Antimicrobial Resistance and Infection Control最新文献

{"title":"Compliance with transmission-based precautions, and associated factors among healthcare providers in Cameroon: a cross-sectional study.","authors":"Leslie Tasha Mbapah, Midrelle Syntyche Tsague, Denise Georges Teuwafeu, Mbapah Tracy Ngwanui, Sandra Tabe Etaka, Fombo Enjeh Jabbossung, Brandon Carl Monika Pouekoua, Longsti Scarlet Tabot Enanga, Taljaard Jantjie","doi":"10.1186/s13756-025-01523-8","DOIUrl":"10.1186/s13756-025-01523-8","url":null,"abstract":"<p><strong>Background: </strong>Transmission-based precautions (TBP) and the proper use of personal protective equipment (PPE) are essential in preventing hospital-acquired infections (HAIs) and in controlling the emergence and spread of antimicrobial resistance (AMR). This study, therefore, aimed to determine healthcare providers' compliance with TBP and its determinants in healthcare settings to help curb the burden of HAIs and AMR.</p><p><strong>Method: </strong>This study was a cross-sectional, hospital-based research conducted among healthcare providers at four health facilities in the Fako division of Cameroon, from January 1 to May 31, 2024. A standardized observation form, adapted from the World Health Organization's checklist for hand hygiene practices, was used to assess compliance with Transmission-Based Precautions (TBP) among healthcare providers when interacting with patients known or suspected of having infectious pathogens. Multivariable logistic regression analysis was performed to identify factors independently associated with TBP compliance, with significance set at a p-value of less than 0.05.</p><p><strong>Results: </strong>The proportion of participants with good TBP compliance was 75.4% (95%CI: 67.4-82.2). Contact precaution compliance was 94.2%, while that for droplet /airborne was 12.8%. Factors independently associated with good TBP compliance were healthcare providers trained in IPC (aOR: 2.89, 95%CI: 1.16-7.22), the availability of PPE in the facility's departments (aOR: 6.00, 95%CI: 1.24-29.17), and working in the facility; Mount Mary Hospital (aOR: 22.47, 95%CI: 2.21-228.08).</p><p><strong>Conclusion: </strong>Compliance with transmission-based precautions was suboptimal. The determinants of good compliance with TBP among healthcare providers were making PPE available in the facility and training healthcare providers on IPC. Tailored public health measures should be implemented to improve and sustain healthcare providers' compliance with TBP.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"21"},"PeriodicalIF":4.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603572","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":"Establishing carbapenem resistant organism surveillance, prevention, and control in a middle-income country: implementation of a hospital-based program in Fiji.","authors":"Aneley Getahun Strobel, Savneel Shivam Kumar, Shammi Prasad, Tracey Young-Sharma, Matthew Richards, Ashlyn Datt, Alvina Lata, Sisilia Assisi Genaro, Timaima Ratusela, Ilisapeci Nabose, Alipate Vakamocea, Sanjeshni Autar, Farheen Hussein, Ravi Naidu, Ana Suka, Donna Cameron, Chantel Lin, Courtney R Lane, Alison Macintyre, Kylie Hui, Rodney James, Bernadette Kennedy, Benjamin P Howden, Kirsty Buising","doi":"10.1186/s13756-025-01534-5","DOIUrl":"10.1186/s13756-025-01534-5","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) is a major public health threat with the highest burden being estimated to be in low- and middle-income countries. Fiji is an upper-middle-income country in Oceania. Recent studies from Fiji highlighted the increasing burden of carbapenem resistant organisms (CRO) such as Acinetobacter baumannii, Pseudomonas aeruginosa and Escherichia coli. A project titled Preparing Fiji for Pathogens with Critical Antimicrobial Resistance was undertaken at the Colonial War Memorial Hospital, Fiji's main referral hospital, in 2022 and 2023. The overarching goal was to support the hospital's readiness for prompt detection, management and prevention of infections caused by pathogens with critical AMR including CRO. This paper describes the steps taken to establish CRO surveillance, prevention, and control interventions, outbreak response and healthcare workers' capacity building initiatives tailored to the hospital's need and capacity. It also shares the results, lessons learned and challenges in setting up the systems that may inform actions in other low- and middle-income countries in the Pacific Region and globally.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"19"},"PeriodicalIF":4.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555646","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":"State of infection prevention and control in Austrian hospitals: data from 81 hospitals completing the WHO Infection Prevention and Control Assessment Framework (IPCAF).","authors":"Ferenc Darius Rüther, Andrea Grisold, Agnes Wechsler-Fördös, Alexander Gropmann, Michael Behnke, Sonja Hansen, Christine Geffers, Seven Johannes Sam Aghdassi","doi":"10.1186/s13756-025-01532-7","DOIUrl":"10.1186/s13756-025-01532-7","url":null,"abstract":"<p><strong>Background: </strong>The WHO Infection Prevention and Control Assessment Framework (IPCAF) can be used for systematically evaluating infection prevention and control (IPC) practices in healthcare facilities. In 2018, a survey among Austrian hospitals using the IPCAF revealed an overall high level of IPC implementation. Here, we report the results of a second survey in Austrian hospitals with the IPCAF, to once again evaluate the state of IPC implementation and investigate potential developments since 2018.</p><p><strong>Methods: </strong>A total of 139 Austrian acute care hospitals participating in the German surveillance network \"KISS\" were invited to complete a translated online version of the IPCAF between October 2023 and January 2024. The IPCAF functions like a questionnaire, where each response is assigned a specific point value, enabling the calculation of an overall IPC score. Based on this score, hospitals were categorized into four distinct IPC levels: inadequate, basic, intermediate, and advanced. The aggregated scores were then calculated and compared with the results from 2018.</p><p><strong>Results: </strong>Complete datasets from 81 hospitals were received and analyzed. The median overall IPCAF score was 645 (interquartile range: 598-685), with 59 hospitals (72.9%) categorized as advanced, and 21 hospitals (25.9%) as intermediate. One hospital (1.2%) fell into the basic category. Questions pertaining to IPC education and training as well as the application of multimodal IPC strategies showed the lowest scores. Compared to 2018, the current median score of 645 was slightly higher (median score 2018: 620; data from 65 hospitals) and the proportion of hospitals with a full-time IPC professional per 250 beds increased markedly by 37 percentage points. However, the most pronounced decrease (median score - 5) was observed for questions on the WHO core component of IPC education and training.</p><p><strong>Conclusions: </strong>IPC standards in Austria show an overall increasing trend, especially in terms of IPC staffing. However, areas for improvement remain, and hospitals should make efforts to strengthen IPC education and training programs.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"18"},"PeriodicalIF":4.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539944","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":"Risk factors for detection of Pseudomonas aeruginosa in clinical samples upon hospital admission.","authors":"Romeo Reyle, Frank Schwab, Selin Saydan, Michael Behnke, Rasmus Leistner, Petra Gastmeier, Christine Geffers, Tobias Siegfried Kramer","doi":"10.1186/s13756-025-01527-4","DOIUrl":"10.1186/s13756-025-01527-4","url":null,"abstract":"<p><strong>Background/introduction: </strong>Antipseudomonal antibiotics are frequently used in patients admitted to hospitals. Many of these substances are classified as a reserve or watch status by the WHO. Inappropriate risk assessment of invasive detection of P. aeruginosa (PAE) can be a reason for overuse of antipseudomonal antibiotics. Therefore it is important to define relevant and specific risk factors for invasive PAE detection.</p><p><strong>Objective: </strong>The objective of this study was to identify risk factors for invasive detection of PAE in patients upon hospital admission.</p><p><strong>Methods: </strong>All patients 18 years of age and older with a detection of PAE and/or Enterobacterales in clinical samples taken within 48 h of admission to one of the hospitals of Charité Universitätsmedizin Berlin between 2015 and 2020 were included into this retrospective cohort study.</p><p><strong>Results: </strong>Overall, we included a total of 27,710 patients. In 3,764 (13.6%) patients PAE was detected in clinical samples taken within 48 h after admission. The most frequently detected Enterobacterales was E. coli in 14.142 (51%) patients followed by Klebsiella spp. in 4.432 (16%) patients. Multivariable regression analysis identified that prior colonisation with a multi drug resistant PAE or detection of a PAE in clinical samples during a previous hospitalisation increased the risk for invasive detection of PAE (OR 39.41; 95% CI 28.54-54.39) and OR 7.87 (95% CI 6.60-9.38) respectively. Admission to a specialised ward for patients with cystic fibrosis was associated with an increased risk (OR 26.99; 95% CI 20.48-35.54). Presence of chronic pulmonary disease (OR 2.05; 95% CI 1.85-2.26), hemiplegia (OR 2.16; 95% CI 1.90-2.45) and male gender (OR 1.60; 95% CI 1.46-1.75) were associated with a modest increase in risk for presence of PAE.</p><p><strong>Conclusion: </strong>Patients with a prior detection of P. aeruginosa or admission to a cystic fibrosis ward had the highest risk for invasive detection of P. aeruginosa. Adherence to specific risk scores based on local risk factors could help to optimize prescription of anti-pseudomonal antibiotics that categorized as reserve and watch.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"17"},"PeriodicalIF":4.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497487","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":"Unveiling antimicrobial stewardship competence among Italian nurses: results from a nationwide survey.","authors":"Matteo Danielis, Tania Buttiron Webber, Chiara Barchielli, Maria Mongardi, Domenico Regano","doi":"10.1186/s13756-025-01531-8","DOIUrl":"10.1186/s13756-025-01531-8","url":null,"abstract":"<p><strong>Background: </strong>The development of nursing competencies in antimicrobial stewardship (AMS) is influenced by a two-dimensional model, encompassing both internal and environmental factors. In the context of Italian clinical nursing, this study aims to assess and measure these aspects.</p><p><strong>Methods: </strong>Employing a cross-sectional online survey design, nurses from various clinical specialties in Italy were involved. The questionnaire assessed individual variables, knowledge, attitudes, practices, as well as structural and process-related variables influencing AMS. Statistical analyses were performed, encompassing descriptive statistics, Pearson correlation, and multiple linear regression.</p><p><strong>Results: </strong>A total of 1,651 nurses aswered the survey, with a participation rate of 50.8%. The participant demographic revealed that 77% were female, and they had an average of 15 years of experience. Workplace and regional factors were found to significantly impact both AMS practices and attitudes. Surgical nurses reported higher practices scores (β = 0.467, P <.01), while critical care nurses scored lower (β= -0.398, P <.01). Regarding perceptions of structure, workplace characteristics significantly influenced nurses' scores, indicating lower perceptions among surgical nurses compared to their medical counterparts (β= -0.315, P <.01).</p><p><strong>Conclusions: </strong>The study reveals the intricate interplay between internal and external factors that impact nurses' AMS competence. This underscores the urgent need for targeted interventions and education initiatives to enhance nurses' AMS competencies. Specifically, addressing variations in settings and nurses' behaviours becomes imperative for achieving improved patient outcomes.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"16"},"PeriodicalIF":4.8,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482053","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":"Knowledge, attitude, and practices regarding antibiotic use and antimicrobial resistance among urban slum dwellers in Uganda.","authors":"Regina Ndagire, Ekwaro A Obuku, Ivan Segawa, Fiona Atim, Catherine Nassozi Lwanira, Rachel Nante Wangi, Moses Ocan","doi":"10.1186/s13756-025-01517-6","DOIUrl":"10.1186/s13756-025-01517-6","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) remains a public health threat especially in low-and-middle-income countries (LMICs). Urban slum dwellers are at higher risk of developing AMR than the general population. The aim of this study was to assess the knowledge, attitude and practices (KAP) regarding antibiotic use and AMR and the associated socio-demographic determinants among urban slum dwellers in Uganda.</p><p><strong>Methods: </strong>A cross sectional study was conducted among 371 adults of Bwaise slum in Uganda selected through multi-stage cluster sampling techniques. An interviewer administered questionnaire was used to collect data on participants' socio-demographics, KAP regarding antibiotic use and AMR. The responses to the KAP were aggregated into scores for each participant which were later dichotomized by the mean to form the predictors variables. Analysis was done in STATA 17.0. A modified Poisson regression model was used to determine predictors of each of KAP, while considering a 5% significance level.</p><p><strong>Results: </strong>The study enrolled 371 participants of which 238(64.2%) were females. The median (IQR) age of the participants was 31 [24, 40] years. Over half of the respondents, 205(55.3%) were married and 157(42.3%) had primary level education. Of all participants, 177 (47.7%), 184 (49.6%) and 205 (55.3%) had good knowledge, a positive attitude and good practices regarding antibiotic use and AMR respectively. Being single (aPR = 0.75, p-value = 0.040) was negatively associated with good knowledge of antibiotic use and resistance, while having acquired tertiary education level (aPR = 1.88, p-value < 0.001) and self-employed (aPR = 1.36, p = 0.017) were associated with good knowledge of antibiotic use and resistance. Male gender (aPR = 1.25, p-value = 0.036) and monthly income < 300,000 UGX (aPR = 1.42, p-value = 0.003) were associated with a positive attitude towards antibiotic use and resistance. Likewise tertiary level of education (aPR = 0.64, p-value = 0.033) was negatively associated with good practices of antibiotic use and resistance.</p><p><strong>Conclusion and recommendations: </strong>Residents of urban slums have limited knowledge of antibiotic use and AMR with minimal understanding of AMR concepts. Education level, gender, occupational status are key players in people's understanding and practices of antibiotic use and AMR. There's need for context specific health education programs. Health promotion messaging should emphasize AMR concepts and dangers of drug misuse. Antimicrobial stewardship initiatives should trickle down to the local citizen.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"12"},"PeriodicalIF":4.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476213","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":"Awareness and perception of antimicrobial stewardship program among healthcare professionals in the hospitals of ministry of health and population, Egypt: antimicrobial stewardship toolkit survey.","authors":"Yara Mohsen Abd El Azeem Khalaf, Zahira Metwally Gad, Mostafa Ahmed Arafa, Marwa Shawky Abdou","doi":"10.1186/s13756-025-01525-6","DOIUrl":"10.1186/s13756-025-01525-6","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) has been recognized by international policymakers as a serious threat due to its current and projected influence on global population health, healthcare expenditures and gross domestic product (GDP). The present work aimed to assess the awareness, perceptions, and practices of healthcare professionals regarding the implementation of the Antimicrobial Stewardship program (ASP).</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 310 health care professionals. A self-administered questionnaire based on Antimicrobial Stewardship Toolkit for Acute and Long-Term Care Facilities; Greater New York Hospital Association (GNYAHA) was used to assess perceptions and knowledge about AMR and automatic selective perception.</p><p><strong>Results: </strong>A total of 310 healthcare professionals participated in the study, of which 60.6% were females, with a mean age of 37.32 ± 8.71, mean years of working of 6.0 ± 5.95 and mean years of experience of 7.97 ± 7.14. The mean scores for AMR awareness, antibiotic (AB) prescribing practices, ASP perception, and intervention beliefs were 73.05 ± 11.21, 32.97 ± 8.22, 52.85 ± 13.99, and 18.24 ± 2.71, respectively. Bivariate analysis showed that profession, primary work unit, staff position significantly affect the AMR awareness and ASP perception, while only staff position affect intervention beliefs. The Multivariate linear regression showed that working in pharmacy, ABs prescribing practice and ASP perception were independent predictors of AMR awareness. Years of work in hospital, AMR awareness and ASP perception were the independent predictors of ABs prescribing practice. AMR awareness, ABs prescribing practice and intervention beliefs were independent predictors of ASP perception while ASP perception was the only independent predictors of intervention beliefs.</p><p><strong>Conclusions: </strong>The study found a high level of awareness and practice regarding AMR and ASP among healthcare professionals. Pharmacists had higher levels of AMR awareness and ASP perception than physician in different specialities. Levels of AMR awareness, ABs prescribing practice, ASP perception and intervention beliefs affect each other in different ways. Linear regression supported our findings that pharmacists had a higher level of AMR awareness, while years of work in hospital had a significant effect on ABs prescribing practice.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"13"},"PeriodicalIF":4.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472065","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 mixed-method study on antimicrobial resistance infection drivers in neonatal intensive care units: pathways, risks, and solutions.","authors":"Almaw Genet Yeshiwas, Gashaw Melkie Bayeh, Tilahun Degu Tsega, Sintayehu Simie Tsega, Asay Alamneh Gebeyehu, Zufan Alamrie Asmare, Rahel Mulatie Anteneh, Amare Genetu Ejigu, Ahmed Fentaw Ahmed, Zeamanuel Anteneh Yigzaw, Abathun Temesgen, Anley Shiferaw Enawgaw, Getasew Yirdaw, Wosenyelesh Desalegn, Chalachew Yenew","doi":"10.1186/s13756-025-01520-x","DOIUrl":"10.1186/s13756-025-01520-x","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) in neonatal intensive care units (NICUs) complicates treatment of healthcare-associated infections, causing high morbidity and mortality, especially among low-birth-weight and critically ill infants. This study evaluates AMR prevalence, risk factors, outcomes and infection control measures at Felege Hiwot Hospital, aiming to guide clinical practices, antimicrobial stewardship, and improved neonatal health outcomes.</p><p><strong>Methods: </strong>This mixed-methods study (Oct 2022-Jun 2023) assessed AMR in NICU neonates by analyzing 420 blood samples, environmental swabs, and staff insights. Bivariable and multivariable regressions identified significant variables, and content analysis was used for qualitative data.</p><p><strong>Results: </strong>Out of 420 samples, 35% tested positive for AMR pathogens, with Coagulase-Negative Staphylococci (16.7%), Klebsiella pneumoniae (12.9%), and Acinetobacter spp. (5.6%) being the most prevalent. Resistance rates for Gentamicin, Cotrimoxazole, and Ciprofloxacin were alarmingly high (98-100%), while Amikacin demonstrated low resistance (3.0-5.56%), indicating potential efficacy. Among the neonates admitted, 91.8% survived, and 8.2% succumbed. Risk factor analysis revealed that improper PPE usage (AOR 3.90, p < 0.001), non-functional handwashing sinks (AOR 3.20, p < 0.001), and inadequate disinfection practices (AOR 2.70, p < 0.001) were strongly associated with microbial contamination. Environmental factors, including cockroach presence (AOR 1.80, p = 0.040) and high traffic flow (AOR 2.10, p = 0.005), were also significant contributors. The qualitative data analysis confirmed that improper PPE use, inadequate disinfection practices, pest control challenges, and non-functional handwashing sinks significantly contributed to microbial contamination risks in the NICU, aligning with the quantitative findings.</p><p><strong>Conclusions: </strong>This study underscores key factors driving AMR in NICUs, such as inadequate IPC practices and environmental contamination, alongside high resistance to Cotrimoxazole and Ciprofloxacin. Amikacin shows promise as an effective treatment for CONS. Urgent actions, including strengthened IPC measures, staff training, and environmental management, are crucial to combat AMR, ensuring improved neonatal care and outcomes.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"15"},"PeriodicalIF":4.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476211","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":"Implementing intranasal povidone-iodine in the orthopedic trauma surgery setting to prevent surgical site infections: a qualitative study of healthcare provider perspectives.","authors":"A M Racila, Erin C Balkenende, Loreen A Herwaldt, Michael C Willey, Linda D Boyken, Jean G Pottinger, Brennan S Ayers, Kimberly C Dukes, Melissa A Ward, Marin L Schweizer","doi":"10.1186/s13756-025-01526-5","DOIUrl":"10.1186/s13756-025-01526-5","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs) are associated with morbidity, mortality, and increased costs. Staphylococcus aureus is the most common cause of SSIs and approximately 30% of hemodialysis patients carry this organism in their nares. Unlike mupirocin, intranasal povidone-iodine (PVI) is applied only the day of surgery to prevent surgical site infections. Thus, intranasal PVI could be valuable in orthopedic trauma surgery settings where time to prepare a patient for surgery is limited.</p><p><strong>Methods: </strong>We conducted a small phase IV post-marketing study from 2020 to 2021 in an academically affiliated hospital wherein staff administered intranasal PVI pre- and post-operatively to consenting patients undergoing orthopedic fixation procedures for traumatic fractures. Before implementing the PVI intervention, we conducted a human factors task analysis to determine the optimal time and hospital location to perform PVI decolonization for patients receiving these orthopedic fixation procedures. After the post-marketing study was completed, we conducted qualitative interviews with healthcare staff to determine barriers and facilitators that could affect staff members' likelihood of administering PVI to patients. We aligned our inductive interview findings with strategies defined in Powell and colleagues' Expert Recommendations for Implementing Change (ERIC) framework to facilitate generalizability and standardized reporting of implementation strategies.</p><p><strong>Results: </strong>Our human factors task analysis identified the Day of Surgery Admissions (DOSA) as the appropriate context for PVI administration within surgical workflow, as there was downtime during this period and direct patient-provider communication could occur. Two DOSA nurses, one postoperative nurse, and one orthopedic trauma surgeon agreed to be interviewed. Facilitators of intranasal PVI administration included emphasizing the non-invasiveness of PVI nasal swabs to patients and emphasizing intranasal PVI efficacy to staff and patients. While the nurse participants felt that having PVI orders with other medication orders in the EMR helped them identify patients enrolled in the study and who required PVI, entering these orders increased the surgeon's workflow and presented a time barrier.</p><p><strong>Conclusions: </strong>Macro- and micro-level contextual factors should be considered when tailoring implementation to healthcare settings. Our findings reinforce prior work demonstrating the value of incorporating human factors engineering methodologies into infection control and prevention implementation approaches.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"14"},"PeriodicalIF":4.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476212","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 and control without borders: comparison of guidelines on multidrug-resistant organisms in the northern Dutch-German cross-border region.","authors":"Cansu Cimen, Matthijs S Berends, Mariëtte Lokate, Corinna Glasner, Jörg Herrmann, Erik Bathoorn, Axel Hamprecht, Andreas Voss","doi":"10.1186/s13756-025-01528-3","DOIUrl":"10.1186/s13756-025-01528-3","url":null,"abstract":"<p><p>Infections due to multidrug-resistant organisms (MDROs) are a health threat due to increasing patient morbidity and mortality and the burden on healthcare systems. Robust infection prevention and control (IPC) measures are needed to minimize their emergence in hospitals. Therefore, various international and national IPC guidelines exist, yet the lack of harmonized IPC guidelines complicates the management of patients seeking healthcare across European borders. This study explores the similarities and differences in IPC measures for vancomycin-resistant enterococci (VRE) and multidrug-resistant (MDR) Enterobacterales both on local and national levels within the northern Dutch-German cross-border region. In Germany, IPC efforts are often led by hospital hygiene doctors, whereas in the Netherlands, they involve a collaboration between infection preventionists and clinical microbiologists, with local variations. The local guidelines in both countries, as expected, are based on national recommendations, yet introduce specific regulations in various aspects. The Dutch guidelines are more stringent for VRE management compared to the German guidelines, often imposing additional local measures beyond national requirements. The Dutch and German guidelines largely diverge in definitions of MDR Gram-negative bacteria. Unlike the Dutch guidelines, the German guidelines do not currently recommend screening or isolation for extended-spectrum beta-lactamase-producing Enterobacterales. For carbapenem-resistant and carbapenemase-producing Enterobacterales, there is no notable distinction between the countries' guidelines, with both sharing the objective of maintaining a low prevalence and actively working towards containment. Inconsistencies in guidelines can lead to inefficient information exchange and inconsistent hygienic measures during patient transfers. Despite common commitments, differences in focus may reflect evolving understanding of MDRO transmission and ongoing debates on their management. Our findings highlight the divergence of IPC guidelines for the management of MDROs across two countries and call for collaboration in cross-border regions to increase the effectiveness of MDRO management in these regions and improve patient care.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"11"},"PeriodicalIF":4.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405140","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}