Antimicrobial Resistance and Infection Control最新文献

{"title":"Improving antibiotic utilization in West Africa: enhancing interventions through systematic review and evidence synthesis.","authors":"Eric S Donkor, Abdul-Halim Osman, Bill Clinton Aglomasa, Aaron Awere-Duodu, Alex Odoom, Bismark Opoku-Asare, Gilbert Lazarus","doi":"10.1186/s13756-024-01504-3","DOIUrl":"10.1186/s13756-024-01504-3","url":null,"abstract":"<p><strong>Background: </strong>Bacterial infection has been estimated to become the leading cause of death by 2050, causing 10 million deaths across the globe due to the surge in antibiotic resistance. Despite western sub-Saharan Africa being identified as one of the major hotspots of antimicrobial resistance (AMR) with the highest mortality, a comprehensive regional analysis of the magnitude and key drivers of AMR due to human antibiotic use has not been conducted.</p><p><strong>Method: </strong>We carried out a systematic review by conducting a comprehensive search in various databases including PubMed and Scopus for eligible articles published in the English Language between 1 January 2000 and 14 February 2024. Five key domains of antibiotic use were focused on: (1) antibiotic consumption; (2) appropriate antibiotic prescription; (3) indicators or key drivers of antibiotic use; (4) antimicrobial stewardship (AMS) interventions; (5) knowledge, attitudes and perceptions of antibiotic consumers and providers. Data were extracted from eligible papers for all the five domains under consideration and random-effects model meta-analysis was carried out for antibiotic consumption.</p><p><strong>Results: </strong>Out of the 2613 records obtained, 64 articles which were unevenly distributed in the region were eligible for inclusion in our study. These articles reported on antibiotic consumption (5), appropriate antibiotic prescription (10), indicators or key drivers of antibiotic use (10), AMS interventions (10), and 31 studies reported on knowledge, attitudes and perceptions. Antibiotic consumption for inpatients has a pooled estimate of 620.03 defined daily dose (DDD) per 100 bed-days (confidence interval [CI] 0.00-1286.67; I² = 100%) after accounting for outliers while prescribing appropriateness ranged from 2.5% to 93.0% with a pooled estimate of 50.09 ([CI: 22.21-77.92%], I² = 99.4%). Amoxicillin, gentamicin, amoxicillin-clavulanate, metronidazole, and ceftriaxone were the commonly consumed antibiotics. Community-acquired infection, hospital-acquired infection, and prophylaxis were the major indicators of antibiotic use. AMS was effective to varying degrees with bundled interventions and gamified antimicrobial stewardship decision support application being the most effective. Healthcare workers demonstrated acceptable antibiotic knowledge but individuals from formal and informal settings self-medicate with antibiotics and had moderate to low knowledge of antibiotic use and resistance.</p><p><strong>Conclusion: </strong>This review identified gaps in knowledge and highlighted areas where prompt actions are required, it further guides future research endeavors and policy development. The findings underscore the need for further implementation of AMS programs across the West African region to enhance understanding of antibiotic use patterns, prescribing practices, and the factors influencing them in the region.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"5"},"PeriodicalIF":4.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143121994","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":"Changing dynamics of bloodstream infections due to methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium in Germany, 2017-2023: a continued burden of disease approach.","authors":"Simon Brinkwirth, Marcel Feig, Ines Noll, Tim Eckmanns, Achim Dörre, Sebastian Haller, Niklas Willrich","doi":"10.1186/s13756-025-01522-9","DOIUrl":"10.1186/s13756-025-01522-9","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance is a global threat to public health, with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VREfm) being major contributors. Despite their clinical impact, comprehensive assessments of changes of the burden of bloodstream infections in terms of Disability-Adjusted Life Years (DALYs) and attributable deaths over time are lacking, particularly in Germany.</p><p><strong>Methods: </strong>We used data from the Antimicrobial Resistance Surveillance system, which covered about 30% of German hospitals. Bloodstream infections were defined by a VREfm or MRSA-positive blood culture. We estimated incidences as a first step to further use these rates to calculate DALYs and attributable deaths using the Burden of Communicable Disease in Europe toolkit. The analysis included stratification by age, sex and region.</p><p><strong>Results: </strong>From 2017 to 2023, 6262 MRSA and 5442 VREfm blood culture-positive isolates were identified. The incidence of MRSA bloodstream infections decreased from 4.0 to 2.1 per 100,000 population, with estimated DALYs decreasing from 14.6 to 8.6 per 100,000 and attributable deaths from 591 to 316. Conversely, VREfm-BSI incidence doubled from 1.7 to a peak of 3.0 (2021) before declining back to 1.7 per 100,000 in 2023, with estimated DALYs increasing from 8.9 to 16.5 and then decreasing to 8.5 per 100,000 and attributable deaths increasing from 317 to 327. Men and people over 60 years had the highest burden, with noticeable regional differences.</p><p><strong>Conclusion: </strong>MRSA and VREfm bloodstream infections followed different trends in the past and now present a comparable burden in Germany. Both pathogens pose a significant threat, particularly to hospitalised older aged men. Our findings highlight the need for targeted prevention and continued surveillance of MRSA and VREfm to reduce infections and their impact.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"4"},"PeriodicalIF":4.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062962","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":"Carbapenem-resistant Enterobacterales infection and colonization in patients with severe burns: a retrospective cohort study in a single burn center.","authors":"Myongjin Kim, Kibum Jeon, Dohern Kym, Jinsun Jung, Yu Jin Jang, Seung Beom Han","doi":"10.1186/s13756-025-01514-9","DOIUrl":"10.1186/s13756-025-01514-9","url":null,"abstract":"<p><strong>Background: </strong>Clinical characteristics and outcomes of carbapenem-resistant Enterobacterales (CRE) infection and colonization have rarely been reported in patients with severe burns, who are prone to severe bacterial infections. This study aimed to evaluate clinical characteristics and outcomes of CRE infection and colonization in patients with severe burns.</p><p><strong>Methods: </strong>The characteristics of 106 episodes of CRE acquisition (infection or colonization) in 98 patients with severe burns were evaluated by a retrospective medical record review. The duration of rectal CRE colonization and its associated factors were determined in the survived patients.</p><p><strong>Results: </strong>Five (4.7%) of the CRE acquisitions were identified on admission, and the remaining 101 (95.3%) were identified at a median of 11 days (range 2-75 days) after admission. Klebsiella pneumoniae represented 73.6% of the isolated CRE strains, and carbapenemase-producing CRE (CP-CRE) were identified in 70.8% of the isolates. Mortality was associated with an abbreviated burn severity index (ABSI) score ≥ 10 (p < 0.001) and previous carbapenem-resistant bacterial acquisition (protective, p = 0.010). For the 58 episodes of CRE acquisition in the survived patients, eradication of rectal CRE colonization was identified in 39 (67.2%) at a median of 64 days (range 10-434 days) after acquisition. CP-CRE strains were associated with prolonged rectal CRE colonization (p < 0.001).</p><p><strong>Conclusions: </strong>The characteristics of CRE infection and colonization in patients with severe burns were similar to those in general critical patients. Enhanced infection prevention and control measures should be considered for patients with severe burns of an ABSI score ≥ 10 and those with CP-CRE.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"3"},"PeriodicalIF":4.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062828","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":"In vitro long-term exposure to chlorhexidine or triclosan induces cross-resistance against azoles in Nakaseomyces glabratus.","authors":"Kathrin Spettel, Dominik Bumberger, Richard Kriz, Sarah Frank, Madita Loy, Sonia Galazka, Miranda Suchomel, Heimo Lagler, Athanasios Makristathis, Birgit Willinger","doi":"10.1186/s13756-024-01511-4","DOIUrl":"https://doi.org/10.1186/s13756-024-01511-4","url":null,"abstract":"<p><strong>Background: </strong>Topical antiseptics are crucial for preventing infections and reducing transmission of pathogens. However, commonly used antiseptic agents have been reported to cause cross-resistance to other antimicrobials in bacteria, which has not yet been described in yeasts. This study aims to assess the in vitro efficacy of antiseptics against clinical and reference isolates of Candida albicans and Nakaseomyces glabratus, and whether prolonged exposure to antiseptics promotes the development of antifungal (cross)resistance.</p><p><strong>Methods: </strong>A high-throughput approach for in vitro resistance development was established to simultaneously expose 96 C. albicans and N. glabratus isolates to increasing concentrations of a given antiseptic - chlorhexidine, triclosan or octenidine. Susceptibility testing and whole genome sequencing of yeast isolates pre- and post-exposure were performed.</p><p><strong>Results: </strong>Long-term exposure to antiseptics does not result in the development of stable resistance to the antiseptics themselves. However, 50 N. glabratus isolates acquired resistance to azole antifungals after long-term exposure to triclosan or chlorhexidine, revealing newly acquired mutations in the PDR1 and PMA1 genes.</p><p><strong>Conclusions: </strong>Chlorhexidine as well as triclosan, but not octenidine, were able to introduce selective pressure promoting resistance to azole antifungals. Although we assessed this phenomenon only in vitro, these findings warrant critical monitoring in clinical settings.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"2"},"PeriodicalIF":4.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare worker views on antimicrobial resistance in chronic respiratory disease.","authors":"Sachin Ananth, Adekunle O Adeoti, Animesh Ray, Peter G Middleton, Miquel Ekkelenkamp, Stephanie Thee, Anand Shah","doi":"10.1186/s13756-025-01515-8","DOIUrl":"10.1186/s13756-025-01515-8","url":null,"abstract":"<p><strong>Background and objective: </strong>Antimicrobial resistance (AMR) is a global crisis, however, relatively little is known regarding its impact in chronic respiratory disease and the specific challenges faced by healthcare workers across the world in this field. We aimed to assess global healthcare worker views on the challenges they face regarding AMR in chronic respiratory disease.</p><p><strong>Methods: </strong>An online survey was sent to healthcare workers globally working in chronic respiratory disease through a European Respiratory Society clinical research collaboration (AMR-Lung) focussed on AMR in chronic lung disease. Responses from different geographic regions were analysed.</p><p><strong>Results: </strong>279 responses were received across 60 countries. 54.5% of respondents encountered AMR in chronic respiratory disease weekly. There were differences in perceived high-priority diseases and species with AMR burden between Europe, Asia and Africa. 76.4% of respondents thought that inappropriate antimicrobial prescribing in chronic respiratory disease was common. However, only 43.4% of respondents thought that there were adequate antimicrobial stewardship programmes in their area for chronic respiratory disease, with limited availability in outpatient (29.0%) and ambulatory settings (24.7%). Developing rapid diagnostics for antimicrobial susceptibility (59.5%) was perceived to be the most common challenge in implementing antimicrobial stewardship, with an improved understanding of regional epidemiology of AMR strains the most important factor to improve outcome (55.2%).</p><p><strong>Conclusions: </strong>AMR has significant perceived burden in chronic respiratory disease by healthcare professionals globally. However, current implementation of antimicrobial stewardship is limited, with significant challenges related to the availability of rapid diagnostics and understanding of regional epidemiology of AMR strains.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"1"},"PeriodicalIF":4.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021767","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":"Screening sites for detection of carbapenemase-producers- a retrospective cohort study.","authors":"Isabelle Vock, Silvio Ragozzino, Pascal Urwyler, Michelle Baumann, Gioele Capoferri, Peter M Keller, Sarah Tschudin-Sutter","doi":"10.1186/s13756-024-01513-2","DOIUrl":"10.1186/s13756-024-01513-2","url":null,"abstract":"<p><p>While screening the rectal site and urine may be appropriate for detection of carbapenemase-producing Enterobacterales, respiratory samples, throat and wound swabs may increase the sensitivity of screening protocols when aiming to detect colonization with carbapenemase-producing non-fermenting bacteria. Our results support the need for tailoring screening recommendations according to the bacterial species targeted.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"157"},"PeriodicalIF":4.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909075","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 environmental impact and sustainability of infection control practices: a systematic scoping review.","authors":"Oliver Lim, Wei Yu Chua, Andrew Wong, Ryan Ruiyang Ling, Hwang Ching Chan, Swee Chye Quek, Sean Wu, Jyoti Somani","doi":"10.1186/s13756-024-01507-0","DOIUrl":"10.1186/s13756-024-01507-0","url":null,"abstract":"<p><p>Infection prevention and control (IPC) programs form the basis of minimizing spread of pathogens in the healthcare setting and beyond. The COVID-19 pandemic amplified the demand for IPC. However, the environmental impact of IPC practices has yet to be addressed and attempts to quantify its climate implications have been sparse. We performed a scoping review to identify current evidence regarding the environmental footprint of IPC measures and to highlight existing gaps in the literature. We included 30 articles, with 23 quantifying the environmental impact by mass of waste generated, six via carbon emissions, and one reporting on the concentration of volatile organic compounds. The mass of infectious waste ranged from 0.16 to 3.95 kg/bed/day, with large variability between countries. In general, higher-income countries produced more waste than lower-income countries. Significant carbon emission savings resulted from substituting reusable gowns and sharps containers, compared to single use items. The most significant gaps are the overall lack of standardisation in quantifying the environmental footprint of IPC-related practices, and a lack of studies on carbon emissions stemming from low and lower-middle income countries. We quantify the environmental impact of IPC practices, suggest areas of infection control that warrant further evaluation, and an approach to standardising environmental metrics in an attempt to better map out the climate implications of adopted IPC measures.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"156"},"PeriodicalIF":4.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885122","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":"Automated surveillance for surgical site infections (SSI) in hospitals and surveillance networks-expert perspectives for implementation.","authors":"Luisa A Denkel, Isabelle Arnaud, Manon Brekelmans, Mireia Puig-Asensio, Hoger Amin, Sophie Gubbels, Pernille Iversen, Mohamed Abbas, Elisabeth Presterl, Pascal Astagneau, Stephanie van Rooden","doi":"10.1186/s13756-024-01505-2","DOIUrl":"10.1186/s13756-024-01505-2","url":null,"abstract":"<p><strong>Background: </strong>This work aims at providing practical recommendations for implementing automated surveillance (AS) of surgical site infections (SSI) in hospitals and surveillance networks. It also provides an overview of the steps, choices, and obstacles that need to be taken into consideration when implementing such surveillance. Hands-on experience with existing automated surveillance systems of SSI (AS SSI systems) in Denmark, France, the Netherlands and Spain is described regarding trend monitoring, benchmarking, quality control, and research for surveillance purposes.</p><p><strong>Methods: </strong>Between April and October 2023, specific aspects/options of various surveillance purposes for AS SSI were identified during regular meetings of the SSI working group in the PRAISE (Providing a Roadmap for Automated Infection Surveillance in Europe) network. Expert discussions provided the basis for this perspective article.</p><p><strong>Results: </strong>Decisions for implementation of AS SSI systems highly depend on the purpose of the surveillance. AS SSI systems presented here differ according to study population, setting, central or local implementation; the level of automation, design, and the data sources used. However, similarities were found for the rationales of automation, design principles and obstacles that were identified. There was consensus among all the experts that shortcomings in interoperability of databases, limited time, a want of commitment on the part of stakeholders, and a shortage of resources for information technology (IT) specialists represent the main obstacles for implementing AS SSI. To overcome obstacles, various solutions were reported, including training in the development of AS systems and the interpretation of AS SSI results, early consultation of end-users, and regular exchanges between management levels, IT departments, infection prevention and control (IPC) teams, and clinicians.</p><p><strong>Conclusion: </strong>Clarity on the intended application (e.g. purpose of surveillance) and information on the availability of electronic and structured data are crucial first steps necessary for guiding decisions on the design of AS systems. Adequate resources for IT specialists and regular communication between management, IT departments, IPC teams, and clinicians were identified as essential for successful implementation. This perspective article may be helpful for a wider implementation of more homogeneous AS SSI systems in Europe.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"155"},"PeriodicalIF":4.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881071","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":"Promoting hand hygiene in a chemotherapy day center: the role of a robot.","authors":"Shuk-Ching Wong, Stephen Chun-Yat Ip, Monica Oi-Tung Kwok, Crystal Yuen-Ki Siu, Jonathan Hon-Kwan Chen, Simon Yung-Chun So, Kelvin Hei-Yeung Chiu, Kwok-Keung Yuen, Vincent Chi-Chung Cheng","doi":"10.1186/s13756-024-01510-5","DOIUrl":"10.1186/s13756-024-01510-5","url":null,"abstract":"<p><strong>Background: </strong>Hand hygiene is a critical component of infection prevention in healthcare settings. Innovative strategies are required to enhance hand hygiene practices among patients and healthcare workers (HCWs).</p><p><strong>Methods: </strong>This study was conducted at the Chemotherapy Day Center of Queen Mary Hospital, Hong Kong. It comprised three phases: phase 1 involved observational audits of hand hygiene practices among patients and HCWs by infection control nurse (ICN); phase 2 included the installation of 53 pressure sensors on alcohol-based hand rub (AHR) bottles at designated sites to monitor usage; phase 3 introduced the robot named Temi Medic to promote hand hygiene through video broadcasts at strategic locations in the center. The mean counts of pressure sensor-equipped AHR per 100 attendances per day (hereafter referred to as the mean count) across phases 2 and 3 were analyzed.</p><p><strong>Results: </strong>A total of 2580 patient attended the center from April to September 2023. The ICN observed a significant increase in hand hygiene practices among patients at the entrance and reception area, rising from phase 1 (0.2%, 1/583) and phase 2 (0.5%, 3/656) to phase 3 (5.0%, 33/654) (p < 0.001). Meanwhile, the overall hand hygiene compliance among HCWs was 74.1% (1341/1810) throughout the study period. From phase 2 to phase 3, the mean counts of 7 AHR bottles designated for patient use (P1-P7) significantly increased (35 ± 17 vs. 64 ± 24, p < 0.001), as did the 33 AHR bottles shared by both patients and HCWs (207 ± 104 vs. 267 ± 113, p = 0.027). In contrast, there was no significant change in the mean count among the 13 AHR bottles designated for HCWs (H1-H13). The mean count of H1-H13 was significantly higher than that of P1-P7 throughout phases 2 and 3 (214 ± 93 vs. 49 ± 25, p < 0.001), indicating a 4.4-fold difference.</p><p><strong>Conclusions: </strong>While HCWs maintained stable hand hygiene compliance, the introduction of the robot significantly improved hand hygiene practices among patients in the chemotherapy day center. This underscores the importance of integrating technology into routine practices to promote infection prevention and control in healthcare settings.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"154"},"PeriodicalIF":4.8,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870749","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":"Identifying risk factors for carbapenem-resistant Acinetobacter baumannii carriage upon admission: a case-case control study.","authors":"Debby Ben-David, Bar Roshansky, Yael Cohen, Niv Sylvie, Lili Raviv, Ariel Zimerman, Orna Schwartz","doi":"10.1186/s13756-024-01500-7","DOIUrl":"10.1186/s13756-024-01500-7","url":null,"abstract":"<p><strong>Background: </strong>Active screening programs and early detection of asymptomatic carriers are effective in preventing carbapenem-resistant Acinetobacter baumannii (CRAB) dissemination in healthcare facilities. This study aims to identify risk factors associated with CRAB carriage among patients upon admission to an acute care hospital.</p><p><strong>Methods: </strong>A case-case-control study was conducted at an acute care hospital. Starting in June 2020, new admissions to medical wards underwent rectal and buccal screening. Patients with CRAB or carbapenem-susceptible A. baumannii (CSAB) carriage were compared to controls, randomly selected from patients with negative cultures, at a one-to-one ratio. Multinomial logistic regression using a backward stepwise method was employed to identify factors associated with CRAB and CSAB carriage. A Chi-square Automatic Interaction Detector analysis was also conducted to further elucidate risk factors.</p><p><strong>Results: </strong>The study included 115 CRAB carriers, 117 CSAB carriers and 121 controls. Increasing age was associated with a reduced risk of CSAB (OR: 0.96, p < 0.001) and CRAB carriage (OR: 0.97, p = 0.02), while higher Charlson Comorbidity Index scores increased the risk for both. CRAB carriage was significantly associated with admission from long-term acute care hospitals (OR: 7.68, p < 0.001) and presence of pressure ulcers (OR: 89.98, p < 0.001). Decision tree analysis identified pressure ulcers, prior location, and Charlson score as key predictors, with CRAB carriage reaching 77.3% in patients admitted from long-term acute care hospitals with pressure ulcers.</p><p><strong>Conclusion: </strong>Pressure ulcers were strongly associated with the carriage of both susceptible and resistant strains of A. baumannii. CRAB carriage was predominantly observed in patients transferred from long-term acute care hospitals, highlighting the need for targeted screening in this high-risk population.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"153"},"PeriodicalIF":4.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871164","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}