Antimicrobial Resistance and Infection Control最新文献

{"title":"Assessing barriers and opportunities for the improvement of laboratory performance and robust surveillance of antimicrobial resistance in Nigeria- a quantitative study.","authors":"Obiageli J Okolie, Sanda U Ismail, Uzoma Igwe, Emmanuel C Adukwu","doi":"10.1186/s13756-025-01530-9","DOIUrl":"https://doi.org/10.1186/s13756-025-01530-9","url":null,"abstract":"<p><strong>Background: </strong>Good quality data is essential in optimising containment strategies for antimicrobial resistance, a global public health threat estimated to cause around 10 million deaths yearly and up-to 5% loss in GDP by 2050 if left unaddressed. The laboratory system plays an important role in the collection of high-quality data as well as ensuring validity, reliability and timeliness of data. However, in many low-medium income countries including Nigeria, the technical capacity of the laboratory for fulfilling these responsibilities is unknown. This paucity of information limits piloting of strategies to complement existing surveillance and planning improvement of subsequent laboratory iterations into the surveillance system. The focus of this study was to assess the gaps, vulnerabilities and enablers of laboratory strengthening processes in the scope of technical capacity for clinical and public health functions and to provide a roadmap for improved surveillance of antimicrobial resistance in Nigeria.</p><p><strong>Methods: </strong>A cross-sectional study design utilising structured questionnaire administered online via Qualtrics and reported in accordance with strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Data analysis involved descriptive and inferential statistics as well as bivariate and multivariate logistics to test predictive analysis of relationship between variables.</p><p><strong>Results: </strong>A total of 302 laboratories completed the questionnaire, 107 (53.4%) government laboratories and 195 (64.6%) private sector laboratories. 18.2% reported excellent knowledge, 25.5% has excellent capacity, 7.3% are fully ready for surveillance, 12.3% are participating in some surveillance, and 1.0% record important microbiological data that correlates with epidemiological information.</p><p><strong>Conclusion: </strong>Tertiary laboratories reported highest performance across all surveillance quality indicators (SQIs). AMR surveillance is skewed toward government and tertiary laboratories, leaving lower-level and rural facilities underutilized despite their potential. This results in missing community-level data and undermines the representativeness of surveillance. The study identifies gaps in recruitment, assessment, and oversight but also offers strategies to address these issues.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"29"},"PeriodicalIF":4.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061949","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":"Clarithromycin-resistant Helicobacter pylori in Africa: a systematic review and meta-analysis.","authors":"Komla Mawunyo Dossouvi, Tchilabalo Bouyo, Simon Sognonnou, Ephraim Ehidiamen Ibadin, Lu-Chao Lv, Bissoume Sambe Ba, Abdoulaye Seck, Sika Dossim, Fábio Parra Sellera, Makhtar Camara, Amr El Kelish, Stella Ifeanyi Smith","doi":"10.1186/s13756-025-01533-6","DOIUrl":"https://doi.org/10.1186/s13756-025-01533-6","url":null,"abstract":"<p><strong>Background: </strong>In 2022, approximately 56.5% of adults and 47.1% of children and adolescents were affected by Helicobacter pylori (H. pylori) infection in Africa, and clarithromycin-resistant H. pylori (CRHp) strains have become global priority pathogens. Therefore, this study aimed to conduct the first comprehensive systematic review and meta-analysis of CRHp in Africa.</p><p><strong>Methods: </strong>This investigation was conducted according to the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (The PRISMA 2020). Literature search of electronic databases (Google Scholar, African Journals Online, ResearchGate, PubMed, Embase, and Scopus) was performed using keywords \"clarithromycin\", \"Helicobacter pylori\", \"African country name\", \"mutation in the 23S rRNA\".</p><p><strong>Results: </strong>Sixty-five studies involving 5,313 H. pylori strains isolated over 26 years (1997-2022) from 23 African countries were included in this study. The samples from which CRHp was isolated included gastric biopsy (60/63; 95%), and stool (4/63; 6%). The pooled prevalence of CRHp in Africa was 27% (95% CI: 22, 33). There was a steady trend in the prevalence of CRHp isolated in Africa over the 26 years (R² = 0.0001, p = 0.92, slope coefficient of -0.05x). Ten types of 23S rRNA mutations (conferring clarithromycin resistance) were identified, and included mainly A2143G (465 H. pylori strains out of 1178 tested) and A2142G (344 H. pylori strains out of 1027).</p><p><strong>Conclusion: </strong>To enhance the accuracy and validity of surveillance data for H. pylori in Africa, there is an urgent need for implementing standardized microbiological methods for resistance detection. The prevalence of CRHp reported in this study was very similar to the overall global prevalence and there is a need for more representative studies on CRHp in Africa. While waiting for this, the treatment of H. pylori infections must be based on the guidelines of the AHMSG first Lagos consensus.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"31"},"PeriodicalIF":4.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962394","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":"Associations between hospital structure, infection control and incidence of hospital-acquired viral respiratory infections: a 10-year surveillance study.","authors":"Costa Salachas, Quentin Le Hingrat, Skerdi Haviari, Audrey Valdes, Vincent Mackiewicz, Isabelle Lolom, Nadhira Fidouh, Benoît Visseaux, Donia Bouzid, Diane Descamps, Jean-Christophe Lucet, Charlotte Charpentier, Solen Kernéis","doi":"10.1186/s13756-025-01543-4","DOIUrl":"https://doi.org/10.1186/s13756-025-01543-4","url":null,"abstract":"<p><strong>Background: </strong>Protecting patients from hospital-acquired viral respiratory infections is a major challenge, but the hierarchy of measures to achieve this is not yet completely clear.</p><p><strong>Aim: </strong>To describe the epidemiology of hospital-acquired viral respiratory infections and associations with structural hospital factors and adherence to infection control protocols.</p><p><strong>Methods: </strong>Retrospective cohort study conducted over 10 consecutive years (2014-2023) within 27 hospital wards in a 900-bed university hospital in Paris, France. All hospitalized adult patients who were tested for at least one virus on a respiratory sample during their stay were included. Structural factors (percentage of double occupancy rooms) and adherence to infection control protocols by healthcare workers (measured by consumption of alcohol-based hand sanitizer and of facemasks) were included as predictors in the model.</p><p><strong>Main outcome and measure: </strong>Incidence of hospital-acquired viral respiratory infections, defined by a positive PCR test for at least one respiratory virus, performed at least 5 days after hospital admission. Data were analyzed on ward-year aggregated data, with a linear mixed-effects model.</p><p><strong>Findings: </strong>Overall, 183 994 viral PCR tests were performed over the study period. Incidence of hospital-acquired viral respiratory infections was 0.57/1000 hospital-days. After adjustment on other factors (mean length of stay, use of PCR testing), incidence of hospital-acquired viral respiratory infections in a given ward was significantly associated with: the incidence of community-acquired viral respiratory infections among patients admitted to the ward (+ 0.10/1000 hospital-days per each additional point of incidence; P < 0.001), the number of double-occupancy rooms (+ 0.04/1000 hospital-days per each 10%-increase of double-occupancy rooms; P = 0.03) and masks consumption (+ 0.33/1000 hospital-days per 10 additional masks used per day; P = 0.04). Similar results were found for double-occupancy rooms (+ 0.01/1000 hospital-days per each 10%-increase of double-occupancy rooms; P = 0.012) in the sub-group analysis of influenza cases.</p><p><strong>Conclusion: </strong>In a given hospital ward, the incidence of community-acquired cases and the proportion of double-occupancy rooms are independently associated with the incidence hospital-acquired viral respiratory infections.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"28"},"PeriodicalIF":4.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957771","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":"Successful termination of a multi-year wastewater-associated outbreak of NDM-5-carrying E. coli in a hemato-oncological center.","authors":"Heidrun Kerschner, Linda Jernej, Adriana Cabal, Patrick Hyden, Sigrid Machherndl-Spandl, Lucia Berning, Anna Blaimschein, Werner Ruppitsch, Petra Apfalter, Rainer Hartl","doi":"10.1186/s13756-025-01539-0","DOIUrl":"10.1186/s13756-025-01539-0","url":null,"abstract":"<p><strong>Background: </strong>In May 2018, an outbreak of NDM-5-carrying Escherichia coli (NDM-5-EC) was detected at the hemato-oncology department of a tertiary care center in Austria. This report details the outbreak investigation, control measures and the whole genome sequencing (WGS) data of the outbreak isolates.</p><p><strong>Methods: </strong>A total of 15 isolates (seven clinical isolates from allogenic stem cell transplant (SCT) recipients and eight wastewater isolates recovered from patients' toilets) were analyzed by whole genome sequencing.</p><p><strong>Results: </strong>Genome based typing identified two clusters of the high risk clones ST167/CT12607 and ST617/CT2791. Long-read sequencing of selected isolates from both clusters identified two different plasmids, however with a highly similar genetic context of the bla_NDM-5 containing region. Genomic analysis revealed the presence of additional resistance genes, including bla_CTX-M-15, and bla_OXA-1, and virulence factors. Four patients were colonized with NDM-5-EC, two patients suffered bacteremia caused by the outbreak strain and two deaths were associated with an NDM-5-EC infection. The outbreak source was traced to toilet sewage pipes, which remained persistently contaminated despite extensive cleaning and disinfection. Successful eradication of NDM-5-EC from the installations required disassembly, hot water pressure washing of the sewage pipes and complete replacement of all movable parts. Additionally, colonized patients were instructed to use wheeled commodes instead of toilets, and a pre-admission screening strategy was implemented for all patients undergoing hematologic stem cell transplantation. The outbreak was successfully terminated in November 2020.</p><p><strong>Conclusion: </strong>NDM-5-EC, especially high-risk clones such as ST167 and ST617, can persist in hospital wastewater systems despite cleaning and disinfection efforts and can cause prolonged outbreaks. Therefore, a comprehensive bundle of interventions like the ones applied in our study is essential, especially in clinical settings with heavily immunosuppressed patients.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"27"},"PeriodicalIF":4.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794547","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":"Implementation of hospital antimicrobial stewardship programmes in low- and middle-income countries: a qualitative study from a multi-professional perspective in the Global-PPS network.","authors":"Ines Pauwels, Ann Versporten, Diane Ashiru-Oredope, Silvia Figueiredo Costa, Herberth Maldonado, Ana Paula Matos Porto, Shaheen Mehtar, Herman Goossens, Sibyl Anthierens, Erika Vlieghe","doi":"10.1186/s13756-025-01541-6","DOIUrl":"10.1186/s13756-025-01541-6","url":null,"abstract":"<p><strong>Background: </strong>Hospitals in low- and middle-income countries (LMIC) face context-specific challenges in implementing antimicrobial stewardship (AMS) programmes. The Global Point Prevalence Survey (Global-PPS) project has established a network of hospitals across 90 countries, using point prevalence surveys to monitor antimicrobial use and guide AMS activities. However, little is known about AMS implementation in these hospitals. Using qualitative research, we aim to explore the implementation process in LMIC hospitals within the Global-PPS network and the factors influencing it, identify potential implementation strategies, and evaluate the role of Global-PPS in this process.</p><p><strong>Methods: </strong>A qualitative study was conducted using semi-structured online interviews with healthcare workers (HCWs) involved in AMS in LMIC hospitals within the Global-PPS network. Participants were selected using a combination of convenience and purposive sampling and included clinicians, microbiologists, pharmacists, and nurses. Interviews followed a topic guide based on the integrated checklist of determinants of practice (TICD Checklist). Transcripts were analysed using a combination of inductive and deductive thematic analyses.</p><p><strong>Findings: </strong>Twenty-two HCWs from 16 countries were interviewed. Hospitals were in different stages of the AMS implementation process at the time of the study, from pre-implementation to institutionalisation of AMS as part of the continuous quality improvement process. While the Global-PPS provided a valuable tool for education and implementation, contextual barriers often hindered the translation of findings into targeted interventions. Four themes influenced AMS implementation, \"institutional support and resource allocation\", \"AMS team functioning, roles, and expertise\", \"adoption and integration of AMS recommendations\", and \"data-driven decision-making\" as a cross-cutting theme. Key determinants included AMS team competencies, multidisciplinary teams, sustainable funding and leadership support, diagnostic capacity, and reliable data to inform interventions. We also identified various strategies employed by local AMS teams to enhance implementation.</p><p><strong>Conclusions: </strong>This study examines AMS implementation in LMIC hospitals in the Global-PPS network and identifies key determinants. AMS teams address challenges through task shifting, local engagement and ownership. While empirical evidence on the effectiveness of these strategies is limited, these insights can guide future AMS interventions and studies within LMIC hospitals. Strengthening AMS requires bridging the gap between measurement and action and expanding research on behaviour change.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"26"},"PeriodicalIF":4.8,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787501","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":"Enhancing antimicrobial resistance surveillance and research: a systematic scoping review on the possibilities, yield and methods of data linkage studies.","authors":"S A M van Kessel, C C H Wielders, A F Schoffelen, A Verbon","doi":"10.1186/s13756-025-01540-7","DOIUrl":"10.1186/s13756-025-01540-7","url":null,"abstract":"<p><strong>Background: </strong>Surveillance data on antimicrobial resistance (AMR) determinants such as antibiotic use, prevalence of AMR, antimicrobial stewardship, and infection prevention and control are mostly analysed and reported separately, although they are inextricably linked to each other. The impact of surveillance and research can be enhanced by linking these data. This systematic scoping review aims to summarize the studies that link AMR data and evaluate whether they yield new results, implications, or recommendations for practice.</p><p><strong>Methods: </strong>For this review, data linkage is defined as the process of linking records, from at least two independent data sources on either (I) at least two AMR determinants or (II) one AMR determinant and one or more general population characteristics. Data linkage should be performed on the level of a certain entity which, in the context of this review, can encompass persons, healthcare institutes, geographical regions or countries. A systematic literature search was performed on February 7th 2025 in Embase.com, PubMed and Scopus to identify AMR data linkage studies.</p><p><strong>Results: </strong>Forty-eight articles were included in our review. Most data linkage studies used two data sources, and most studies were published in the last 5 years (n = 23 in 2020-2024). A predominance of studies linked data on geographical location, and thirteen studies linked data on individual patient level. Findings demonstrate that the majority of studies (43/48) had added value and provided recommendations for clinical practice and future policies or had suggestions for further research and surveillance. Additionally, data linkage studies appeared to be suitable for hypothesis generating. Several limitations were identified. Most studies had ecological designs, which are prone to ecological fallacy and unobserved confounding, making it hard to establish causality.</p><p><strong>Conclusion: </strong>This systematic scoping review showed that AMR data linkage studies are increasingly performed. They have potential to gain a more comprehensive understanding of AMR dynamics by generating hypotheses, assisting in optimisation of surveillance, and interpretation of data in the context of guideline/policy development. To increase the added value of data linkage, more studies should be performed to improve knowledge on methodological approaches, data access, data management, and governance issues.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"25"},"PeriodicalIF":4.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741850","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-associated bloodstream infections caused by bacterial and fungal contamination of intravenous fluids and medicines in healthcare facilities in low- and middle-income countries: a scoping review.","authors":"Jemima Nyandwaro, Peter Hyland, Raffaella Ravinetto, Jan Jacobs","doi":"10.1186/s13756-025-01536-3","DOIUrl":"10.1186/s13756-025-01536-3","url":null,"abstract":"<p><strong>Introduction: </strong>We reviewed culture-confirmed healthcare-associated outbreaks linked to bacterial and fungal contamination of intravenous fluids and medicines (further \"infusates\") in low-income countries and lower and upper middle-income countries (LIC, Lower-MIC and Upper-MIC). We assessed the scope, impact, risks, and gaps in knowledge.</p><p><strong>Methodology: </strong>Literature search including PubMed, Web of Science, Worldwide Database for Nosocomial Outbreaks, Global Health, and Google Scholar. National essential medicine lists (NEMLs) of sub-Saharan countries were searched for listing of pediatric infusates.</p><p><strong>Results: </strong>Between 1975 and 2023, 50 articles were retrieved. Median (range) number of patients affected was 12 (3-185); 74.2% (761/1025) of all patients affected were children. All patients presented with bloodstream infections; median case fatality ratio was 21.1% (0.0-87.5%). Upper-MIC, Lower-MIC and LIC accounted for 21, 25 and 4 articles, respectively. Most frequently affected wards were neonatal and adult intensive care units (19 and 6 articles). The 50 articles revealed 59 contaminated infusates: IV fluids (n = 37), including TPN (n = 10, of which 8 were from Upper-MIC), and IV medicines (n = 22), comprising amongst others propofol (n = 4) and Water for Injection (n = 3). The 63 isolates included Enterobacterales (46.0% (29/63) of isolates), non-fermentative Gram-negative bacteria (NFGNB, 47.6% (30/63)), fungi (4.8%, 3/63)) and Bacillus circulans (1.6% (1/63)). Among the Enterobacterales, the genera Serratia, Klebsiella, and Enterobacter represented 82.8% (24/29) of isolates. Burkholderia cepacia was the most frequent NFGNB (53.3% (16/30) isolates). Excluding TPN, 18 IV fluids and 7 IV medicines (representing half (51.0%, (25/49) of these infusates) were incorrectly used as multidose vial. A third (33.9%, 20/59) of infusates in 40.0% (20/50) of articles was intrinsically contaminated. In LIC and LMIC, staff in neonatology units turned to in-ward preparation of infusates because of lack of access to pediatric IV formulations and sizes. Less than a third (31.8%, 18/44) of the NEMLs listed neonatal IV premixtures.</p><p><strong>Conclusion: </strong>Infusate contamination is a serious, underreported risk especially for children in LICs and Lower-MIC. Outstanding issues are access to pediatric infusates and preventing in-ward preparation of IV medicines in LIC and Lower-MIC, and safe preparation and administration of TPN in Upper-MIC.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"24"},"PeriodicalIF":4.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741853","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 of a strain-specific PCR as a diagnostic tool for surveillance, detection, and monitoring of vancomycin-resistant Enterococcus faecium during outbreak.","authors":"Artur J Sabat, Lilli Gard, Monika A Fliss, Viktoria Akkerboom, Robin F J Benus, Mariette Lokate, Andreas Voss, Erik Bathoorn","doi":"10.1186/s13756-025-01538-1","DOIUrl":"10.1186/s13756-025-01538-1","url":null,"abstract":"<p><strong>Introduction: </strong>Vancomycin-resistant Enterococcus faecium (VREfm) poses a significant concern in healthcare settings, particularly during outbreaks. Traditional antibiotic susceptibility testing may fail to detect occult vancomycin resistance, and long culture times delay diagnosis. While whole genome sequencing (WGS) is the most accurate method for tracing infectious disease transmissions, its response times are not rapid enough to optimally support controlling of ongoing outbreaks. To address this limitation, we investigated the genomic diversity among outbreak isolates and developed outbreak-specific PCR tests for rapid VREfm carrier screening using strain-specific biomarkers identified through comparative genomics.</p><p><strong>Materials and methods: </strong>Total DNA from VREfm isolates was sequenced using Oxford Nanopore and Illumina platforms. Multi locus sequence types (MLST-ST) and core genome sequence type clusters (cgMLST-CT) were determined with Ridom SeqSphere + software. Comparative analysis of whole genomes was conducted using Lasergene software (DNASTAR).</p><p><strong>Results: </strong>A large VREfm outbreak involving 111 patients caused by E. faecium ST117-CT469 was identified in the Northern Netherlands, spanning from August 2021 to September 2024. A subset of 55 E. faecium ST117-CT469 isolates were evaluated by WGS and outbreak specific PCRs. Antibiotic susceptibility testing revealed occult vancomycin resistance in the outbreak strain. Comparative genomics identified unique markers specific to E. faecium ST117-CT469. Two PCR assays were developed for rapid outbreak detection: a traditional PCR assay distinguishing outbreak from non-outbreak strains based on amplicon size and a TaqMan real-time PCR assay. Both assays demonstrated 100% reproducibility and specificity. The TaqMan assay was able to detect as little as 5 fg of bacterial DNA in the presence of human DNA, equivalent to approximately one bacterial genomic copy. Sequence analysis of WGS data for all 55 outbreak isolates showed perfect nucleotide sequence conservation in the regions where the primers and probe hybridized. Sequence comparison against NCBI GenBank entries confirmed the perfect specificity of both PCR assays for detecting the ST117-CT469 outbreak strain.</p><p><strong>Conclusions: </strong>These PCR tests maintain the accuracy and discriminatory power of WGS for identifying the ST117-CT469 outbreak strain but are more cost-effective, faster, and easier to use compared to WGS. They enhance VREfm outbreak management by providing an efficient method for rapid screening. Application of strain-specific PCR based on WGS data is currently the most effective screening method during large, ongoing outbreaks.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"23"},"PeriodicalIF":4.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699371","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":"High incidence of multidrug-resistant organisms and modifiable risk factors associated with surgical site infections: a cohort study in a tertiary medical center in Kuala Lumpur, Malaysia from 2020 to 2023.","authors":"Anis Najwa Muhamad, Cindy Shuan Ju Teh, Mohd Rusdi Draman, Yohan Khirusman Adnan, Azlina Amir Abbas, Tak Loon Khong, Vairavan Narayanan, Soo Nee Tang, Rina Karunakaran, Norhafizah Ab Manan, Anjanna Kukreja, Siti Zuhairah Mohamad Razali, Chun Yoong Cham, Robert D Hontz, Michael J Gregory, Anca Selariu, Huy C Nguyen, Andrew G Letizia, Sasheela Sri La Sri Ponnampalavanar","doi":"10.1186/s13756-025-01537-2","DOIUrl":"10.1186/s13756-025-01537-2","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs) are a persistent challenge in healthcare, contributing significantly to patient morbidity, mortality, and healthcare costs. Despite advancements in preventive measures, SSIs remain prevalent, especially in countries like Malaysia where rates are higher than in high-income nations.</p><p><strong>Methods: </strong>A prospective, cohort study was conducted at the University Malaya Medical Center (UMMC), Malaysia, from November 2020 to May 2023. Clinical and microbiological data were collected, and logistic regression were performed to identify risk factors associated with SSIs.</p><p><strong>Results: </strong>A total of 1,815 patients undergoing orthopedic, neurosurgical, and general surgical procedures were monitored for SSIs. The incidence rate of SSIs was 3.23 per 100 procedures (n = 71) with significant associations observed between SSI occurrence and prolonged surgical duration > 100 min, extended hospitalization > 5 days, trauma-to-surgery interval > 8 days, and presence of implants. Common pathogens isolated included Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Multidrug-resistant organisms (MDROs) were identified in 42.1% of the total isolates.</p><p><strong>Conclusions: </strong>In this study, a high rate of MDRO and risk factors for SSI were identified. It emphasises the need for ongoing surveillance to guide infection prevention strategies and antimicrobial stewardship programs. Future research should prioritize evaluating the impact of targeted interventions tailored to identified risk factors to optimize surgical patient outcomes.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"22"},"PeriodicalIF":4.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622977","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":"Bodily waste management and related hygiene practices in nursing homes of Vaud: findings from a multicentre cross-sectional survey as a basis for targeted interventions.","authors":"Emmanouil Glampedakis, Marie-Catherine Snoussi, Béatrix Sobgoui, Firmino Battistella, Patricia Cuiña Iglesias, Coralie Riccio, Laetitia Qalla-Widmer, Alessandro Cassini, Marie Immaculée Nahimana Tessemo","doi":"10.1186/s13756-025-01535-4","DOIUrl":"10.1186/s13756-025-01535-4","url":null,"abstract":"<p><strong>Introduction: </strong>Bodily waste management is a critical yet frequently neglected domain of infection prevention and control. We conducted a survey to examine various aspects of bodily waste management and related hygiene practices in nursing homes (NH) based on existing recommendations.</p><p><strong>Methods: </strong>All NHs (n = 120) of canton Vaud in Switzerland were invited to participate in this cross-sectional survey between July 2022 and February 2023 using a questionnaire.</p><p><strong>Results: </strong>Eighty-seven NHs participated in the survey (72.5%). Of these, 33% had internal protocols on bodily waste management, 98% had at least a dirty utility room (median: 4 per NH) and all a bedpan washer-disinfector (WD), yet only 66% met the cantonal recommendation of bedpan WD density (1/15 beds). Separation of soiled and clean compartments was present in 51%, complete hand hygiene supplies in 73% and personal protective equipment (PPE) in 30% of utility rooms. Fifty-four percent of NHs reported having a lid for each bedpan. Systematic use of lids was reported in 33% of institutions and of gloves in 98%, for the transport of used bodily waste collection tools. All surveyed institutions reported performing automated reprocessing of bodily waste collection tools in bedpan WDs and use of manual pre-cleaning was anecdotal. Regular maintenance and validation of bedpan WDs was present in almost all participating NHs.</p><p><strong>Conclusion: </strong>Identified actionable priorities include making bodily waste management protocols accessible to staff, delineation of clean and soiled compartments in utility rooms and equipping them with PPE and hand hygiene supplies, as well as educating healthcare workers on best practices for the transport and disposal of bodily waste.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"20"},"PeriodicalIF":4.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603570","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}