusted odds of MRSA carriage post-intervention were 0.52 (95% CI 0.36-0.75; p < 0.001). HH compliance improved from 42.7% (486/1139 observed opportunities) to 71.3% (801/1123; p < 0.001). Although individual antimicrobial resistance proportions remained largely unchanged, the median MAR index decreased from 0.42 (IQR 0.33-0.50) to 0.33 (IQR 0.25-0.42) (p < 0.001), indicating a reduction in the overall multidrug resistance burden among circulating MRSA isolates. No vancomycin resistance was detected.</p><p><strong>Conclusions: </strong>Implementation of a multimodal WHO-aligned HH intervention was associated with a significant reduction in MRSA carriage among HCWs and a lower overall multidrug resistance burden, as reflected by the MAR index. These findings provide pragmatic, low-cost evidence to support strengthening infection prevention and control programs in Libya and comparable low- and middle-income country settings.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13014959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211980","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":"Contextual analysis of antibiotic prescribing practices for upper respiratory infections and diarrhoea in rural Punjab, Pakistan.","authors":"Muhammad Ahmar Khan, Nida Khan, Rabab Sakina, Mashal Amin, Shaheer Ellahi Khan, Farah Zafar, Saad Alam Khan, Erica Westwood, Ahmad Wesal Zaman, Joseph P Hicks, Shahzad Ali Khan, Muhammad Amir Khan","doi":"10.1186/s13756-026-01700-3","DOIUrl":"10.1186/s13756-026-01700-3","url":null,"abstract":"<p><strong>Introduction: </strong>Antimicrobial resistance (AMR) poses a major global public health threat, with deaths projected to reach 10 million annually by 2050, disproportionately affecting LMICs. Almost 80% of prescriptions at primary healthcare facilities contain at least one antibiotic. This study explores the existing care context at rural health centres (RHC) in Punjab to inform the development of an intervention package aimed at reducing inappropriate antibiotic prescriptions for two most common infections in the outpatient department of RHCs i.e., upper respiratory tract infections (URTI) and diarrhoea.</p><p><strong>Methods: </strong>This study employed a care-cascade framework, selected for its suitability in resource-constrained settings and its applicability in contexts with limited evidence on AMR and stewardship practices. The mixed-methods design included: literature review; facility review (n = 3); key informant interviews with healthcare providers (n = 6) and patients (n = 6); and focus group discussions with health managers (n = 1), healthcare providers (n = 2), patients (n = 2), patients with experience of using mobile healthcare applications (n = 2) and community significants (n = 1). The data analysed at each step informed the next step and was populated in the pre-defined care tasks considered as themes.</p><p><strong>Results: </strong>Using the care-cascade framework, four major care tasks were identified in URTI and diarrhoea management at RHCs: (1) patient consultation and laboratory testing, (2) drug prescription, (3) drug dispensing, and (4) patient education and counselling. At the RHCs there were no standard guidelines or diagnostic protocols being followed, inadequate lab facilities, and very brief patient consultations. Antibiotic prescription was largely empirical, driven by doctor's clinical acumen and patient demands. Drug dispensing practices were inconsistent, involving dispensing partial courses without counselling. Patients were insufficiently counselled on disease management and antibiotic use. Stakeholders made context specific recommendations for developing clinical protocols, patient counselling, and training both doctors and dispensers. They also informed the design and content of the digital tools for patient engagement.</p><p><strong>Conclusion: </strong>This study underscores the complexity of antibiotic stewardship in rural health systems. A care-cascade framework allowed us to unpack these multi-layered challenges and identify leverage points for improvement. Future implementation strategies must embed these insights into program design, ensuring that stewardship is not merely a clinical responsibility but a health system imperative.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146163464","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":"Trends in the prevalence of bloodstream infections in Spanish hospitals (2013-2023).","authors":"Lina Marcela Parra, Raquel Escuredo, Mireia Cantero, Marta Eva Gonzalez-Perez, Manuel García de la Vega, Ángel Asensio","doi":"10.1186/s13756-025-01675-7","DOIUrl":"10.1186/s13756-025-01675-7","url":null,"abstract":"<p><strong>Background: </strong>Bloodstream infections (BSI) represent a growing and significant issue due to their associated mortality, morbidity, and economic burden. This study aimed to assess the prevalence of BSI from 2013 to 2023, by type and onset, and to describe patients' characteristics and identified microorganisms.</p><p><strong>Methods: </strong>Data from the point prevalence survey on infections and antimicrobial use in Spanish hospitals were analysed. Logistic regression was conducted to identify temporal trends and associations between different factors and hospital-acquired BSI (HA-BSI). Stepwise backward selection with bootstrap resampling was applied for refinement and internal validation.</p><p><strong>Results: </strong>From 2013 to 2023, a total of 578,780 patients were included and 12,968 patients had a BSI. The mean prevalence of BSI was 22.4‰ (HA-BSI: 11.1‰; community-acquired BSI (CA-BSI): 11.3‰). BSI prevalence rose from 18.0‰ in 2013 to 24.3‰ in 2023, corresponding to a significant 3.5% yearly increase in the odds of infection (OR 1.035, 95% CI 1.029-1.040). This upward trend was also observed for HA-BSI and CA-BSI, with significant increases in the odds of 1.1% (OR 1.011, 95% CI 1.004-1.019) and 5.7% (OR 1.057, 95% CI 1.049-1.065), respectively. The multivariate logistic regression model identified CVC use as the strongest factor associated with BSI with an overall aOR of 8.31 (95% CI 7.58-9.12). The most common microorganisms in HA-BSI were Gram-positive cocci (52.4%) while Enterobacterales were more prevalent in CA-BSI (47.5%). Antimicrobial resistance was significantly higher in HA-BSI for methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecalis, third-generation cephalosporin-resistant Escherichia coli, third-generation cephalosporin-resistant and carbapenem-resistant Klebsiella pneumoniae, and Pseudomonas aeruginosa.</p><p><strong>Conclusions: </strong>The prevalence of BSI in hospitalised patients in Spain is high and has been increasing over the past decade for both HA-BSI and CA-BSI, underscoring the need for continued efforts to reduce BSI rates.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146163559","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":"Application of the infection risk scan in an intensive care unit.","authors":"José Miguel Yánez-Ramírez, Luciano Santana-Cabrera, Eva Elisa Álvarez-León, Yanira Del Carmen Zerpa-Pérez, Olivia Perera-Tejera, Rita Ramírez-Falcón, Miguel F Ruiz-Garrido, José Javier Blanco-López, María Desamparados Bernat-Adell","doi":"10.1186/s13756-026-01714-x","DOIUrl":"10.1186/s13756-026-01714-x","url":null,"abstract":"<p><strong>Background: </strong>Healthcare Associated Infections generate a high cost in healthcare systems. The Infection Risk Scan (IRIS) tool may be a suitable tool to assess the quality of infection prevention measures in Intensive Care Units (ICU). The aims are to identify individual risk factors in patients and quantify the degree of non-compliance with measures to prevent healthcare-associated infections using the IRIS method in an ICU.</p><p><strong>Methods: </strong>It is an observational and cross-sectional study. The method was piloted in 8 beds and subsequently in 32 beds in a tertiary hospital. Adult patients (> 18 years) admitted to ICU during the study and healthcare staff belonging to the ICU. Risk of infection and adherence to prevention measures were measured. The IRIS consists of two parts called risk profile and improvement chart. In the first, variables related to the patient's history and susceptibility to acquiring a healthcare-associated infection were studied, and in the second, the adequacy of procedures performed on the patient or their environment, considered important indicators for infection control, were assessed.</p><p><strong>Results: </strong>Critically ill patients had a high use of invasive devices such as central venous catheters, urinary catheters and invasive mechanical ventilation. Adherence to healthcare-associated infection prevention measures could be improved due to high non-compliance with hand hygiene (48% non-compliance in the first measurement and 55.6% in the second measurement), non-compliance with hygiene recommendations among healthcare workers (> 4 workers wore at least a wristband and/or wristwatch in the second measurement) and insufficient cleaning and disinfection of surfaces and equipment in both measurements (some surfaces were completely clean).</p><p><strong>Conclusion: </strong>The IRIS provides comprehensive information on the quality of infection prevention measures and offers an opportunity for focused improvement in infection control based on the results of the improvement chart.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12990479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155883","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":"Outbreak investigation and genomic analysis reveal hidden transmission networks of KPC-2-producing Enterobacterales in a South Korean hospital.","authors":"Sun Hee Park, Seul Ki Ji, Soyoung Shin, Chulmin Park, Jeong-Ih Shin, Seung-Hyun Jung, Jung-Hyun Choi, Dong-Gun Lee","doi":"10.1186/s13756-026-01706-x","DOIUrl":"10.1186/s13756-026-01706-x","url":null,"abstract":"<p><strong>Background: </strong>We investigated a KPC-2-producing Enterobacterales (KPC-2 CPE) outbreak in a Korean hospital from July to September 2019, which subsided following enhanced surveillance and strict infection control. The study aimed to elucidate transmission dynamics using epidemiological and genomic methods.</p><p><strong>Methods: </strong>The study period covered the outbreak and a 9-month post-outbreak observation. Investigations included a matched case-control study and whole-genome sequencing (WGS) of isolates, including long-read sequencing for two isolates. Single nucleotide polymorphism (SNP) analysis (≤ 6 SNPs for clonality, ≤ 15 for relatedness) was used to construct transmission networks.</p><p><strong>Results: </strong>A total of 42 KPC-2 CPE cases were identified: 34 Klebsiella pneumoniae, 4 Escherichia coli, 1 Enterobacter asburiae, and 3 cases co-colonized with K. pneumoniae and E. coli. Among these, 33 were hospital-linked and 9 were imported. Retrospective tracing indicated that covert transmission began a month before the outbreak, and 13 hospital wards were identified as potential acquisition sites. Genomic analysis revealed all but one K. pneumoniae belonged to ST307, cgMLST 439, which grouped into three clades. Clade 1 was linked to a specific hospital ward, supported by the case-control study (adjusted odds ratio, 3.63; 95% confidence interval, 1.36-9.63); Clade 2 was spread between wards via a haemodialysis unit and shared healthcare personnel. Imported cases had the same clones as early hospital-linked cases, suggesting undetected introduction before enhanced surveillance. Additionally, an IncX3 plasmid carrying bla_KPC-2 was found in both K. pneumoniae and E. coli, indicating horizontal gene transfer.</p><p><strong>Conclusion: </strong>This study demonstrates that clonal spread of KPC-2 CPE can remain undetected without enhanced active surveillance, underscoring the need for early detection. Genomic analysis clarified ST307 K. pneumoniae transmission through unrecognised epidemiological links and horizontal bla_KPC-2 transfer to E. coli.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12977476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137102","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":"Advancing hospital-onset bacteraemia surveillance: a five-year retrospective study following the hospital-wide implementation of an automated surveillance system at a German university hospital.","authors":"Ferenc Darius Rüther, Michael Behnke, Luis Alberto Peña Diaz, Frank Schwab, Christine Geffers, Seven Johannes Sam Aghdassi","doi":"10.1186/s13756-026-01708-9","DOIUrl":"10.1186/s13756-026-01708-9","url":null,"abstract":"<p><strong>Background: </strong>Hospital-onset bacteraemia and fungaemia (HOB) has emerged as a novel surveillance metric in recent years and a prime target for automation of surveillance of healthcare-associated infections. However, real-life HOB data from European institutions remain scarce. This study explores the epidemiology of HOB at a German university hospital and describes characteristics of HOB cases.</p><p><strong>Methods: </strong>A retrospective single-centre study was conducted by applying an extended version of the Providing a Roadmap for Infection Surveillance in Europe (PRAISE) automated HOB algorithm to data from the electronic health records of all in-hospital patients admitted to Charité university hospital between 2018 and 2022. HOB rates per 1,000 patient days were calculated for different groups of wards. Furthermore, the distribution of microorganisms, share of antimicrobial resistance, and source of possible secondary HOB (defined as HOB-causing pathogens detected in relevant clinical samples other than blood) were analysed. Additionally, patient characteristics and outcomes were investigated.</p><p><strong>Results: </strong>A total of 3,648,254 patient days and 7,256 HOB with 8,357 microorganisms were included. The pooled HOB rate was 6.0 per 1,000 patient days in intensive care units, and between 0.9 and 2.0 in the various groups of non-intensive care units. Around 34.5% (n = 2,505) of HOB were deemed potentially secondary, with respiratory tract (37.6%, n = 943) being the most common source. A total of 1,106 of 8,357 (13.2%) microorganisms were classified as multidrug-resistant, including 60.5% (23 of 38) of Acinetobacter baumannii with resistance to carbapenems. Case fatality within 14 days of HOB onset was 16.2% (990 of 6,093 patients).</p><p><strong>Conclusions: </strong>Analysis of electronic health record data provides important insights into the epidemiology and characteristics of HOB cases. Substantial rates of antimicrobial resistance and case fatality underscore the relevance of HOB as an IPC metric. Results from this study may inform refinement of algorithms for automated HOB surveillance.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123510","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":"Antimicrobial locks for the prevention of central line associated bloodstream infections in pediatric patients: a systematic review and network meta-analysis.","authors":"Nathan L'Etoile, Yun Li, Ericka Hayes, Susan E Coffin","doi":"10.1186/s13756-026-01704-z","DOIUrl":"10.1186/s13756-026-01704-z","url":null,"abstract":"<p><strong>Background: </strong>Central-line-associated bloodstream infections (CLABSI) impart substantial morbidity and mortality worldwide Neonates and other pediatric patients with chronic conditions that require long-term central access are at the highest risk and often develop CLABSIs despite high compliance with evidence-based prevention bundles. One potential adjunctive prevention strategy is the use of antimicrobial locks; however, data concerning the effectiveness of locks in preventing pediatric CLABSIs are mixed.</p><p><strong>Methods: </strong>We conducted a systematic review of randomized controlled trials and, separately, observational studies of pediatric patients who received antimicrobial locks for primary and secondary CLABSI prevention since antimicrobial locks were described in 1990. We conducted meta-analyses for both study designs to evaluate the effectiveness of antimicrobial locks in reducing CLABSIs.</p><p><strong>Results: </strong>Thirty-five studies were included in the systematic review; twenty-six studies were included in the meta-analyses. Among the 11 randomized controlled trials eligible for inclusion in the meta-analysis, there was a 48% lower rate of CLABSIs in those with antimicrobial locks than in those with standard locks (pooled IRR: 0.52 (p = 0.016, [95% CI 0.317, 0.86], I²: 52%). This reduction in CLABSIs varied among patient populations and lock types. Among 15 observational studies eligible for inclusion in the meta-analysis, there was a 70% reduction in the rate of CLABSIs with antimicrobial locks compared with standard locks (pooled IRR: 0.31, p = 0.001, [95% CI 0.17, 0.57], I²: 92%); however, this reduction was not significant among all subgroups or between lock types. Significant bias was noted in the observational studies.</p><p><strong>Conclusions: </strong>This review highlights the need for well-designed studies to determine the clinical effectiveness of antimicrobial locks for primary and secondary CLABSI prevention in specific pediatric populations and to determine whether there is differential impact by lock type.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12977923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123531","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":"Prevention of surgical site infections in lower limb fracture fixation and elective arthroplasty: a systematic review and meta-analysis of decolonization and skin antisepsis strategies.","authors":"Ralf Henkelmann, Christoph Hellmund, Dirk Hasenclever, Babak Moradi, Christian Kleber, Andreas Roth, Christina Pempe, Iris Freya Chaberny","doi":"10.1186/s13756-026-01713-y","DOIUrl":"10.1186/s13756-026-01713-y","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs) account for up to 20% of healthcare-associated infections and significantly increase morbidity, mortality, and healthcare costs. Preoperative decolonization strategies-targeting nasal and/or skin colonization-are variably recommended across surgical disciplines. While benefits have been reported in elective arthroplasty, their efficacy in trauma surgery remains unclear.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis in accordance with PRISMA 2020 guidelines and the Cochrane Handbook for systematic reviews and Meta-Analyses. The study protocol was registered in PROSPERO (CRD420250642382). MEDLINE, Cochrane Library, ClinicalTrials.gov, and Google Deep Research were searched up to 26 February 2025. Eligible studies reported on patients undergoing elective lower extremity joint arthroplasty or fracture surgery and compared nasal, skin, or combined decolonization protocols to standard care. Primary outcome was the incidence of SSIs. Risk of bias was assessed using RoB 2 for RCTs and ROBINS-I for observational studies.</p><p><strong>Results: </strong>Nineteen studies (n = 64,796 patients) met inclusion criteria. Of those, five were RCTs and 14 were observational, retrospective or pre-post studies. 17 focused on elective arthroplasty; two addressed fracture surgery. Among orthopedic patients, nasal decolonization reduced SSIs with an OR of 0.65 (95% CI, 0.34-1.22), skin decolonization with an OR of 0.43 (95% CI, 0.29-0.64), and combined strategies with an OR of 0.48 (95% CI, 0.33-0.69). Trauma surgery data were limited and heterogeneous (I² = 81%); the pooled OR for combined decolonization was 0.59 (95% CI, 0.08-4.32), but with conflicting individual study results.</p><p><strong>Conclusion: </strong>Nasal and skin decolonization protocols seem to reduce the incidence of SSIs in elective hip and knee arthroplasty. Thereby, skin, nasal and combined decolonization strategies may be used. However, current evidence in fracture surgery remains insufficient and inconsistent. High-quality randomized trials are urgently needed to evaluate decolonization efficacy in lower extremity trauma surgery.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146130980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of preoperative antibiotic prophylaxis in the relationship between intestinal colonization and post-ERCP biliary tract infection: a prospective cohort study.","authors":"Peng Li, Yin Chen, Zhenjuan Li, Junping Liu, Jiangfeng Zhang, Yuzhu Wang, Leilei Guo, Yuanyuan Li, Bin Hu, Shichao Zhu, Junzhe Bao, Mingjie Sun","doi":"10.1186/s13756-026-01707-w","DOIUrl":"10.1186/s13756-026-01707-w","url":null,"abstract":"<p><strong>Background: </strong>Post-ERCP biliary tract infection (PEBTI) is a critical complication influenced by multiple factors, yet the role of preoperative antibiotic prophylaxis remains unclear. This study investigated the relationship between intestinal colonization and PEBTI, and whether antibiotic prophylaxis mediates this association.</p><p><strong>Methods: </strong>A multi-center, prospective cohort of 2110 patients undergoing ERCP for biliary obstruction was analyzed. Preoperative rectal swabs screened for common intestinal colonizers. Directed acyclic graphs (DAGs), Cox regression models, inverse probability of treatment weighting (IPTW), and mediation analysis were employed to assess confounders, effect estimates, and mechanistic pathways.</p><p><strong>Results: </strong>PEBTI occurred in 100 (4.7%) enrolled patients, and intestinal colonization was detected in 343 (16.2%), predominantly ESBL-producing Escherichia coli (73.2%). Initial unadjusted analysis showed a significant association between intestinal colonization and PEBTI (HR = 2.18, 95% CI 1.41-3.36). However, after adjusting for DAG-suggested confounders, the association attenuated to non-significance (adjusted HR = 1.53, 95% CI 0.89-2.66). Mediation analysis revealed no significant indirect effect via antibiotic prophylaxis (HR = 0.93, P = 0.132), accounting for 21% of the observed attenuation. Sensitivity analyses by trimmed-IPTW and stratified center confirmed robustness of findings.</p><p><strong>Conclusions: </strong>Our analysis did not find significant evidence that intestinal colonization independently increases PEBTI risk. The observed associations appear to be largely confounded by patient vulnerability factors, with no significant evidence of mediation by antibiotic prophylaxis. These findings suggest prioritizing host-directed prevention strategies over pathogen-directed interventions in clinical practice.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146111921","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":"Dissemination of OXA-23/NDM co-producing Acinetobacter baumannii in northern Paris hospitals: inter-hospital transmission and screening gaps.","authors":"Marion Dutkiewicz, Claire Durand, Marie Petitjean, François Caméléna, Valentine Berti, Véronique Leflon-Guibout, Guillaume Mellon, Rishma Amarsy, Simone Nérome, Aurélie Carlier, Emmanuel Weiss, Emmanuel Dudoignon, Margaux Allain, Emilie Rondinaud, Stéphane Lo, Nathalie Grall, Noémie Mayer, Céline Ciotti, Isabelle Lolom, Signara Gueye, Luce Landraud, Frédéric Bert, Béatrice Bercot, Solèn Kernéis, Laurence Armand-Lefèvre","doi":"10.1186/s13756-025-01694-4","DOIUrl":"10.1186/s13756-025-01694-4","url":null,"abstract":"<p><p>Carbapenem-resistant Acinetobacter baumannii (CRAB) are rare in France and are usually reported in intensive care units (ICU). In 2021/2022, an unexpected increase in the incidence of CRAB isolates co-producing OXA-23 and NDM carbapenemases (OXA-23/NDM-CRAB) in several hospitals in the north of Paris prompted a common retrospective investigation. These strains were extremely resistant to both first- and second-line antibiotics, resulting in difficult-to-treat infections. We collected all cases of OXA-23/NDM-CRABs infection/colonisation between January 2020 and December 2022 in five northern Paris hospitals. Demographic and clinical data were collected for each patient. Isolates were sequenced using Illumina and representative isolates were sequenced using Nanopore. An OXA-23/NDM-CRAB was detected in 42 patients (mean age 61 years, M/F: 1.3), 58% of whom were hospitalised in a medical ward and 42% in an ICU, within three hospitals. Of these patients, 26% (11/42) were infected with CRAB, while 74% (31/42) were colonised. Two clonal strains spread over one year: ST^Ox231^/Pas1 in hospital 1 (n = 12) and hospital 3 (n = 13) differing by 0-16 SNPs and ST^Ox1632^/Pas600 in hospital 2 (n = 13) differing by 0-17 SNPs. WGS and epidemiological investigation identified the likely index patient for hospitals 1 and 3 outbreaks as a patient repatriated from hospitalisation in Cape Verde. This patient was not screened for multidrug resistant bacteria carriage during hospitalisation in hospital 1 and was detected positive 5 days after admission to the ICU in hospital 3. All outbreaks were stopped after infection control teams' intervention. This is the first description of OXA-23/NDM-CRAB outbreaks in metropolitan France. The simultaneous dissemination of two clonal OXA-23/NDM-CRAB strains in Parisian hospitals is unusual, particularly in non-ICU settings. Medical and nursing staffs must be sensitized to the importance of screening patients returning from abroad, including for CRAB, to prevent future outbreaks.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12947424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096645","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}