Antimicrobial Resistance and Infection Control最新文献

{"title":"Two clusters of carbapenemase-producing bacteria linked to hospital utility room wastewater drains - an outbreak report.","authors":"Isabelle Vock, Gioele Capoferri, Sabine Kuster, Pascal Urwyler, Patricia Domene, Dennis Roy, Nicolas Guertler, Nina Khanna, Jörg Halter, Stefano Bassetti, Josefine Putbrese, Claudio Neidhöfer, Christopher Field, Pascal Schläpfer, Branislav Ivan, Peter M Keller, Sarah Tschudin-Sutter","doi":"10.1186/s13756-026-01772-1","DOIUrl":"10.1186/s13756-026-01772-1","url":null,"abstract":"<p><strong>Background: </strong>Outbreak investigations of two carbapenemase-producing bacteria (CPB)-clusters identified a link to utility room wastewater drains (URWD), prompting an investigation into CPB-colonization of the hospital's URWD and into utility room management to identify possible breaches in infection prevention and control (IPC) measures.</p><p><strong>Methods: </strong>At the University Hospital Basel, Switzerland, a cluster of four patients with VIM-1-producing Enterobacter hormaechei and two patients with KPC-3-producing Citrobacter freundii, occurred between 07/2022 - 07/2024. A multidisciplinary team (IPC specialists, nurses, cleaning experts) evaluated utility room management. Wastewater drains in affected patient rooms and 25 utility rooms of the hospital building (including two wards in which the two transmission-cluster occurred) affected by the clusters were screened for CPB-colonization and whole genome sequencing was performed on clinical and environmental CPB isolates.</p><p><strong>Results: </strong>The bla_VIM-1 and the bla_KPC-3 gene corresponding to both clusters were identified in sequences of Citrobacter freundii and Klebsiella pneumoniae isolates colonizing the ward's URWD. Colonized drains were in proximity to affected patient's rooms, while none of the wastewater drains in the respective patient rooms was colonized with CPB. Overall, CPB were identified in 52% of all URWD. Several breaches in utility room management and design facilitating colonization with CPB and potentially leading to contamination of shared medical equipment by dispersal were observed, including lacking separation between clean and contaminated zones in utility rooms (34%), and improper use of contaminated zones for storage of clean shared medical equipment (88.7%).</p><p><strong>Conclusions: </strong>URWD serve as reservoirs for CPB. Breaches in utility room management and design, potentially leading to contamination of shared medical equipment by dispersal from contaminated wastewater drains, represent an intervention target for prevention of CPB-transmission.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148147985","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 reservoirs of carbapenem-resistant organisms in the intensive care unit: a multicenter longitudinal study in two middle-income country hospitals.","authors":"Valeria Fabre, Mathew L Robinson, Florencia Martino, Renata Monge, Agustina Forastiero, Alejandra Corso, Fernando Pasteran, Rajesh Karyakarte, Bharat Randive, Sweety Singh, Mrunmayi Naik, Haridas B Prasad, Kellogg J Schwab, Patricia J Simner, Yehudit Berman, Wendy I Foy, Alejandra B Salinas, Anushruti Gupta, Jennifer Lu, Amber M Vasquez, Judith Noble-Wang, Kara A Moser, K Allison Perry-Dow, Molly Patrick, Clare Rock","doi":"10.1186/s13756-026-01768-x","DOIUrl":"10.1186/s13756-026-01768-x","url":null,"abstract":"<p><strong>Background: </strong>There is limited data regarding environmental reservoirs of carbapenem-resistant organisms (CRO) during non-outbreak settings in resource-limited hospitals, or the role of these reservoirs in healthcare transmission.</p><p><strong>Methods: </strong>Prospective longitudinal study in which sinks and high-touch surfaces (HTS) were sampled prior to room cleaning in intensive care units (ICUs) in two hospitals (hospital A, Argentina, and hospital B, India), July 2023-February 2024. Selective media was used to recover CROs. Whole genome sequencing (WGS) and single nucleotide polymorphism (SNP) pairwise analysis were performed on environmental and clinical isolates to evaluate bacterial transmission dynamics. Metagenomic sequencing was performed to evaluate bacterial diversity of environmental samples.</p><p><strong>Results: </strong>Of 541 environmental samples collected, 47.9% in hospital A and 97.5% in hospital B grew at least one CRO. Most CROs tested for the presence of a carbapenemase were positive (63.9-91.0% for hospital A and B isolates, respectively). Carbapenemase producer (CP)-Acinetobacter baumannii and CP-Pseudomonas spp. predominated in HTS and sinks samples, respectively, in hospital A; while CP-Klebsiella pneumoniae predominated in hospital B samples. WGS of 113 CRO isolates and SNP analysis demonstrated certain lineages established enduring reservoirs in the ICUs environment (e.g., blaVIM-36 P. aeruginosa ST395 isolates with 2-9 SNP difference were detected in sinks over 7 months). Several clusters involving environmental and clinical isolates that shared an epidemiological link and displayed ≤ 10 SNP difference were identified (e.g., blaOXA-23 A. baumannii ST195 isolated from three unique patients who stayed in the same private room on sampling months 4, 5, 6 and 7, and from HTS of that room on sampling month 5 displayed 0-3 SNP difference). Metagenomic analysis identified additional AMR genes of clinical importance.</p><p><strong>Conclusions: </strong>CROs were abundant and persisted in the ICU environment in countries with high prevalence of MDROs. Our data suggests movement of clones between the environment and patients.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148100772","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":"Control of a hospital outbreak with methicillin-resistant Staphylococcus argenteus in The Netherlands, June-September 2023.","authors":"Serena Slavenburg, Dennis Souverein, Sandra Witteveen, Esther de Vries, Angela de Haan, Annelot F Schoffelen, Daan W Notermans, Bjorn L Herpers, Antoni P A Hendrickx","doi":"10.1186/s13756-026-01756-1","DOIUrl":"10.1186/s13756-026-01756-1","url":null,"abstract":"<p><strong>Background: </strong>Staphylococcus argenteus belongs to the Staphylococcus aureus complex and causes similar disease. Methicillin-resistant S. argenteus (MRSArg) is rare in the Netherlands. We describe the first hospital outbreak and its management.</p><p><strong>Methods: </strong>After a healthcare worker linked to a patient with MRSArg bacteremia tested positive, cohort screening of healthcare workers, patients, and family members was performed. Carriers received eradication therapy. Whole-genome multilocus sequence typing (wgMLST) and antimicrobial susceptibility testing were used to characterize isolates and mupirocin resistance.</p><p><strong>Results: </strong>Fifteen (2.6%) MRSArg carriers were detected: 9/317 (2.8%) healthcare workers, 4/238 (1.7%) patients, 2/16 (12.5%) family members; age range 22-88 years, median 55 years. Nine (60%) were complicated and six (40%) uncomplicated carriers. After transfer of one initially negative patient to a nursing home, subsequent positivity led to two carriers among nursing home staff. wgMLST confirmed a single outbreak cluster of 15 isolates, all MLST ST2250. The isolates carried mecA, dfrG, and blaZ, but not PVL. Eradication therapy was started in 13/15 (86.7%) persons, with 84.6% (11/13) successful eradication. Six isolates carried a V588F-mutated ileS gene and had mupirocin MICs of 2-32 mg/L; nine were sensitive.</p><p><strong>Conclusions: </strong>We report the first successfully controlled MRSArg hospital outbreak in the Netherlands. The outbreak strain was clonally related and showed low-level mupirocin resistance linked to a mutated ileS gene. This work supports the importance of infection prevention and control measures that are applied for MRSA are also effective for MRSArg.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148100739","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":"From 'droplet' to 'respiratory' precautions: implementation and adherence monitoring in a Swiss tertiary care center, 2023-2025.","authors":"Aude Nguyen, Rebecca Grant, Valérie Goldstein, Marlène Fraccaro-Hamoneau, Monique Perez, Véronique Camus, Jonathan Sobel, Klara M Posfay-Barbe, Yoann Kronneberg, Stephan Harbarth, Marie-Céline Zanella","doi":"10.1186/s13756-026-01769-w","DOIUrl":"10.1186/s13756-026-01769-w","url":null,"abstract":"<p><strong>Background: </strong>Following updated 2023 guidance from the European Centre for Disease Prevention and Control (ECDC), and in parallel with recommendations from the Swiss Center for Infection Control, a tertiary care centre in Switzerland replaced droplet precautions with 'respiratory precautions' on 1 November 2023. A multifaceted strategy was implemented to facilitate the transition to this updated transmission-based precaution. We aimed to describe the implementation of and adherence to respiratory precautions between November 2023 and March 2025.</p><p><strong>Methods: </strong>From October 2023 to March 2024, a multifaceted, hospital-wide strategy was implemented to introduce changes in infection control policy with updated respiratory precautions, including standardized training, educational materials, a communication campaign, updated signage and prescription orders. Adherence to the updated respiratory precautions was audited during two periods: January-March 2024 and October 2024-March 2025.</p><p><strong>Results: </strong>A total of 150 training sessions on infection control precautions were conducted for 1967/9410 (21%) healthcare workers and 2913 pocket cards summarizing updated precautions were distributed. Among 793 audits conducted, there was high adherence to recommended patient placement and signage (89-99%). Availability and suitability of placement for FFP2 respirators and eye protection were initially low but improved during the second audit (59% and 36%, respectively). FFP2 use was 76%, while use of eye protection remained low (38%), potentially due to limited availability and suitable placement.</p><p><strong>Conclusions: </strong>A structured, multifaceted strategy -combining training, audits, and feedback - supported the implementation of a change in respiratory precautions, achieving good adherence overall.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148051950","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":"Evaluating the appropriateness of prescribing antibiotics among persons with HIV (PWH) in an Urban HIV outpatient clinic in Uganda.","authors":"Brian Otaalo, Grace Banturaki, Joseph Musaazi, Derek Ngabirano, Herman Mwanja, Reuben Kiggundu, Eva Agnes Laker Odongpiny, Mackline Hope, Francis Kakooza, Andrew Kambugu, Noela C Owarwo, Barbara Castelnuovo","doi":"10.1186/s13756-026-01760-5","DOIUrl":"10.1186/s13756-026-01760-5","url":null,"abstract":"<p><strong>Background: </strong>Sub-Saharan Africa (SSA) faces a high burden of antimicrobial resistance (AMR). Inappropriate antibiotic use is the major driver of AMR. Populations at high risk for infections, such as persons living with HIV (PWH), are more likely to experience AMR. However, data on the appropriateness of antibiotic prescribing in outpatient settings for PWH are limited.</p><p><strong>Methods: </strong>We conducted a retrospective review of antibiotic prescriptions from 1st January 2016 to 31st December 2022 in an HIV tertiary care outpatient clinic in Uganda. We extracted data from patients' records and assessed appropriateness using a customized tool. Data were abstracted across three points of care: the general clinic, the urgent care unit, and the TB clinic for presumptive TB patients. Prescriptions were considered appropriate if they had a documented indication, the right drug, dose, frequency, and duration, when evaluated against national guidelines and the national formulary in some instances. Appropriateness was measured in proportions, and differences in patient characteristics were analyzed. Factors associated with inappropriate antibiotic prescriptions were assessed using a modified Poisson regression model.</p><p><strong>Results: </strong>We reviewed the medical records of 1367 participants, with a median age of 49 years (IQR: 42-57), and the majority, 944 (69.1%), were female. In total, the participants contributed 1823 antibiotic prescriptions, of which 1605 (88%) were inappropriate. Of the 1605 inappropriate prescriptions, 842 (52.5%) were due to absence of an indication, 539 (33.5%) to nonadherence to the guidelines, and 224 (14%) didn't have a suspected or confirmed infection. The urgent care unit had the highest proportion of inappropriate antibiotic use (82.4%), p = 0.02. Fluoroquinolones 14/124 (11.3%), macrolides 22/189 (11.6%), and cephalosporins 56/479 (11.7%) were the least appropriately prescribed classes of antibiotics. The male participants had a 17% lower prevalence of inappropriate prescriptions compared to females [adjusted PR 0.83 (95% CI: 0.75-0.92)].</p><p><strong>Conclusion: </strong>We found a high level of inappropriate antibiotic use among PWH in outpatient care. Notably, more than half of the prescriptions lacked a documented indication, highlighting poor documentation practices.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040776","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":"Infection prevention, control and antimicrobial stewardship measures in intensive in-patient rehabilitation setting: a systematic review.","authors":"Matteo Raponi, Rossella Mancini, Silvia Martinelli, Mario Cesare Nurchis, Giuseppe Santoli, Rosa Liperoti, Patrizia Laurenti, Gianfranco Damiani","doi":"10.1186/s13756-026-01770-3","DOIUrl":"10.1186/s13756-026-01770-3","url":null,"abstract":"<p><strong>Introduction: </strong>The necessity for targeted strategies to prevent and manage multidrug-resistant organism infections in intensive rehabilitation settings is driven by the heightened vulnerability of patients, exacerbated by the unique organizational and technical aspects of these environments. This study aimed to establish an interpretative framework of internationally validated interventions to enhance infection prevention in intensive rehabilitation facilities.</p><p><strong>Materials and methods: </strong>A systematic review, conducted following PRISMA guidelines, categorized interventions into three key domains: Antimicrobial Stewardship, Behavioural Prevention, and Sanitation and Environmental Cleaning.</p><p><strong>Results: </strong>The 17 articles selected for review provide a comprehensive overview of interventions within the three domains. Antimicrobial Stewardship interventions demonstrated potential in reducing Clostridioides difficile colonization through decreased antimicrobial use. Behavioural Prevention interventions were associated with reduced multidrug-resistant organism colonization and infections. Sanitation and Environmental Cleaning interventions, including hand hygiene, correlated with a decreased incidence of Clostridioides difficile cases.</p><p><strong>Discussion and conclusions: </strong>This systematic review underscores the importance of implementing multi-component interventions, encompassing both pharmacological and non-pharmacological approaches, across this critical setting.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148025802","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":"An international randomised controlled trial of a novel antimicrobial dressing for peripheral intravenous catheters (ProP trial).","authors":"Bertrand Drugeon, Daner L Ball, Tricia M Kleidon, Catherine O'Brien, Gabor Mihala, Nicole Marsh, Amanda Ullman, Amanda Corley, Jessica A Schults, Jérémy Guenezan, Kate McCarthy, Sabrina Seguin, Guillaume Batiot, Joshua Byrnes, Thiago Lopes Silva, Olivier Mimoz, Claire M Rickard","doi":"10.1186/s13756-026-01767-y","DOIUrl":"10.1186/s13756-026-01767-y","url":null,"abstract":"<p><strong>Background: </strong>Peripheral intravenous catheters (PIVCs) are extensively used in hospitals worldwide and frequently associated with complications. Phlebitis is a common complication and may indicate infection, while infectious events, although uncommon, contribute to antimicrobial use and healthcare-associated infection. Chlorhexidine gluconate (CHG) impregnated dressings effectively prevent infections in central venous catheters but evidence for PIVC use is lacking. We assessed the feasibility and preliminary clinical outcomes of CHG-impregnated dressings for PIVCs.</p><p><strong>Methods: </strong>The ProP trial was a multi-centre, open-label, two-arm, parallel adaptive randomised controlled trial (RCT) in Australia and France. Adult and paediatric patients in emergency and acute settings who were expected to require a PIVC for ≥48 hours were eligible. Randomisation was centralised (1:1 ratio; allocation concealed; stratified by site) to either a CHG-impregnated dressing or a standard polyurethane dressing. In Phase I, feasibility outcomes included eligibility, recruitment, retention, protocol fidelity, missing data and satisfaction, with exploratory analysis of clinical outcomes. Phase II was planned to definitively compare clinical outcomes (composite infectious complications of local infection, catheter tip colonisation, PIVC-related bloodstream infection (BSI), and/or phlebitis), however progression to Phase II depended on pre-defined Phase I feasibility criteria.</p><p><strong>Results: </strong>Between May 2023 and March 2024, 300 patients were enrolled at three hospitals. Most feasibility criteria achieved pre-specified targets including 92% recruitment, 99% retention, 99% protocol fidelity, 0% missing data, and >98% satisfaction for both participant and staff. However, eligibility was 76%, (<80% feasibility threshold), triggering trial cessation. Composite infectious complications and/or phlebitis occurred in 19% of control participants and 20% of the intervention participants. This included local infection (1% control; 0% intervention), PIVC-tip colonisation (3% control; 1% intervention), phlebitis (14% control; 18% intervention), and PIVC-BSI (none in either group). All adverse events were minor, and none required dressing removal.</p><p><strong>Conclusion: </strong>This study can inform the design of a definitive trial to assess the clinical and economic effectiveness of CHG-impregnated dressings for PIVCs, including refinement of the eligibility criteria and primary outcome.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05741866.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013196","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 to facilitate antimicrobial stewardship of hospital clinicians in Korea: a mixed-methods study using a qualitative study and survey results.","authors":"Geunwoo Lee, Bongyoung Kim, Dong-Sook Kim","doi":"10.1186/s13756-026-01763-2","DOIUrl":"10.1186/s13756-026-01763-2","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial stewardship (AS) programs have the potential to improve antibiotic use and mitigate antimicrobial resistance (AMR). However, several challenges hinder the successful implementation of AS programs. The aim of this study was to explore hospital clinicians' perceptions and attitudes toward AS programs, as well as the associated barriers to facilitating their adoption in Korea.</p><p><strong>Methods: </strong>We conducted both focus group interviews and online surveys. In-depth focus group interviews were held with 14 physicians-comprising three otolaryngologists, three infectious diseases physicians, three pediatricians, three pulmonologists, one family medicine physician and one general surgeon-from three hospitals in South Korea in 2018. Additionally, a web-based survey was distributed to secondary and tertiary hospitals.</p><p><strong>Results: </strong>We identified several key barriers imposed by non-clinical factors, including hierarchical structures within hospitals, physicians' concerns about disease progression, and patients' expectations regarding antibiotics. As a result, participants reported a need for education targeting both patients and physicians. In the survey of 120 respondents, knowledge gaps were found to differ by hospital type and the presence of infectious disease specialists.</p><p><strong>Conclusion: </strong>This study examined the enablers and barriers to AS using a mixed-methods approach in Korea. Our findings provide insight into the current status of AS and identify areas where efforts should be focused to promote appropriate antimicrobial use and address barriers to AS.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986372","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 targeted infection prevention and control interventions on bloodstream infections and colonization with carbapenem-resistant organisms among hospitalized neonates, Bangladesh, 2023-2024.","authors":"Ashley Styczynski, Amelia Keaton, Gazi Md Salahuddin Mamun, Sanzida Khan, Shariful Amin Sumon, Tanzir Ahmed Shuvo, Shabrina Sharmin, Md Aminul Islam, Aninda Rahman, Tahsinul Amin, Jesmin Akter, Kakali Halder, Sazzad Bin Shahid, Gemma Parra, Lisa P Oakley, Katie Wilson, Molly Patrick, Md Golam Dostogir Harun, Fahmida Chowdhury","doi":"10.1186/s13756-026-01765-0","DOIUrl":"10.1186/s13756-026-01765-0","url":null,"abstract":"<p><strong>Background: </strong>Neonates admitted to neonatal intensive care units (NICUs) are particularly susceptible to acquiring healthcare-associated infections because of factors such as prematurity, prolonged hospital stays, and need for invasive support devices. A longitudinal study in a Bangladeshi NICU demonstrated a high burden of bloodstream infections (BSIs) and rectal colonization with carbapenem-resistant organisms (CROs). We aimed to assess the impact of infection prevention and control (IPC) interventions on BSIs and CRO colonization in this NICU.</p><p><strong>Methods: </strong>We conducted a quasi-experimental study in a 38-bed NICU of a tertiary care referral hospital in Dhaka, Bangladesh. Following a baseline assessment in December 2023-January 2024, an IPC intervention was carried out during February-September 2024, with a pause during June-August because of political instability. NICU staff, including environmental cleaners, received multimodal IPC training with an emphasis on hand hygiene and environmental cleaning. Compliance was monitored through covert observation of hand hygiene and use of fluorescent markers on environmental surfaces. Colonization with CROs was evaluated through twice monthly point prevalence surveys using rectal swabs plated on selective media followed by Vitek 2 confirmatory testing. BSIs were assessed based on recovery of pathogenic organisms from blood cultures, and mortality rates were determined based on the number of deaths per 100 admissions. We assessed for trends in process and outcome measures over time using the Mann-Kendall test.</p><p><strong>Results: </strong>Over the course of the IPC intervention, hygiene compliance improved from 13% to 69% (p < 0.001) while environmental cleaning improved from 10% to 87% (p < 0.001). We sampled 363 neonates across 12 point prevalence surveys. CRO colonization was similar at the beginning of the intervention compared with the endline (88% vs. 81%, p = 0.45). However, BSI incidence decreased from 28 to 4 per 100 admissions (p = 0.034), representing an 86% reduction. Similarly, mortality decreased from 26 to 4 per 100 admissions (p = 0.064), though this change was not statistically significant.</p><p><strong>Conclusions: </strong>Enhancing basic IPC practices may be effective in reducing adverse outcomes in low-resource settings with a high burden of multidrug-resistant organisms (MDROs). However, the lack of impact on CRO colonization suggests the need for additional IPC and/or antibiotic stewardship interventions to further mitigate MDRO transmission and the selective pressures driving MDRO proliferation in this NICU.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147979812","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 compliance among healthcare workers at a tertiary maternity hospital in Sierra Leone: a cross-sectional study.","authors":"Sia Morenike Tengbe, Ibrahim Franklyn Kamara, Mary Jane Koroma, Bobson Derrick Fofanah, Desta Betula Ali, Braima Munda Koroma, Joseph Mustapha Macarthy","doi":"10.1186/s13756-026-01762-3","DOIUrl":"10.1186/s13756-026-01762-3","url":null,"abstract":"<p><strong>Background: </strong>Maternal and neonatal mortality remains a global health problem, with infections accounting for a significant proportion of this burden. Major predisposing factors include poor aseptic techniques and contaminated hands of healthcare workers (HCWs). Hand hygiene (HH) is the most effective and simplest infection prevention and control (IPC) measure to minimise infection transmission. This study aimed to assess HH compliance and identify barriers among HCWs at a tertiary hospital in Sierra Leone.</p><p><strong>Methods: </strong>This hospital-based cross-sectional study utilised a standardised World Health Organization (WHO) HH observation form to assess HH compliance among HCWs in the labour ward of the Princess Christian Maternity Hospital (PCMH). A root cause analysis was also used to determine the barriers to HH compliance. Data analysis was conducted using Microsoft Excel, with findings presented in frequencies and proportions.</p><p><strong>Results: </strong>A total of 404 HH opportunities were observed at the labour ward. The overall HH compliance rate was 32%, and HH compliance for nurses, midwives, doctors, and nursing students was 37%, 34%, 27%, and 0%, respectively. Based on the WHO \"5 moments\" for HH compliance, the highest adherence was observed for moment 3 (83%), followed by moment 4 (68%). Conversely, moment 2 had the lowest compliance (6%). Identified barriers to HH compliance included organisational concerns, availability of IPC materials and equipment, staffing, environmental factors, cultural influences, and existing practices.</p><p><strong>Conclusion: </strong>HH compliance among HCWs at PCMH was found to be low. To enhance HH practices and patient safety, promoting HH practices through investing in IPC supplies, strategic placement of workplace reminders, training, mentorship, and coaching should be prioritised.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969834","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}