Antimicrobial Resistance and Infection Control最新文献

{"title":"Development of indicators to evaluate the effectiveness of antimicrobial stewardship programs in Korea: a Delphi consensus study.","authors":"Sung Min Lim, Raeseok Lee, Jinnam Kim, Ji Young Park, Choseok Yoon, Myung Jin Lee, Song Mi Moon, Yong Chan Kim, Hong Bin Kim, Se Yoon Park, Bongyoung Kim","doi":"10.1186/s13756-026-01778-9","DOIUrl":"10.1186/s13756-026-01778-9","url":null,"abstract":"<p><strong>Background: </strong>A pilot program launched in November 2024 to establish and operationalize Antimicrobial Stewardship Programs (ASPs) in Korean hospitals is expected to accelerate nationwide adoption. However, consensus on indicators for evaluating ASP performance remains lacking. This study aimed to develop indicators for evaluating the short- and long-term effectiveness of ASPs.</p><p><strong>Methods: </strong>An expert panel comprised 18 specialists from academic societies and government agencies involved in infectious diseases and antimicrobial control in South Korea. Candidate indicators for evaluating ASP effectiveness were identified by five infectious disease specialists through a systematic literature review. The Delphi survey consisted of an initial open-ended round, followed by two multiple-choice rounds (rounds 2 and 3) with an intervening online panel meeting. Responses to the multiple-choice questions were rated on a 7-point Likert scale, and indicators with a content validity ratio of ≥ 0.47 were selected.</p><p><strong>Results: </strong>The systematic literature review yielded 59 candidate indicators of ASP effectiveness, which were classified into seven primary categories. After the third-round Delphi survey, the final set of indicators included the following. In the Antibiotic Use Indicators category: (1) days of therapy per 1,000 patient-days, (2) defined daily dose per 1,000 patient-days, (3) reduction rate of broad-spectrum antibiotic use, (4) intravenous-to-oral antibiotic conversion rate, (5) reduction rate of unnecessary combination therapy, and 6) change in antibiotic prescription ratio according to the World Health Organization Access, Watch, and Reserve classification. In the Process-Related Indicators category: (1) appropriate rate of preoperative surgical antibiotic prophylaxis, (2) implementation of therapeutic drug monitoring with dosage recommendations, and (3) establishment of institutional antibiotic use guidelines. In the Department-Specific Indicators related to operating rooms and surgery: (1) appropriate rate of preoperative surgical antibiotic prophylaxis, (2) appropriateness of postoperative antibiotic discontinuation timing, and (3) appropriateness of prophylactic antibiotic selection. Finally, among the Other Indicators, the implementation rate of core ASP elements was selected as an indicator for evaluating ASP effectiveness.</p><p><strong>Conclusions: </strong>This study established consensus-based indicators and proposed short- and long-term targets for evaluating the effectiveness of ASPs in Korea. These indicators enable standardized assessment and help inform evidence-based policies for the sustainable operation of ASPs.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257131","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":"Audit of the prescription of antimicrobials using the four moments of decision tool in a university hospital.","authors":"Amanda Magalhães Vilas Boas Cambiais, Vanusa Barbosa Pinto, Andréa Cassia Pereira Sforsin, Luiz Marcelo Sa Malbouisson, Arnaldo Lichtenstein, Nelson De Luccia, Aleia Faustina Campos, Ícaro Boszczowski, Silvia Figueiredo Costa, Thaís Guimarães","doi":"10.1186/s13756-026-01761-4","DOIUrl":"10.1186/s13756-026-01761-4","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance is a growing global threat driven by inappropriate antimicrobial use. The Four Moments of Antibiotic Decision Making is a stewardship framework that promotes rational antibiotic use. This study applied this framework to audit antimicrobial prescribing, assess adherence, and measure antimicrobial use.</p><p><strong>Methods: </strong>We conducted a retrospective, cross-sectional audit of patients who received systemic antimicrobials between October and November 2023. The four audited moments included: (1) indication, suspected site, and clinical evidence of infection; (2) antimicrobial selection and culture collection; (3) reassessment between days 3 and 5 based on clinical response and culture results; and (4) treatment duration. Antimicrobial consumption was measured using days of therapy (DOT), length of therapy (LOT) and the WHO AWaRe classification.</p><p><strong>Results: </strong>A total of 228 patients (53.5% male; mean age 57 years) received 304 antimicrobial treatments, including 129 intensive care units (ICU) admissions. 75.0% were fully adherent to all Four Moments. Adherence rates across moments 1 to 4 were 97%, 88.8%, 89.3%, and 87.1%, respectively. In moment 2, cultures were indicated in 201 treatments but not requested in 15% of cases. Vancomycin was the most prolonged treatment, followed by ceftriaxone, piperacillin-tazobactam, and meropenem. Antimicrobial use was higher in ICUs, with DOT and LOT reaching 739 and 706 per 1,000 patient-days, respectively, compared with 496 and 319 in the wards. Most antimicrobial consumption corresponded to WHO AWaRe Watch antibiotics.</p><p><strong>Conclusions: </strong>Adherence to stewardship principles was high, although opportunities for improvement remain, particularly regarding culture collection and treatment duration optimization.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238403","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":"A non-inferiority trial comparing manual and automated high-level disinfection for reprocessing of transabdominal and transvaginal ultrasound probes.","authors":"Hannah Siwe, Maryse Van Landegem, Shari De Vriese, Astrid Luypaert, Merima Hecimovic, Steven Weyers, Isabelle Dehaene, Erik Van Laecke, Philip Meuleman, Piet Cools","doi":"10.1186/s13756-026-01777-w","DOIUrl":"10.1186/s13756-026-01777-w","url":null,"abstract":"<p><p>Manual chemical methods are commonly used for ultrasound probe disinfection but are known to be operator dependent and subject to variability. Automated ultraviolet-C (UV-C) light-emitting diode (LED) disinfection represents a chemical and mercury free alternative, however, clinical evidence comparing UV-C LED to conventional disinfectants for high-level disinfection of ultrasound probes remains limited. In this single-centre non-inferiority study conducted in the departments of gynaecology, obstetrics and urology of a Belgian university hospital, automated UV-C LED disinfection was compared to manual chlorine dioxide disinfection for the reprocessing of transabdominal and transvaginal ultrasound probes. Following clinical use, probes were decontaminated by healthcare practitioners alternating between both reprocessing methods. Samples were collected after treatment and processed for microbial analysis to assess the effectiveness of the decontamination process. A total of 296 probes were included, comprising 86 transabdominal and 210 transvaginal probes. UV-C LED disinfection achieved effectiveness rates of 92.86% for transabdominal probes and 97.17% for transvaginal probes, compared with 79.49% and 93.27%, respectively for chlorine dioxide disinfection. Positive samples following UV-C disinfection yielded single colonies whereas chlorine dioxide treated probes showed greater variability in colony counts and species diversity. Although the total reprocessing time for UV-C disinfection was longer, manual handling times were comparable between both methods. Here, we demonstrated that UV-C LED disinfection was non-inferior to chlorine dioxide disinfection for reprocessing of transabdominal and transvaginal ultrasound probes under routine conditions.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148222641","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":"Passive sampling of hospital wastewater as a promising warning signal for Candidozyma auris in a low-prevalence setting: a proof-of-concept study.","authors":"Anne H Verkerk, Marlies Mulder, Erik V H Beuken, Christian J H von Wintersdorff, Remy P S Schilperoort, Paul H M Savelkoul, Lieke B van Alphen","doi":"10.1186/s13756-026-01773-0","DOIUrl":"10.1186/s13756-026-01773-0","url":null,"abstract":"<p><strong>Background: </strong>Candidozyma (Candida) auris is an opportunistic fungal pathogen with increasing worldwide prevalence. As it can spread quickly in healthcare settings, monitoring C. auris is essential for effective infection control. Current hospital surveillance of C. auris often focuses on screening high-risk patients, as prevalence in the Netherlands is low. Wastewater-based surveillance may provide a complementary approach by capturing signals from all hospital inpatients, but this commonly relies on expensive automated water samplers. This study examined the feasibility of using lower-cost, easily deployable passive samplers to detect C. auris in hospital wastewater of a low-prevalence setting.</p><p><strong>Methods: </strong>Ten passive samplers containing one cotton bud, one piece of medical gauze, and two electronegative membrane filters were deployed for 24 h during a 16-week period in whole-hospital wastewater. Samplers were installed before, during, and after admission of a patient colonized with C. auris. DNA was extracted using a combination of phenol-chloroform and bead-beating, and C. auris presence was assessed by real-time polymerase chain reaction (RT-PCR).</p><p><strong>Results: </strong>One patient was sampled during two separate admission periods and was identified as C. auris-colonized based on the detection of C. auris DNA in multiple specimens at both time points. The load of the clinical specimens decreased from a cycle threshold (Ct) value of 27.9 to 34.4 at second sampling. Hospital wastewater was C. auris negative before patient admission, low positive throughout patient stay, with average Ct-values of passive materials ranging from 33.2 to 38.0, and returned to negative after patient discharge.</p><p><strong>Conclusion: </strong>Our findings highlight the possibility to detect C. auris in a passive sampler wastewater-based RT-PCR screening in a low-prevalence country during admission of a C. auris-positive patient. Although further studies are required, this proof-of-concept study identified passive wastewater sampling as potential C. auris-surveillance tool. This low-cost method may eventually complement existing risk-based strategies and provide warning signals to prevent C. auris transmission within the hospital.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148222673","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":"Hand hygiene opportunities and consumption of alcohol-based handrub across nursing homes of canton of Vaud, Switzerland.","authors":"Emmanouil Glampedakis, Coralie Riccio, Firmino Battistella, Patricia Cuiña Iglesias, Francisco-Javier Garcia Sanchez, Marie-Catherine Snoussi, Béatrix Sobgoui, Marie Immaculée Nahimana Tessemo","doi":"10.1186/s13756-026-01776-x","DOIUrl":"10.1186/s13756-026-01776-x","url":null,"abstract":"<p><strong>Background: </strong>Optimal hand hygiene (HH) is necessary to prevent healthcare-associated infections among nursing home (NH) residents. We aimed to quantify the number of HH opportunities per resident-day in NHs and assess institutions' alcohol-based hand rub (ABHR) consumption based on the HH needs of their population.</p><p><strong>Methods: </strong>Cross-sectional study between 2022 and 2024 with the participation of 117 NHs (95%) and a random sample of 1633 residents. For each resident we accessed the daily care schedule, attributed 2-4 HH opportunities per nursing activity and collected the care dependency score. We estimated the average number of HH opportunities per resident-day across NHs using linear mixed-effects modeling. We also compared theoretical and observed ABHR consumption on an institutional level.</p><p><strong>Results: </strong>The average amount of HH opportunities was 21.65 per resident-day and the need was highly dependent on the care dependency score (β = 2.93; 95% confidence interval: 2.77-3.10, p < 0.01). Median ABHR was 9.43 L per 1000 resident-days. Overall, across all institutions ABHR consumption was 24% of the expected as most institutions consumed up to 25% of the expected amount of ABHR.</p><p><strong>Conclusions: </strong>In this setting, HH opportunities are higher than previously assumed and significantly associated with care dependency. Most NHs perform poorly and should be prioritized in HH improvement actions like education and auditing with direct feedback.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148222620","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 cleaning and disinfection practices for respiratory viruses in hospitals and long-term care facilities in the Netherlands.","authors":"Laura M Orsel, Jeroen J A van Kampen, Bart L Haagmans, Marion P G Koopmans, Cynthia P Haanappel, Laura van Buul, Karin Ellen Veldkamp, Rosa van Mansfeld, Marjolein Knoester, Mariëtte Lokate, Andreas Voss, Herbert J de Jager, Edmée C Bowles, Anne F Voor In 't Holt, Juliëtte A Severin","doi":"10.1186/s13756-026-01775-y","DOIUrl":"10.1186/s13756-026-01775-y","url":null,"abstract":"<p><strong>Background: </strong>In 2025, five years after the start of the COVID-19 pandemic, international healthcare guidelines continued to recommend cleaning and disinfecting surfaces in a room after a COVID-19 patient is discharged. Meanwhile, in March 2023, the Dutch guidance document was updated to recommend cleaning only. Our aim was to determine cleaning and disinfection practices in Dutch hospitals and long-term care facilities (LTCF) concerning SARS-CoV-2, compare these to practices during the first COVID-19 wave, and explore whether they differ for other respiratory viruses.</p><p><strong>Methods: </strong>In June 2023, a web-based survey in the Dutch language was developed and distributed among infection prevention and control professionals from hospitals and LTCF across the Netherlands. The survey included questions about cleaning and disinfection practices for SARS-CoV-2, influenza and respiratory syncytial virus (RSV) at that moment, and during the first COVID-19 wave.</p><p><strong>Results: </strong>In total, 95 responses were analysed from academic hospitals (n = 7), non-academic hospitals (n = 56), and LTCF (n = 32). Between June 2023 and February 2024, half of the institutions applied a cleaning-only strategy. Hospitals most commonly used damp microfiber cloths. The institutions that applied cleaning and disinfection used a variety of disinfectants. Hospitals had largely changed their disinfectant since the first COVID-19 wave. Cleaning and disinfection strategies for influenza and RSV largely corresponded with those applied for SARS-CoV-2.</p><p><strong>Conclusions: </strong>Despite a cleaning-only recommendation in the national guidance document, half of the institutions still applied disinfection. This highlights the need for clear and consistent guidelines on cleaning and disinfection, including setting-specific adaptation and implementation strategies.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216118","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":"Multidrug-resistant organism carriage in Vietnamese district hospitals before and after an antimicrobial stewardship intervention.","authors":"Jaslyn Doshi, Thai Duy Pham, Yen Ngoc Pham, Thuy Thu Ma, Linh Thuy Duong, Qingbin Li, Thanh Ha Nguyen, Matthew Watts, Jon Iredell, Thu Anh Nguyen, Hoang Huy Tran, Greg J Fox, Annaleise R Howard-Jones","doi":"10.1186/s13756-026-01752-5","DOIUrl":"10.1186/s13756-026-01752-5","url":null,"abstract":"<p><strong>Introduction: </strong>Antimicrobial resistance is a critical global health challenge, with Southeast Asia identified as a hotspot of multidrug-resistant organism (MRO) carriage in hospitalised patients and the general population. This study aimed to estimate the prevalence of gastrointestinal and nasal MRO carriage among district hospital inpatients in Vietnam and assess changes following an antimicrobial stewardship (AMS) intervention.</p><p><strong>Methods: </strong>Two repeated cross-sectional prevalence surveys were conducted among inpatients at four district hospitals in Vietnam (two urban hospitals in Hanoi and two rural hospitals in Ca Mau). The baseline survey was undertaken immediately prior to implementation of a 6-month AMS intervention (March 2022), and the post-intervention survey was conducted during the final 2 weeks of the intervention (August 2022). The intervention bundle comprised establishing hospital AMS committees and teams, implementing antimicrobial prescribing guidelines, healthcare worker education, and regular antimicrobial prescribing audits with feedback to clinicians. Carriage of extended spectrum β-lactamase (ESBL)-producing Enterobacterales and carbapenemase-producing Enterobacterales (CPE) was determined from stool or rectal swabs, and methicillin-resistant Staphylococcus aureus (MRSA) carriage using nasal swabs. MROs were characterised using phenotypic antimicrobial susceptibility testing and molecular analyses. A participant questionnaire assessed demographic, behavioural and healthcare-related risk factors. Pre- and post-intervention prevalence estimates were compared using two-proportion tests. Mixed-effects binary regression models were used to identify risk factors for ESBL-producing Enterobacterales carriage.</p><p><strong>Results: </strong>A total of 402 participants (ages 18-99 years, M:F 176:226) provided nasal swabs and rectal or stool samples across both surveys. Participant demographics differed modestly between surveys. Overall, 76.1% of participants carried Enterobacterales isolates harbouring bla_CTX-M (ESBL) genes, while carriage of representative CPE (2.7%) and MRSA (3.0%) were low. Risk factors for ESBL-producing Enterobacterales carriage included female sex, older age, recent antibiotic use, smoking and admission to an urban hospital. The prevalence of ESBL-producing Enterobacterales and CPE were unchanged following the AMS intervention. MRSA carriage decreased from 5 to 1% following the intervention [- 4.0%, 95% CI - 7.2%, - 0.7%).</p><p><strong>Conclusion: </strong>ESBL-producing Enterobacterales carriage was highly prevalent among inpatients in four Vietnamese district hospitals, while CPE and MRSA carriage remained low. A 6-month AMS intervention was associated with a modest reduction in MRSA carriage but no change in ESBL-producing Enterobacterales or CPE carriage.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216055","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":"Increasing burden of Clostridioides difficile infection in Spain: nationwide trends in hospitalisations, 2016-2023.","authors":"Yolanda Ortega-López, Jesús Molina-Cabrillana, Marco Antonio Sempere-Alcocer, Rosa López-Gigosos","doi":"10.1186/s13756-026-01774-z","DOIUrl":"10.1186/s13756-026-01774-z","url":null,"abstract":"<p><strong>Background: </strong>Clostridioides difficile infection (CDI) is a major cause of morbidity and mortality worldwide. In Spain, the epidemiology of Clostridioides difficile infection remains insufficiently characterised due to the limited availability of epidemiological data.</p><p><strong>Aim: </strong>To provide a comprehensive national description of the incidence, temporal trends and epidemiological characteristics of CDI in Spain from 2016 to 2023.</p><p><strong>Methods: </strong>A nationwide retrospective observational study was conducted, using the Spanish Hospital Discharge Database (RAE-CMBD). Annual incidence rates were calculated per 10,000 hospital admissions at national and autonomous community (AC) levels, by sex and age group. Temporal trends were assessed using Kendall's tau. CDI cases were classified according to timing of onset as present on admission or hospital-onset.</p><p><strong>Results: </strong>A total of 81,487 CDI -related hospitalisations were identified. National incidence increased steadily from 15.6 to 31.4 cases per 10,000 admissions between 2016 and 2023, showing a significant upward trend. The highest burden was observed among patients aged ≥ 75 years. Overall, 72% of CDI cases were present at hospital admission, while 28% were hospital-onset. Hospital-onset CDI was associated with higher in-hospital mortality compared with cases present on admission (13.8% vs 10.7%).</p><p><strong>Conclusion: </strong>The incidence of Clostridioides difficile infection diagnosed in Spanish hospitals showed a substantial increase over the study period. Despite the study's limitations, these results reinforce the importance of antimicrobial stewardship and infection prevention programmes across all levels of healthcare settings to reduce the impact of CDI.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203787","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":"A prospective, observational, cost of implementation analysis for the National Infection Surveillance Program for Aged Care (NISPAC).","authors":"Natasha Brusco, Sara Whittaker, Karin Thursky, David Dunt, Janet K Sluggett, Ann Bull, Leon J Worth, Noleen Bennett","doi":"10.1186/s13756-026-01722-x","DOIUrl":"10.1186/s13756-026-01722-x","url":null,"abstract":"<p><strong>Background: </strong>The National Infection Surveillance Program for Aged Care (NISPAC) is a new standardised and streamlined infection and antimicrobial use surveillance tool for Australian Residential Aged Care Homes (RACHs). As a part of the program development and implementation, it was identified that the cost of NISPAC implementation in Australian RACHs was currently unknown, and the objective of this study was to determine this cost from the perspective of the Australian Aged Care setting.</p><p><strong>Methods: </strong>The cost of implementation included those of the three coordinating bodies, as well as the individual RACHs who participated in the NISPAC program implementation. Development and implementation resources and costs for the coordinating bodies were determined over a 3 year period and then attributed equally across the participating RACHs. Participating RACHs (n = 69) reported the resources and cost of NISPAC implementation over a 5 month period, and this included salary and non-salary costs (2 months pre-implementation and 3 months of implementation). Costs for the participating RACHs were added to the costs of the coordinating bodies to determine the total cost per RACH. The price year for the analysis was 2024.</p><p><strong>Results: </strong>The total implementation cost for the three coordinating bodies was $AUD1,869,279, resulting in a mean cost attributed per RACH of $AUD27,091 (SD $AUD0). The mean cost of RACH staff time for the intervention during the pre-implementation planning phase was $276.18 (SD $AUD219.55), and during the implementation phase was $AUD1,146.47 ($AUD1,003.48). The mean cost of NISPAC implementation per RACH was $AUD28,805 (SD $AUD1,137).</p><p><strong>Conclusion: </strong>The novel NISPAC was a relatively low-cost infection and antimicrobial use surveillance program to implement in RACHs. Future studies are required to establish the cost-effectiveness of the program.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"15 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161607","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":"Long-term dissemination of NDM-producing Enterobacterales in two French hospitals (2020-2024): outbreak complexity and the role of drains as environmental reservoirs.","authors":"G Ménard, D Huart, K Le Carrour-Quéré, F Gourmelen, A Morin Le Bihan, F Guérin, L Dortet, R A Bonnin, V Cattoir, Cécile Emeraud","doi":"10.1186/s13756-026-01766-z","DOIUrl":"10.1186/s13756-026-01766-z","url":null,"abstract":"<p><strong>Background: </strong>Carbapenemase-producing Enterobacterales (CPE) represent a major public health threat, particularly in healthcare settings where long-term outbreaks may be sustained by environmental reservoirs. In France, although OXA-48-like enzymes remain predominant, NDM-producing Enterobacterales are increasingly reported, notably among Enterobacter cloacae complex (ECC) and Citrobacter freundii complex (CFC). The contribution of hospital drainage systems to the persistence of such outbreaks remains insufficiently characterised.</p><p><strong>Methods: </strong>We conducted a five-year genomic and epidemiological investigation (2020-2024) of NDM-producing ECC and CFC in two hospitals in western France. Clinical and environmental isolates were analysed using whole-genome sequencing to assess clonality, resistance profiles and plasmid structures. Fourier-transform infrared spectroscopy was used to compare additional environmental and clinical isolates. Targeted environmental control bundles, including replacement with valve drains, daily bleaching and steam-based sanitization, were implemented and evaluated.</p><p><strong>Results: </strong>Fifty-one patients were identified as carriers or infected with NDM-producing ECC or CFC. Two clonal outbreaks were documented: Enterobacter xiangfangensis ST111, persisting in both hospitals over four years (n = 34), and Citrobacter portucalensis ST408, responsible for a shorter outbreak in one hospital (n = 7). Whole-genome sequencing confirmed clonal transmission without evidence of plasmid-mediated spread between species. Environmental sampling repeatedly identified E. xiangfangensis ST111 in drains, including sink and shared shower drains, over time, demonstrating sustained environmental persistence despite reinforced infection prevention and control measures.</p><p><strong>Conclusions: </strong>Our findings demonstrate that hospital drainage systems can act as long-term reservoirs sustaining the transmission of NDM-producing Enterobacterales. Standard infection control measures alone may be insufficient to control such outbreaks. Targeted environmental interventions should be systematically integrated into infection prevention strategies to limit the spread of highly resistant organisms.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155107","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}