Antimicrobial Resistance and Infection Control最新文献

{"title":"Assessing infection control training in ICUs using the Kirkpatrick model: a prospective cohort study.","authors":"Sahar Elsheikh, Afaf Magdy, Lamiaa Asem","doi":"10.1186/s13756-025-01587-6","DOIUrl":"10.1186/s13756-025-01587-6","url":null,"abstract":"<p><strong>Background: </strong>Hospital-acquired infections (HAIs) are a significant global health challenge, particularly in intensive care units (ICUs), where patient vulnerability is high. Effective infection prevention and control (IPC) training is critical for reducing HAIs and improving healthcare outcomes. This aims to evaluate the efficacy of an IPC training program via Kirkpatrick's four-level model.</p><p><strong>Methods: </strong>A prospective cohort study was conducted between June and December 2024 at Shebin El Kom Fever Hospital's ICU. The study involved 106 healthcare workers (84 nurses, 22 physicians) who participated in a two-month training program combining theoretical lectures and practical sessions. Program effectiveness was assessed via Kirkpatrick's 4 levels: reaction (satisfaction surveys), learning (knowledge tests), behavior (direct observation), and results (clinical outcomes).</p><p><strong>Results: </strong>Ninety health care workers (HCWs) whose level of satisfaction exceeded 80% across all training aspects (Level 1) were included. The knowledge assessment revealed a significant improvement in the mean test score from 76.93 to 82.29% (p = 0.0112) (Level 2). Behavioral evaluation revealed substantial improvements in infection control practices, particularly in nurses' aseptic procedures (40.00-83.54%, p < 0.001) and physicians' personal protective equipment (PPE) usage (19.05-62.50%, p = 0.0391) (Level 3). At Level 4, no significant changes were observed in HAIs, mortality rates, or hospital stay costs.</p><p><strong>Conclusion: </strong>IPC training programs significantly enhance HCW knowledge and compliance with infection control practices, laying the groundwork for sustainable ICU infection control. While immediate improvements in hospital metrics were not observed, long-term monitoring is crucial to achieving full benefits. Enhanced compliance may reduce HAIs and associated costs over time.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"65"},"PeriodicalIF":4.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257175","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":"Virtual reality for education on infection prevention and control: the impact on medical students' knowledge, attitudes and practices.","authors":"Bente Schippers, Olga Coenen, Franka Luk, Mark Graner, Frans van Hoek, Nike Stikkelbroeck, Machteld Dronkers, Edmée Bowles, Alma Tostmann","doi":"10.1186/s13756-025-01585-8","DOIUrl":"10.1186/s13756-025-01585-8","url":null,"abstract":"<p><strong>Background: </strong>This study aims to analyse the impact of a newly developed infection prevention and control (IPC) Virtual Reality (VR)-module on medical students' IPC knowledge, attitudes and practices. Additionally, the impact of the module on students' and healthcare professionals' (HCPs) confidence regarding IPC decision-making and their insight into consequences of IPC decisions were analysed.</p><p><strong>Methods: </strong>The IPC VR-module was developed using a cyclical design process consisting of a prototype, first and final version. Knowledge, attitudes and practices (KAP) regarding IPC were compared between two groups of medical students. The VR-module was added to the IPC program for the VR group. After completion of the program, students of both groups were asked to complete an online questionnaire. Scores were summated for each subscale of the KAP, a Mann-Whitney U test was performed to compare scores between groups. Student and HCP responses to VR-specific questions were dichotomized and a chi-square test was used to compare responses to different versions of the module.</p><p><strong>Results: </strong>Students who completed the VR-module (n = 34) scored higher on IPC knowledge questions (score 8 / 10), than those who followed the regular program (n = 58; score 7/10; p = 0.003). For the final version, the added value of the VR-module in the program was recognized by 95% of students and 90% of HCPs. Students and HCPs who completed the final version of the VR-module agreed more often with learning objectives of the VR-module than those who completed the first version. 100% vs. 80% for the statement on insight into consequences of choices (p < 0.001) and 89% vs. 73% for the statement on confidence taking IPC decisions (p < 0.001).</p><p><strong>Conclusions: </strong>The innovative IPC VR-module positively impacted students IPC knowledge and was highly appreciated by students and HCPs. VR-specific learning objectives were achieved, especially for the final version of the VR-module, demonstrating the importance of a cyclical design process.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"64"},"PeriodicalIF":4.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245883","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":"Environmental investigation of 10 cases of nosocomial Bacillus cereus bacteraemia between 2018 and 2023.","authors":"Elissa Maalouf, Barthélémy Tosello, Sophie Schipani, Frédérique Gouriet, Claire Nicaise, Alix Lamoureux, Farah Beih, Agnès Delaby, Véronique Roux, Remi N Charrel, Carole Eldin","doi":"10.1186/s13756-025-01586-7","DOIUrl":"10.1186/s13756-025-01586-7","url":null,"abstract":"<p><strong>Background: </strong>Bacillus cereus can cause severe and potentially fatal bloodstream infections in immunocompromised patients, including preterm neonates. When the infection is nosocomial, investigating a potential environmental source is crucial to mitigate the transmission. This study investigated the potential environmental sources of ten cases of B. cereus bacteraemia in a neonatal intensive care unit.</p><p><strong>Methods: </strong>We retrospectively analysed strains from 6 temporal groups of cases involving 10 preterm neonates with bacteraemia (December-2018 to November-2023) and 28 related environmental samples. Strain typing used Multi-locus Sequence Typing (MLST) to identify sequence types (ST), followed by core-genome analysis (cgMLST) and whole genome sequencing (WGS) for strains within the same ST.</p><p><strong>Results: </strong>The 10 clinical strains belonged to 10 different STs, while environmental strains fell into 18 STs. Fourteen strains across four STs matched clinical and environmental sources and were grouped into 4 groups (G1 to G4). Two environmental strains linked to clinical cases were isolated from medical offices, and five from nurses' locker rooms. These strains were analysed by WGS (Illumina) alongside other Bacillus species. G1 and G2 corresponded to B. cereus species whereas strains of G3 and G4 were closely related to B. pacificus and B. paranthracis, respectively.</p><p><strong>Conclusion: </strong>We determined that severe B. cereus infections cases in 10 preterm neonates were not linked to each other, but rather to multiple potential environmental reservoirs within the NICU, often located farther from clinical wards than expected. These areas are not subject to same hygienic standards as medical units. Our findings highlight the need for routine monitoring of hand hygiene practices along with close surveillance and systematic biocleaning that targets not only direct patient care areas but also the broader hospital environment.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"62"},"PeriodicalIF":4.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214660","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":"Strengthening neonatal care through ward assistants: a Kenyan case study in enhancing infection prevention and control practices.","authors":"Michuki Maina, Nancy Odinga, Vincent Kagonya, Gloria Ngaiza, Sebastian Fuller, Onesmus Onyango, Caroline Waithira, Dorothy Oluoch, David Gathara, Peter Mwangi, Loise Mwangi, Penina Musyoka, Lucy Kinyua, Lydia Thuranira, Virginia Njoroge, Ngina Mwangi, Zainab Kioni, Mike English, Edna Mutua","doi":"10.1186/s13756-025-01575-w","DOIUrl":"10.1186/s13756-025-01575-w","url":null,"abstract":"<p><strong>Background: </strong>Infection prevention and control (IPC) is a critical component of neonatal care, particularly in low- and middle-income countries (LMICs), where healthcare settings face unique challenges. Neonates, especially preterm and low birth weight infants, are at higher risk for infections, including healthcare-associated infections. In Kenya, neonatal units struggle with limited resources, understaffing, and shortages of essential supplies, significantly impeding effective IPC practices.</p><p><strong>Methods: </strong>This study employed a mixed methods approach in four public neonatal units in Kenya to assess the impact of deploying ward assistants on IPC practices. Data collection included structured and unstructured observations, in-depth interviews, and focus group discussions with healthcare workers and caregivers. The intervention aimed to address gaps in routine cleanliness, waste management, and adherence to IPC protocols.</p><p><strong>Results: </strong>The introduction of ward assistants led to noticeable improvements in overall ward cleanliness and waste disposal, highlighting the potential for enhanced infection control. Mothers' hand hygiene practices improved, driven by targeted sensitization efforts. Despite these gains, significant challenges remained. Hand hygiene adherence among healthcare providers was inconsistent, and equipment cleaning and decontamination were frequently compromised by insufficient supplies and overwhelming patient demand. The findings underscored the critical role of resources and the need for consistent supervision and training to support sustainable IPC improvements.</p><p><strong>Conclusion: </strong>Deploying ward assistants in neonatal units can positively influence IPC practices, particularly in addressing environmental cleanliness and waste management. However, these benefits alone are insufficient to address systemic barriers to IPC, including resource constraints and variability in adherence among staff. To sustain these gains, robust training, consistent supervision, and adequate resourcing are imperative. Future research should explore the long-term impact of such interventions and design context-specific strategies to overcome persistent barriers, ensuring safer neonatal care in resource-limited settings.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"61"},"PeriodicalIF":4.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207466","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 resistance in the Nordics: mapping existing surveillance systems and assessing the impact of COVID-19 using regression models.","authors":"Tam T Tran, Adriana Krolicka, Ananda Tiwari, Tarja Pitkänen, Rolf Lood, Ásta Margrét Ásmundsdóttir, Odd-Gunnar Wikmark","doi":"10.1186/s13756-025-01552-3","DOIUrl":"10.1186/s13756-025-01552-3","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) pandemic constituted the largest global health crisis in recent generations. It may also have disrupted the pattern of antimicrobial use (AMU) and subsequently affected the development of antimicrobial resistance (AMR) - a grave human health concern. This study aimed to give an overview of existing AMR surveillance systems and evaluate the impact of COVID-19 on AMU and AMR in the Nordics using data from these systems.</p><p><strong>Methods: </strong>Nordic AMU data (2017-2022) were extracted from national annual reports (for both humans and animals) and the European Surveillance System (TESSy) (for humans only). For humans, AMU was expressed in defined daily dose (DDD) per 1000 inhabitants per day; for animals, it was expressed in kilogram (kg). Nordic human AMR data (2017-2022) were extracted from TESSy. Multilevel linear regression and negative binomial regression models were used to fit the TESSy data. Data between 2017 and 2019 were categorised as the pre-COVID-19 time, while data between 2020 and 2022 were the per-COVID-19 time.</p><p><strong>Results: </strong>Denmark had a remarkably greater AMU in animals (about 10 times greater) than Norway, Sweden, and Finland. Iceland had the highest human AMU, while Sweden had the lowest. Drug categories, countries, and sectors were significant predictors in the model used to fit human AMU. Bacterial species and drug categories were significant predictors in the models used to fit human resistant Gram-negative and Gram-positive bacteria. The COVID-19 time was not a significant predictor in these models. Among the Nordics, Iceland had the lowest number of resistant isolates; however, high human AMU remains a great concern for Iceland.</p><p><strong>Conclusions: </strong>The study provided insight into current existing AMR surveillance systems in the Nordics. It also showed that the COVID-19 pandemic had very little impact on AMU and AMR in theses countries. This implied that strict regulations on AMU as well as well-coordinated national AMR surveillance systems in the Nordics mitigated the development of AMR crisis also during COVID-19 pandemic. However, the Nordics would still benefit further from a standardized AMR surveillance at regional level, which ultimately facilitate timely information sharing and improve our preparedness for and response to future pandemics and/or large-scale outbreaks.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"55"},"PeriodicalIF":4.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172486","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 neglected model validation of antimicrobial resistance transmission models - a systematic review.","authors":"Maja L Brinch, Andrea Palladino, Jeroen Geurtsen, Thierry Van Effelterre, Lorenzo Argante, Michael J McConnell, Lene Christiansen, Michelle A Pihl, Natasja K Lund, Tine Hald","doi":"10.1186/s13756-025-01574-x","DOIUrl":"10.1186/s13756-025-01574-x","url":null,"abstract":"<p><strong>Background: </strong>In the fight against antimicrobial resistance, mathematical transmission models have been shown as a valuable tool to guide intervention strategies in public health.</p><p><strong>Objective: </strong>This review investigates the persistence of modelling gaps identified in earlier studies. It expands the scope to include a broader range of control measures, such as monoclonal antibodies, and examines the impact of secondary infections.</p><p><strong>Methods: </strong>This review was conducted according to the PRISMA guidelines. Gaps in model focus areas, dynamics, and reporting were identified and described. The TRACE paradigm was applied to selected models to discuss model development and documentation to guide future modelling efforts.</p><p><strong>Results: </strong>We identified 170 transmission studies from 2010 to May 2022; Mycobacterium tuberculosis (n = 39) and Staphylococcus aureus (n = 27) resistance transmission were most commonly modelled, focusing on multi-drug and methicillin resistance, respectively. Forty-one studies examined multiple interventions, predominantly drug therapy and vaccination, showing an increasing trend. Most studies were population-based compartmental models (n = 112). The TRACE framework was applied to 39 studies, showing a general lack of description of test and verification of modelling software and comparison of model outputs with external data.</p><p><strong>Conclusion: </strong>Despite efforts to model antimicrobial resistance and prevention strategies, significant gaps in scope, geographical coverage, drug-pathogen combinations, and viral-bacterial dynamics persist, along with inadequate documentation, hindering model updates and consistent outcomes for policymakers. This review highlights the need for robust modelling practices to enable model refinement as new data becomes available. Particularly, new data for validating modelling outcomes should be a focal point in future modelling research.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"59"},"PeriodicalIF":4.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172500","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":"Cultural differences in attitudes towards surgical site infections among French anesthetists and surgeons in digestive surgery in 2022.","authors":"Antoine Deslandes, Niki Christou, Patrice Baillet, Joseph Hajjar, Philippe Marre, Hubert Johanet, Marc Leone, Gabriel Birgand","doi":"10.1186/s13756-025-01576-9","DOIUrl":"10.1186/s13756-025-01576-9","url":null,"abstract":"<p><strong>Background: </strong>Although it generates a significant burden, little attention has been paid to preventing Surgical Site Infection (SSI) in digestive surgery.</p><p><strong>Objective: </strong>This study explored the factors underpinning anesthetists' and surgeons' attitudes toward SSI prevention in digestive surgery, focusing on their perceptions of SSI, preventive measures, guidelines, and cooperation across both specialties.</p><p><strong>Methods: </strong>Qualitative semi-structured interviews were conducted with 15 surgeons and 19 anesthetists working in digestive surgery. Participants were approached through established mailing lists and snowball sampling. Interviews were recorded and transcribed verbatim. Transcripts were coded and analyzed thematically using a constant comparative approach.</p><p><strong>Results: </strong>SSI in digestive surgery was perceived as an inevitable consequence and ranked down in the priorities of surgeons. A paradox existed between the low consideration of superficial infections that are easily manageable through antibiotics and the strong awareness of the antibiotic resistance threat. Global trust appeared regarding the guidelines, but a knowledge gap of the guidelines was observed among surgeons in comparison with anesthetists. SSI ownership was perceived as collective, but the responsibility belonged to the surgeon alone. Surgeons focused on actions and short-term tasks within a culture of individualism, whereas anesthetists worked collectively with systemic approaches. Overall, the cooperation between both specialties was positive, but tightly reliant on teamwork, workload, and organization in the operating theatre.</p><p><strong>Conclusions: </strong>The cultural differences between surgeons and anesthetists should be recognized as a key overarching factor in defining their respective roles in the prevention of SSI and in establishing accountability in digestive surgery - including aspects such as adherence to guidelines, and the implementation of preventive measures.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"57"},"PeriodicalIF":4.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172490","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":"Value of collaborative investigation by hospital infection control, public health services and a national reference laboratory during an increase in puerperal sepsis.","authors":"Irene V Hoogendijk, Diane de Zwart-Slats, Stefan A Boers, Boas C L van der Putten, Nina M van Sorge, Bibi D H Molenaar, Myrthe M A Toorop, Marieke B Veenhof, Karin Ellen Veldkamp, Adriënne S van der Schoor, Joffrey van Prehn","doi":"10.1186/s13756-025-01564-z","DOIUrl":"10.1186/s13756-025-01564-z","url":null,"abstract":"<p><strong>Background: </strong>In a Dutch tertiary care hospital, two cases of puerperal sepsis were diagnosed within 16 days in June-July 2022. The subsequent outbreak investigation emphasizes the value of collaboration between hospital infection control, regional public health services (PHS) and a national reference laboratory. The aim was to identify possible causes of this increase to prevent further cases of puerperal sepsis.</p><p><strong>Methods: </strong>Hospital infection control identified a group of puerperal sepsis cases clustered within the last year in the hospital, a cluster caused by S. pyogenes emm12.0. The hospital and PHS performed contact tracing of cases and HCW involved, investigating epidemiological links, and screening of HCW. The Netherlands Reference Laboratory for Bacterial Meningitis (NRLBM) identified additional regional cases. Subsequently, whole genome sequencing (WGS) analysis was performed on clinical, HCW and regional S. pyogenes isolates.</p><p><strong>Results: </strong>Four maternity ward patients were diagnosed with puerperal sepsis caused by S. pyogenes emm12.0 between April and November 2022. Although no additional epidemiological links were identified, all four cases resided within a 6.6 km radius. WGS analysis showed that the four cases were part of an 11-case cluster. Screening of HCW (n = 197) identified two individuals carrying clonally related S. pyogenes isolates.</p><p><strong>Conclusions: </strong>Collaboration between hospital, PHS, and NRLBM resulted in an overview of possible epidemiological links. Centralized collection of iGAS case information and strain typing are critical to place hospital clusters in the context of local epidemiology. An increase in healthcare-associated infections may not necessarily imply in-hospital transmission.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"60"},"PeriodicalIF":4.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for household colonization by extended-spectrum cephalosporin-resistant enterobacterales (ESCrE) in Botswana.","authors":"Sukaina Shivji, Naledi Mannathoko, Mosepele Mosepele, Robert Gross, Leigh Cressman, Anne Jaskowiak-Barr, Warren B Bilker, Kevin Alby, Laurel Glaser, Melissa Richard-Greenblatt, Laura Cowden, Alexa Patel, Kgotlaetsile Sewawa, Dimpho Otukile, Giacomo Maria Paganotti, Margaret Mokomane, Evan Snitkin, Ebbing Lautenbach","doi":"10.1186/s13756-025-01581-y","DOIUrl":"10.1186/s13756-025-01581-y","url":null,"abstract":"<p><strong>Background: </strong>The epidemiology of community colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) in low- and middle-income countries (LMICs) is largely uncharacterized. In the community, the household is of particular importance. Identifying risk factors for household ESCrE colonization is critical to inform antibiotic resistance reduction strategies.</p><p><strong>Methods: </strong>Participants were enrolled at 6 clinics in Botswana. All participants had rectal swabs collected for selective plating and confirmation of ESCrE. Data were collected on demographics, comorbidities, antibiotic use, healthcare exposures, travel, and farm/animal contact. Households were considered exposed if any member had the exposure of interest. Households with ESCrE colonization (cases) were compared to non-colonized households (controls) to identify risk factors for household ESCrE colonization.</p><p><strong>Results: </strong>From 1/1/20 - 9/4/20, 327 households were enrolled. The median (IQR) number of people enrolled per household was 3 (2-4) ranging from 2 to 10. The median (IQR) age of subjects was 18 years (5-34) and 304 (93%) households included at least one child. Of 327 households, 176 (54%) had at least one household member colonized with ESCrE. Independent risk factors [adj OR (95%CI)] for household colonization were: (1) horse/donkey exposure [2.32 (1.05, 5.10)]; (2) yogurt consumption [1.73 (1.04, 2.88)]; (3) region [2.83 (1.48,5.43)]; and (4) enrollment during pre-COVID lockdown [2.90 (1.66, 5.05)].</p><p><strong>Conclusions: </strong>ESCrE household colonization was common with evidence of geographic variability as well as a possible role of animal exposure. The role of yogurt exposure requires further study with consideration of source (commercial, homemade). Further prospective studies of household ESCrE colonization with longitudinal assessments of exposures are required to identify effective prevention strategies.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"58"},"PeriodicalIF":4.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172498","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 and control of two consecutive Serratia marcescens outbreaks linked to reusable LigaSure devices in an operating room.","authors":"Mahsa Mazaheri Tirani, Samaneh Pourajam, Vajihe Sadat Nikbin, Mohammad Shirzadi, Hamid Solgi","doi":"10.1186/s13756-025-01570-1","DOIUrl":"10.1186/s13756-025-01570-1","url":null,"abstract":"<p><strong>Background: </strong>Serratia marcescens is an opportunistic gram-negative bacterium that is commonly associated with sudden outbreaks of various healthcare-associated infections in healthcare settings. This study describes two consecutive mini-outbreaks of S. marcescens in an operating room following laparoscopic sleeve gastrectomy procedures.</p><p><strong>Methods: </strong>Between December 16 and 26, 2020, five patients who underwent sleeve gastrectomy at a university hospital were re-admitted with clinical symptoms. An investigation by the infection control team was conducted to identify the source. Environmental and instrument samples were collected, and antimicrobial susceptibility testing was performed. Molecular typing using pulsed-field gel electrophoresis (PFGE) was conducted to assess the genetic relatedness of the isolates. Infection control interventions were implemented during the outbreak.</p><p><strong>Findings: </strong>During this period, four of the five patients tested positive for S. marcescens. A total of 31 surveillance samples were collected, isolates from the handle of one LigaSure and the grasper of another were also positive for S. marcescens. PFGE revealed two distinct clones, indicating two separate outbreaks. Four of the six isolates from samples of patients and environment were the same, while two isolates belonging to another clone were collected from the blood samples of patients. After discontinuation of the reused LigaSure devices and implementation of strict infection control measures, no new cases were reported.</p><p><strong>Conclusion: </strong>The two consecutive S. marcescens outbreaks were linked to the reuse of inadequately sterilized LigaSure devices. The implementation of targeted infection control measures successfully halted further transmission.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"54"},"PeriodicalIF":4.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101001","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}