Antimicrobial Resistance and Infection Control最新文献

{"title":"Neonatal infection with Staphylococcus capitis NRCS-A in Iceland: A 12-year longitudinal, retrospective study of strains from patients, staff and the environment in a neonatal intensive care unit.","authors":"Ingibjörg Hilmarsdóttir, Kristján Orri Helgason, Álfheidur Thórsdóttir, Mélanie Bonhomme, Jóhanna Dröfn Stefánsdóttir, Ásdís Elfarsdóttir Jelle, Thórdur Thórkelsson, Frédéric Laurent, Marine Butin","doi":"10.1186/s13756-025-01623-5","DOIUrl":"10.1186/s13756-025-01623-5","url":null,"abstract":"<p><strong>Background: </strong>The multidrug resistant NRCS-A clone of Staphylococcus capitis (SC) has spread globally in neonatal intensive care units (NICUs) where it causes neonatal sepsis and colonisation of infants, fomites and staff. Whole genome sequencing (WGS) of international isolates has suggested a putative origin of the clone in Norway, which is closely related to Iceland geopolitically. No data have been available about the NRCS-A clone in Iceland where a case of neonatal sepsis in 2014 suggested its presence for the first time. This study examines the epidemiology of the clone in the single Icelandic NICU over a 12-year period and its relationship to international isolates.</p><p><strong>Methods: </strong>The study involved retrospective examination of the occurrence and clinical significance of SC-NRCS-A isolated from blood cultures of infants during 2009 - 2020, and prospective screening for SC among infants, staff and the environment. WGS was done on selected isolates to verify the presence of the SC-NRCS-A clone, examine phylogenetic relationship within the Icelandic isolates, and compare them with an international collection of SC-NRCS-A.</p><p><strong>Results: </strong>SC-NRCS-A was found in blood cultures from 28 infants, of which nine with sepsis, and was a frequent coloniser of infants and diverse fomites. In staff SC-NRCS-A was detected in nares, throat and scalp. WGS of 93 isolates from blood and prospective screening specimens and comparison with international isolates revealed that the Icelandic SC-NRCS-A was distributed into two clusters, one related to Norwegian and the other to Irish SC-NRCS-A isolates. Both clusters contained isolates representing all sample sources.</p><p><strong>Conclusion: </strong>The study demonstrated interpatient transmission, widespread dissemination and persistence of the SC-NRCS-A clone in the Icelandic NICU. The close phylogenetic relationship of Icelandic isolates with those from Norway and Ireland suggests potential import to Iceland by NICU staff or infants receiving medical care in these neighbouring countries at some point before 2009 for the Irish clone and before 2014 for the Norwegian clone.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"107"},"PeriodicalIF":4.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172450","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":"Pattern and appropriateness of antimicrobial prescription for acute respiratory tract infection in primary healthcare settings in Ethiopia.","authors":"Gashaw Enbiyale Kasse, Suzanne M Cosh, Judy Humphries, Md Shahidul Islam","doi":"10.1186/s13756-025-01612-8","DOIUrl":"10.1186/s13756-025-01612-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Acute respiratory tract infections (ARTIs) are the leading cause of antimicrobial misuse, contributing to the increasing problem of antimicrobial resistance. Little information exists about the pattern and appropriateness of antimicrobial prescribing in patients with ARTIs in the study area. Therefore, this study aims to investigate antimicrobial prescriptions and their appropriateness for ARTIs in primary healthcare settings in Ethiopia, as well as to identify potential risk factors for inappropriate antimicrobial prescriptions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional study was conducted in seven selected primary health centres. Data were collected through face-to-face structured questionnaire interviews with outpatients diagnosed with ARTIs and a review of their medical charts. To be eligible for this study, patients had to be diagnosed with one of the ARTIs as diagnosed by physicians. The appropriateness of antimicrobial prescription was evaluated by two experienced physicians based on national and international guidelines. Multivariable logistic regression was used to identify the significant factors, including sociodemographic and clinical characteristics, associated with inappropriate antimicrobial prescriptions. A p-value &lt; 0.05 was considered a level of statistical significance. We used Variance Inflation Factors (VIF) to check the multicollinearity of independent variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 420 patients included in the study, 55% were female. The mean age of the participants was 45.1 years (SD ± 16.8 years) with a range of 18-90 years. The most frequent diagnoses of ARTIs were acute bronchitis (24%), common cold (22.4%), and tonsillitis (15.2%). 352 (83.8%) of patients received antimicrobial prescriptions. The most frequently prescribed antimicrobial classes were penicillin (69.1%), macrolides (20.4%), and fluoroquinolones (6.2%). Moreover, amoxicillin (36.9%) and amoxicillin-clavulanic acid (32.4%) were the most inappropriately prescribed antimicrobials. The rate of inappropriate antimicrobial prescription was 64.2%. Among these, 71.7% of patients received antimicrobials that were not indicated, while the remaining 28.3% received an inappropriate dose and frequency. Patients diagnosed with common colds, acute bronchitis and tonsillitis had a higher rate of inappropriate antimicrobial prescriptions. The presence of fever (OR = 5.42; 95% CI = 3.36-8.75; P &lt; 0.001), patients with comorbidities (OR = 1.31; 95% CI = 1.23-3.93; p = 0.001) and patient age ≥ 60 years (OR = 1.18; 95% CI = 1.08-2.48; p &lt; 0.001) were associated with a higher likelihood of inappropriate antimicrobial prescribing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Overall, the study findings highlight a high rate of antimicrobial prescriptions for ARTIs, with the majority being prescribed inappropriately. These results underscore the need for targeted interventions, including antimicrobial stewardship programs and adher","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"110"},"PeriodicalIF":4.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and evaluation of a massive open online course (MOOC) to teach medical students the prudent use of antibiotics.","authors":"Miriam Wiese-Posselt, Selin Saydan, Thiên-Trí Lâm, Alina Rörig, Clara Bergmann, Felicia Becker, Oliver Kurzai, Markus A Feufel, Petra Gastmeier, Sandra Schneider","doi":"10.1186/s13756-025-01640-4","DOIUrl":"10.1186/s13756-025-01640-4","url":null,"abstract":"<p><strong>Background: </strong>If antibiotics are used appropriately, the development of antimicrobial resistance (AMR) can be curbed. Many medical students feel that they do not receive sufficient training in this respect during their undergraduate medical education. In recent years, digital learning formats are being successfully employed in student teaching. Our aim was to develop and evaluate a massive open online course (MOOC) on appropriate antibiotic therapy and the development of AMR. The intention was to provide the MOOC as an effective learning format in medical schools and to encourage others to develop their own MOOCs on other topics.</p><p><strong>Methods: </strong>We developed a MOOC for medical students that consisted of four modules (M1-4) on bacteriology, microbiology diagnostics, pharmacology, antibiotics, AMR, the One Health approach, principles of appropriate antibiotic therapy, and transfer of knowledge to clinical practice. MOOC learners were asked to answer the same 16 knowledge and five self-assessment questions at the beginning and end of the MOOC and to give course feedback in an anonymous online questionnaire.</p><p><strong>Results: </strong>From July 1, 2021 until June 30, 2022 the MOOC was actively attended by 2061 learners. Of them, 473 (23%) completed the final exam and 389 (19%) answered the knowledge and self-assessment questions at the beginning and end of the MOOC. A significant increase in knowledge and a strengthening of competence and self-confidence was observed in these 389 learners. The median knowledge score increased significantly from 10/16 (IQR 8; 12) points before the MOOC to 16/16 (15; 16) afterwards (p < 0.001). Overall, course activity decreased from M1 (100% attendance) to M4 (38%). At the end of the MOOC, the online feedback questionnaire was completed by 304 (15%) learners, most of whom rated the MOOC positively. For example, 97% of them stated that they had increased their knowledge in relevant areas.</p><p><strong>Conclusions: </strong>A high dropout rate for voluntary MOOCs is generally reported. Therefore, a course completion rate of 23% is acceptable. The learners who completed the MOOC showed a significant increase in knowledge and self-confidence. The use of the MOOC, or parts of it, as digital learning format for undergraduate medical education appears promising.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"105"},"PeriodicalIF":4.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123947","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":"Barriers and facilitators of the implementation for the antimicrobial Social Norm Feedback (SNF) intervention strategy in primary care institutions: a qualitative study based on the Consolidated Framework for Implementation Research (CFIR).","authors":"Yuxing Yan, Junli Yang, Yun Lu, Yutong Fu, Jiao Chen, Xinchen Li, Yue Chang","doi":"10.1186/s13756-025-01617-3","DOIUrl":"10.1186/s13756-025-01617-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Although current evidence supports the effectiveness of social norm feedback (SNF) interventions, their sustained integration into primary care remains limited. Drawing on the elements of the antimicrobial SNF intervention strategy identified through the Delphi-based evidence applicability evaluation, this study aims to explore the barriers and facilitators to its implementation in primary care institutions, thereby informing future optimization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Based on the five domains of the Consolidated Framework for Implementation Research (CFIR), we developed semi-structured interview and focus group discussion guides. Employing purposive sampling, we selected health administrators, hospital managers, physicians, and pharmacists for semi-structured interviews, while patients who had received antimicrobial therapy in primary care institutions participated in focus group discussions. Data collection continued until saturation was achieved, ultimately gathering insights from 36 participants across 5 health administration departments and 7 primary care institutions in 5 locations of Guizhou Province, Southwest China. Textual data were coded and categorized using NVivo 12.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified 33 barriers, 38 facilitators, and 1 mixed determinant influencing the persistent implementation of the antimicrobial SNF intervention strategy in primary care institutions. The highest number of factors influencing implementation was found in the inner setting domain. Key barriers included insufficient available resources, insufficient accessibility of knowledge and information, lack of relative priority (referring to the perception that the intervention was less important than competing organizational tasks), organizational culture that prioritizes short-term efficiency, lack of organizational incentives and rewards, inadequate implementation climate, insufficient readiness for implementation, insufficient oversight and leadership engagement, lack of clear goals and feedback, lack of networks and communications, and absence of Pharmacist Council in organizational structure. Improving these factors would promote continuous implementation. Furthermore, facilitators within this domain also included the tension for change (stakeholders' perception that current prescribing practices urgently need improvement), excellent learning climate, excellent compatibility, and organizational structure in newly established large-scale hospitals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Long-term implementation of the antimicrobial SNF intervention strategy necessitates synergistic effects among intervention characteristics, organizational setting, characteristics of individuals, outer setting, and dynamic implementation process. The study provides critical evidence and references for the sustainable implementation of the antimicrobial SNF intervention strategy and the optimized design of complex intervent","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"104"},"PeriodicalIF":4.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028751","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":"Assessment of Infection Prevention and Control in Somali Healthcare Facilities using the WHO Infection Prevention and Control Assessment Framework.","authors":"Abdikarim Abdi Adam, Hassan Dahir Mohamed, Felix Emeka Anyiam","doi":"10.1186/s13756-025-01584-9","DOIUrl":"10.1186/s13756-025-01584-9","url":null,"abstract":"<p><strong>Background: </strong>Improving healthcare-associated infections, fighting antibiotic resistance, and controlling outbreaks are all made possible by infection prevention and control, a significant global public health concern, particularly in Africa. To pinpoint areas that needed improvement, this study aimed to assess Infection Prevention and Control in Somali Healthcare Facilities using the WHO Infection Prevention and Control Assessment Framework.</p><p><strong>Methods: </strong>307 healthcare facilities in Somalia, or 30% of the 1,023 facilities listed by the Federal Ministry of Health, had their IPC practices evaluated by cross-sectional research in October and November 2022. Descriptive statistics were used in the study to examine data categorized by facility type, ownership, and location. The facilities were divided into four IPC levels-inadequate, basic, intermediate, and advanced using the World Health Organization's Infection Prevention and Control Assessment Framework (IPCAF).</p><p><strong>Results: </strong>The mean overall IPCAF score was 136/800, which indicates inadequate IPC practices. 85% of the institutions were public hospitals, while the majority (68.83%) were primary healthcare centers. CC1 (IPC Program) and CC 5 (Multi-modal Strategies) got the lowest values out of the eight IPC core components, suggesting major improvement. while CC 7 (Workload, Staffing, and Bed Occupancy) and CC 8 (Environments, Materials, and Equipment) had the greatest results. Inadequate IPCAFs were found in all States. The results highlight the urgent need for national and regional policies to give IPC programs and infrastructure funding the Highest priority, mainly in low-performing areas and primary healthcare settings. Regional differences highlight the need for specialized approaches to increase IPC capacity in every state.</p><p><strong>Conclusions: </strong>The initial IPCAF assessment of Somali healthcare facilities reveals inadequate IPC levels, highlighting the need for urgent intervention to improve practices, ensure patient safety, and support the development of a national IPC policy in Somalia.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"103"},"PeriodicalIF":4.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939533","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":"Impact of surgical field disinfection on vaginal microbiome in transvaginal urogynecological surgery: a prospective cohort study.","authors":"Yingan Zhang, Lucie Allegre, Florian Salipante, Madjid Morsli, Thibault Thubert, Jean-Philippe Lavigne, Catherine Dunyach-Remy, Renaud de Tayrac","doi":"10.1186/s13756-025-01622-6","DOIUrl":"https://doi.org/10.1186/s13756-025-01622-6","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to assess the effects of vaginal disinfection and sterile draping on the composition and dynamics of the vaginal microbiota during vaginal surgery.</p><p><strong>Methods: </strong>A prospective cohort study was conducted involving post-menopausal patients undergoing vaginal urogynecological surgery. The vaginal microbiota was assessed by partial 16 S rRNA gene sequencing at three time points: before disinfection (V1); immediately after disinfection and sterile draping (V2); and one-hour post-disinfection (V3).</p><p><strong>Findings: </strong>In a cohort of 54 postmenopausal women (median age: 69.2 ± 7.6 years), with a mean operative time of 92.89 ± 45.92 min, native tissue prolapse repair was the most common urogynecological vaginal procedure performed (n = 47, 87%). The vaginal microbiota diversity was significantly increased after disinfection associated with reduced abundance of Lactobacillus and Bifidobacterium and increased Pseudomonas (p < 0.0001). Community state type (CST) I prevalence decreased notably from 20% at V1 to 6% at V3, primarily due to the disappearance of CST I-A, while CST IV prevalence rose from 31 to 44%, which was mainly secondary to an increase in CST IV-C (from 20 to 33%).</p><p><strong>Conclusions: </strong>These findings highlight the impact of povidone-iodine on vaginal microbiota composition during vaginal urogynecological surgery. Disinfection significantly increased vaginal bacterial diversity and reducing Lactobacillus abundance. This observation requires further exploration in the context of development of optimized disinfection protocols aimed at preserving vaginal health during and after surgery.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"102"},"PeriodicalIF":4.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939512","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":"Secular trends of bloodstream infections in hemodialysis patients: insights from a longitudinal Swiss study.","authors":"Nasreen Hassoun-Kheir, Niccolò Buetti, David Jaques, Valérie Olivier, Marie-Noelle Chraiti, Monique Perez, Marlieke Ea de Kraker, Holly Jackson, Jacques Schrenzel, Patrick Saudan, Stephan Harbarth","doi":"10.1186/s13756-025-01620-8","DOIUrl":"10.1186/s13756-025-01620-8","url":null,"abstract":"<p><strong>Background: </strong>Hemodialysis-associated bloodstream infections (BSIs) represent a significant burden for patients. Understanding the trends in BSIs among hemodialysis patients is crucial for informing strategies to reduce their incidence and improve patient outcomes. This study aimed to evaluate secular trends, identify causative organisms, assess resistance patterns, and determine the sources of hemodialysis-associated BSIs at Geneva University Hospitals, where Staphylococcus aureus screening and decolonization of hemodialysis patients have been implemented since the year 2000.</p><p><strong>Methods: </strong>A longitudinal cohort study was conducted using data from 2006 to 23. We included all patients receiving maintenance hemodialysis treatment at our institution. A hemodialysis-associated BSI was defined as BSI occurring during active hemodialysis treatment and diagnosed either during hospital admission or in outpatient hemodialysis unit. Outcomes included incidence rates of hemodialysis-associated BSIs, trends in causative pathogens, sources, and resistant organisms. Poisson regression was used to model trends over time of incidence rate ratios (IRR).</p><p><strong>Results: </strong>A total of 313 true BSI episodes were identified in 218 hemodialysis patients over 11,413 patient-hemodialysis months. The overall BSI incidence rate was 2.7 episodes per 100 patient-hemodialysis-months, with a consistent decrease over time. Compared to 2006-08, hemodialysis-associated BSI rates decreased by 16% in 2009-11 (IRR 0.84, 95% confidence interval [CI] 0.60-1.18), and by a maximum of 44% in 2021-23 (IRR 0.56, 95% CI 0.36-0.83). The decreasing trend was mainly due to reduced S. aureus BSIs, while Enterobacterales BSIs rates remained stable. Catheter-related BSIs accounted for 41.5% of infections (130/313), with marked reduction following 2014. BSIs caused by resistant bacteria were rare, with decreasing trends of methicillin-resistant S. aureus.</p><p><strong>Conclusions: </strong>Hemodialysis-associated BSI rates significantly declined, driven largely by reductions in S. aureus BSIs and catheter-related infections. No replacement by Gram-negative BSI was observed. Prevention of hemodialysis-associated BSI is key for reducing infection burden among hemodialysis patients.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"100"},"PeriodicalIF":4.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881916","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":"Hidden transmissions of Pseudomonas aeruginosa ST111 -the importance of continuous molecular surveillance.","authors":"Jasmin Kaur Jasuja, Eva-Maria Klupp, Martin Aepfelbacher, Knut Kurt William Kampe, Michael Fabian Nentwich, Stefan Kluge, Johannes Karl-Mark Knobloch","doi":"10.1186/s13756-025-01619-1","DOIUrl":"10.1186/s13756-025-01619-1","url":null,"abstract":"<p><strong>Background: </strong>A series of transmission of Pseudomonas aeruginosa ST111 bla_VIM-2, previously undetected by standard surveillance, was discovered in a tertiary care hospital in Northern Germany through molecular genetic monitoring. Hence, environmental sampling was initiated to find the source of infection.</p><p><strong>Methods: </strong>First, routine epidemiological data ruled out patient-to-patient transmission and two initial diagnoses were assessed as externally acquired. After the discovery of the highly related cluster by whole genome sequencing, a more detailed epidemiological analysis was carried out, including previous hospitalizations. An environmental investigation was initiated due to a possible connection of transmissions with an intensive care unit.</p><p><strong>Results: </strong>Between 2018 and 2023 16 clinical isolates of Pseudomonas aeruginosa ST111 bla_VIM-2 were identified of which 12 isolates belonged to ST111 carrying an In59-like integron. Routine whole-genome sequencing of carbapenem resistant P. aeruginosa identified a highly related cluster (maximum of three allelic differences) of high-risk ST111 isolates in ICU patients over five years, confirming sink-to-patient transmission associated to sink drains in two ICU rooms. In initial routine epidemiological categorization of these highly related isolates four isolates were categorized as possible nosocomial acquisition without direct epidemiological link to other patients, whereas two isolates were categorized as 'externally acquired'.</p><p><strong>Conclusions: </strong>This finding highlights the ability of high-risk clone ST111 to persist in hospital environments and emphasizes the importance of integrating molecular surveillance with routine epidemiology to uncover hidden transmissions. In this case, the frequent detection of the ST111 high-risk clone led to targeted environmental sampling, uncovering a prolonged outbreak that had gone unnoticed by conventional surveillance. The clone was eliminated from the ward during a reconstruction project.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"99"},"PeriodicalIF":4.4,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858817","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":"Correction: Implementing intranasal povidone-iodine in the orthopedic trauma surgery setting to prevent surgical site infections: a qualitative study of healthcare provider perspectives.","authors":"A M Racila, Erin C Balkenende, Loreen A Herwaldt, Michael C Willey, Linda D Boyken, Jean G Pottinger, Brennan S Ayres, Kimberly C Dukes, Melissa A Ward, Marin L Schweizer","doi":"10.1186/s13756-025-01621-7","DOIUrl":"10.1186/s13756-025-01621-7","url":null,"abstract":"","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"98"},"PeriodicalIF":4.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854271","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":"Incidence, clinical and genomic trends of hospital- and Non-hospital-onset KPC-producing Klebsiella pneumoniae infections before and during the COVID-19 era: a ten-year interrupted time series study.","authors":"Manuel Recio-Rufián, Teresa López-Viñau, Víctor Gálvez-Soto, Ángela Cano, Rafael Ruiz-Montero, Belén Gutiérrez-Gutiérrez, Irene Gracia-Ahufinger, Germán Peñalva, Juan Antonio Marín-Sanz, Miriam Marín-Sanz, David Segorbe, Juan Jesús Pineda-Capitán, Montserrat Muñoz-Rosa, Cristina Riazzo, Federico Giovagnorio, Elisa Ruiz-Arabi, José David Torres-Peña, Juan José Castón, Isabel Machuca, Inmaculada Salcedo-Leal, Luis Martínez-Martínez, Elena Pérez-Nadales, Julián Torre-Cisneros","doi":"10.1186/s13756-025-01614-6","DOIUrl":"10.1186/s13756-025-01614-6","url":null,"abstract":"<p><strong>Background: </strong>Infections caused by KPC-producing Klebsiella pneumoniae (KPC-KP) represent a persistent public health challenge. This prospective study examines ten-year trends, clinical features, and genomic epidemiology of hospital-onset (HOI) and non-hospital-onset (non-HOI, including healthcare-associated [HcAI] and community-acquired [CA]) KPC-KP infections following a 2012 outbreak. We evaluated the impacts of a 2014 antimicrobial stewardship program (ASP) and COVID-19-related infection prevention and control (IPC) measures, with emphasis on hospital-to-community dissemination.</p><p><strong>Methods: </strong>We analysed a prospective, longitudinal cohort of patients (2012-2022) in a tertiary referral hospital. Interrupted time series and ARIMA models assessed ASP and IPC impacts on incidence density (ID). Cross-correlation analysis explored temporal associations between HOI and non-HOI trends. Whole-genome sequencing and PERMANOVA evaluated the genomic structure of ST512/KPC-3 isolates. Multivariable regression analysed the association between infection type and clinical outcomes.</p><p><strong>Results: </strong>Among 467 patients, 33.2% had non-HOI (ID 0.53/1,000 admissions/month) and 66.8% HOI (ID 0.30, p = 0.39). Urinary tract infections predominated in non-HOI (52.9%), while bloodstream and respiratory infections were more common in HOI. Incidence density of HOI and non-HOI infections declined significantly following ASP implementation, with a 4-month lag suggesting sequential transmission dynamics. These reductions were maintained during the pandemic. Genomic data confirmed ST512/KPC-3 dominance and hospital-to-community spread, with temporal factors-rather than acquisition type-explaining genetic variation. Adjusted analyses showed similar 30-day mortality and treatment responses across HOI and non-HOI.</p><p><strong>Conclusions: </strong>ASP and COVID-19 IPC measures contributed to maintaining low KPC-KP incidence. Genomic evidence underscores the role of temporal dynamics and clonal expansion in ST512/KPC-3 dissemination. Non-HOI infections are clinically significant and require targeted, system-wide surveillance and control strategies.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"97"},"PeriodicalIF":4.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798021","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}