Antimicrobial Resistance and Infection Control最新文献

{"title":"Value of collaborative investigation by hospital infection control, public health services and a national reference laboratory during an increase in puerperal sepsis.","authors":"Irene V Hoogendijk, Diane de Zwart-Slats, Stefan A Boers, Boas C L van der Putten, Nina M van Sorge, Bibi D H Molenaar, Myrthe M A Toorop, Marieke B Veenhof, Karin Ellen Veldkamp, Adriënne S van der Schoor, Joffrey van Prehn","doi":"10.1186/s13756-025-01564-z","DOIUrl":"10.1186/s13756-025-01564-z","url":null,"abstract":"<p><strong>Background: </strong>In a Dutch tertiary care hospital, two cases of puerperal sepsis were diagnosed within 16 days in June-July 2022. The subsequent outbreak investigation emphasizes the value of collaboration between hospital infection control, regional public health services (PHS) and a national reference laboratory. The aim was to identify possible causes of this increase to prevent further cases of puerperal sepsis.</p><p><strong>Methods: </strong>Hospital infection control identified a group of puerperal sepsis cases clustered within the last year in the hospital, a cluster caused by S. pyogenes emm12.0. The hospital and PHS performed contact tracing of cases and HCW involved, investigating epidemiological links, and screening of HCW. The Netherlands Reference Laboratory for Bacterial Meningitis (NRLBM) identified additional regional cases. Subsequently, whole genome sequencing (WGS) analysis was performed on clinical, HCW and regional S. pyogenes isolates.</p><p><strong>Results: </strong>Four maternity ward patients were diagnosed with puerperal sepsis caused by S. pyogenes emm12.0 between April and November 2022. Although no additional epidemiological links were identified, all four cases resided within a 6.6 km radius. WGS analysis showed that the four cases were part of an 11-case cluster. Screening of HCW (n = 197) identified two individuals carrying clonally related S. pyogenes isolates.</p><p><strong>Conclusions: </strong>Collaboration between hospital, PHS, and NRLBM resulted in an overview of possible epidemiological links. Centralized collection of iGAS case information and strain typing are critical to place hospital clusters in the context of local epidemiology. An increase in healthcare-associated infections may not necessarily imply in-hospital transmission.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"60"},"PeriodicalIF":4.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172505","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 household colonization by extended-spectrum cephalosporin-resistant enterobacterales (ESCrE) in Botswana.","authors":"Sukaina Shivji, Naledi Mannathoko, Mosepele Mosepele, Robert Gross, Leigh Cressman, Anne Jaskowiak-Barr, Warren B Bilker, Kevin Alby, Laurel Glaser, Melissa Richard-Greenblatt, Laura Cowden, Alexa Patel, Kgotlaetsile Sewawa, Dimpho Otukile, Giacomo Maria Paganotti, Margaret Mokomane, Evan Snitkin, Ebbing Lautenbach","doi":"10.1186/s13756-025-01581-y","DOIUrl":"10.1186/s13756-025-01581-y","url":null,"abstract":"<p><strong>Background: </strong>The epidemiology of community colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) in low- and middle-income countries (LMICs) is largely uncharacterized. In the community, the household is of particular importance. Identifying risk factors for household ESCrE colonization is critical to inform antibiotic resistance reduction strategies.</p><p><strong>Methods: </strong>Participants were enrolled at 6 clinics in Botswana. All participants had rectal swabs collected for selective plating and confirmation of ESCrE. Data were collected on demographics, comorbidities, antibiotic use, healthcare exposures, travel, and farm/animal contact. Households were considered exposed if any member had the exposure of interest. Households with ESCrE colonization (cases) were compared to non-colonized households (controls) to identify risk factors for household ESCrE colonization.</p><p><strong>Results: </strong>From 1/1/20 - 9/4/20, 327 households were enrolled. The median (IQR) number of people enrolled per household was 3 (2-4) ranging from 2 to 10. The median (IQR) age of subjects was 18 years (5-34) and 304 (93%) households included at least one child. Of 327 households, 176 (54%) had at least one household member colonized with ESCrE. Independent risk factors [adj OR (95%CI)] for household colonization were: (1) horse/donkey exposure [2.32 (1.05, 5.10)]; (2) yogurt consumption [1.73 (1.04, 2.88)]; (3) region [2.83 (1.48,5.43)]; and (4) enrollment during pre-COVID lockdown [2.90 (1.66, 5.05)].</p><p><strong>Conclusions: </strong>ESCrE household colonization was common with evidence of geographic variability as well as a possible role of animal exposure. The role of yogurt exposure requires further study with consideration of source (commercial, homemade). Further prospective studies of household ESCrE colonization with longitudinal assessments of exposures are required to identify effective prevention strategies.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"58"},"PeriodicalIF":4.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172498","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":"Whole genome sequence analysis reveals limited diversity among Clostridioides difficile ribotype 027 and 078 isolates collected in 22 hospitals in Berlin and Brandenburg, Germany.","authors":"Esther E Dirks, Vanessa Pfiffer, Genevieve Sohl, Fabian K Berger, Ina Friesen, Johannes Friesen, Ralf Ignatius, Johannes Elias, Alexander Mellmann, Mardjan Arvand","doi":"10.1186/s13756-025-01565-y","DOIUrl":"10.1186/s13756-025-01565-y","url":null,"abstract":"<p><strong>Background: </strong>Clostridioides difficile infections (CDI) present significant health risks and are among the most important nosocomial infections. Ribotype (RT) 027 poses a particular risk due to its proposed \"hypervirulence\". Traditionally, C. difficile isolates are characterized using PCR-ribotyping. More recently, whole genome sequence (WGS) analysis is increasingly used, which may provide a higher discriminatory power. This study aimed to assess the distribution of different C. difficile RTs in hospitals in the Berlin-Brandenburg area, and to analyse the heterogeneity within isolates of different ribotypes using WGS.</p><p><strong>Methods: </strong>Between February 2020 and November 2021, stool samples from patients with laboratory-confirmed CDI were collected from 22 hospitals (approximately 13,900 beds) in Berlin and Brandenburg. Toxigenic isolates (n = 476) were further characterized by ribotyping, antibiotic susceptibility testing, toxinotyping, and core genome multilocus sequence typing (cgMLST).</p><p><strong>Results: </strong>Sixty-five different RTs were detected, with RT014 (16.1%), RT027 (12.8%), and RT001 (7.6%) being the most prevalent. RT027 isolates exhibited resistance to several antibiotics. Further, cgMLST analysis revealed very close genetic relatedness between RT027 isolates despite being epidemiologically unrelated. Similar findings of a monomorphic population were observed for RT078 isolates. In contrast, other RTs showed a heterogenic population structure.</p><p><strong>Conclusions: </strong>This study provides first insights into the distribution of C. difficile genotypes, corresponding antimicrobial resistance, and clonal relatedness using cgMLST, highlighting RT027 as the second most common genotype for the studied area. For the monomorphic RT027 and RT078 populations, new definitions of clonal relatedness might be necessary.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"56"},"PeriodicalIF":4.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172508","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":"Investigation and control of two consecutive Serratia marcescens outbreaks linked to reusable LigaSure devices in an operating room.","authors":"Mahsa Mazaheri Tirani, Samaneh Pourajam, Vajihe Sadat Nikbin, Mohammad Shirzadi, Hamid Solgi","doi":"10.1186/s13756-025-01570-1","DOIUrl":"10.1186/s13756-025-01570-1","url":null,"abstract":"<p><strong>Background: </strong>Serratia marcescens is an opportunistic gram-negative bacterium that is commonly associated with sudden outbreaks of various healthcare-associated infections in healthcare settings. This study describes two consecutive mini-outbreaks of S. marcescens in an operating room following laparoscopic sleeve gastrectomy procedures.</p><p><strong>Methods: </strong>Between December 16 and 26, 2020, five patients who underwent sleeve gastrectomy at a university hospital were re-admitted with clinical symptoms. An investigation by the infection control team was conducted to identify the source. Environmental and instrument samples were collected, and antimicrobial susceptibility testing was performed. Molecular typing using pulsed-field gel electrophoresis (PFGE) was conducted to assess the genetic relatedness of the isolates. Infection control interventions were implemented during the outbreak.</p><p><strong>Findings: </strong>During this period, four of the five patients tested positive for S. marcescens. A total of 31 surveillance samples were collected, isolates from the handle of one LigaSure and the grasper of another were also positive for S. marcescens. PFGE revealed two distinct clones, indicating two separate outbreaks. Four of the six isolates from samples of patients and environment were the same, while two isolates belonging to another clone were collected from the blood samples of patients. After discontinuation of the reused LigaSure devices and implementation of strict infection control measures, no new cases were reported.</p><p><strong>Conclusion: </strong>The two consecutive S. marcescens outbreaks were linked to the reuse of inadequately sterilized LigaSure devices. The implementation of targeted infection control measures successfully halted further transmission.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"54"},"PeriodicalIF":4.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101001","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 Clostridioides difficile infection caused by ribotype 027 strains in the Veterans Affairs Healthcare System: a matched case-control study.","authors":"Sandra Y Silva, Brigid M Wilson, Curtis J Donskey","doi":"10.1186/s13756-025-01571-0","DOIUrl":"10.1186/s13756-025-01571-0","url":null,"abstract":"<p><strong>Background: </strong>In case-control studies, a variety of factors have been associated with Clostridioides difficile infection (CDI) due to the epidemic ribotype 027 strain. However, many studies have been limited due to small sample size and inclusion of only one facility.</p><p><strong>Methods: </strong>Using a nationwide cohort of hospitalized patients in the Veterans Affairs (VA) Healthcare System, we conducted a retrospective, 1:3 matched case-control study of patients with CDI due to the ribotype 027 strain versus non-027 strains from October 1, 2008, to September 30, 2020. Controls were matched to cases by health care facility and year of diagnosis. Multivariate logistic regression was used to identify risk factors for CDI due to the 027 strain.</p><p><strong>Results: </strong>A total of 3,353 cases were matched to 10,059 controls in 84 VA facilities. CDI due to the ribotype 027 strain was independently associated with prior macrolide or fluoroquinolone exposure, decreased functional capability, methicillin-resistant Staphylococcus aureus nasal colonization, age >65 years, white blood cell count >11,000 cells/mm³, and serum albumin < 3.5 g/dl.</p><p><strong>Conclusion: </strong>Antimicrobial stewardship interventions focused on fluoroquinolones and macrolides could be beneficial in reducing the risk for infection due to the ribotype 027 C. difficile strain. Several other factors could potentially be used to identify patients at increased risk for CDI due to the ribotype 027 strain, but further studies are needed to assess their utility in clinical settings.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"53"},"PeriodicalIF":4.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085712","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":"Trends of antibiotic use for acute upper respiratory infections in Chinese emergency departments and the impact of COVID-19: a cross-sectional study.","authors":"Tingxi Wu, Tongxu Li, Heng Guo, Bin Zhu, Yang Zhang, Zhigang Zhao","doi":"10.1186/s13756-025-01567-w","DOIUrl":"10.1186/s13756-025-01567-w","url":null,"abstract":"<p><strong>Background: </strong>The emergence of Coronavirus Disease 2019 (COVID-19) has impacted antibiotic use; however, studies on antibiotic use for acute upper respiratory infections (AURIs) in Chinese emergency department (ED) settings are still scarce.</p><p><strong>Objective: </strong>This study aimed to explore trends and patterns in antibiotic use and the impact of COVID-19 in Chinese ED settings.</p><p><strong>Methods: </strong>A cross-sectional, retrospective analysis was conducted using prescriptions for ED visits due to AURIs through the Hospital Prescription Analysis Cooperative Project Database between 2018 and 2023. We examined patterns of antibiotic use for AURIs and employed an interrupted time series analysis to assess the impact of the COVID-19 pandemic on antibiotic use. The proportion of antibiotic prescriptions adhering to first-line guideline recommendations was also evaluated.</p><p><strong>Results: </strong>A total of 1,972,270 prescriptions for AURIs from 108 hospitals in EDs were extracted. The antibiotic prescription rate (APR) was 58.44%. The predominant antibiotics prescribed for AURIs were second- and third-generation cephalosporins and azithromycin. Among these prescriptions, only 22.26% adhered to first-line guideline recommendations, while 83.82% involved Watch-group antibiotics. A substantial decrease in antibiotic consumption was observed at the onset of the pandemic, but no significant changes were found in the APR. After the relaxation of anti-COVID-19 measures, both antibiotic consumption and the APR exhibited an upward trend. However, neither returned to pre-pandemic levels.</p><p><strong>Conclusion: </strong>Antibiotic use for AURIs was prevalent in ED settings, with a predominant use of broad-spectrum and Watch-group antibiotics. After the lifting of pandemic control measures, both antibiotic consumption and the APR exhibited an upward trend, underscoring the need to reinforce antimicrobial stewardship, particular targeting broad-spectrum and Watch-group antibiotic use.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"51"},"PeriodicalIF":4.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075428","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":"Quick and dirty: improper glove use increases infection risk and has global consequences.","authors":"Alexandra Peters, Martina Močenić, Alberto Spitilli, Sally Bloomfield, Mahmood F Bhutta","doi":"10.1186/s13756-025-01563-0","DOIUrl":"10.1186/s13756-025-01563-0","url":null,"abstract":"<p><p>The development of disposable gloves and the discovery that good hand hygiene are essential for protecting patients are among the most important developments in the history of infection prevention and control, and are both essential for protecting patients and healthcare workers. Although there are international-level guidelines for glove use and hand hygiene during patient care, there are major issues concerning compliance. The overuse of gloving does not only contribute to reduced patient safety and increased healthcare-associated infections, but leads directly to environmental degradation and labor rights abuses.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"52"},"PeriodicalIF":4.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075421","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":"Between heuristic and deliberative thinking: a multi-center qualitative study of physicians' decision-making in infection prevention practice.","authors":"Miriam Schutte, Mireille Dekker, Jonne Sikkens, Rosa van Mansfeld","doi":"10.1186/s13756-025-01572-z","DOIUrl":"10.1186/s13756-025-01572-z","url":null,"abstract":"<p><strong>Background: </strong>Application of standard infection prevention and control (IPC) measures is crucial to prevent hospital-acquired infections, but compliance by physicians is suboptimal. Interventions aimed to improve compliance are often generic and lack sustained effects. A better understanding of physicians' trade-offs regarding application of IPC and influences on their behavior is needed to develop effective behavior change interventions. We aimed to understand physicians' decision-making processes around application of IPC and the factors that influence their behavior.</p><p><strong>Methods: </strong>This qualitative study involved semi-structured interviews with 18 physicians and 7 nurses from five different hospitals in the Netherlands. Reflexive thematic analysis involved inductive coding followed by deductive analysis using mechanisms of action, including the Theoretical Domains Framework, that link to behavior change techniques.</p><p><strong>Results: </strong>We found heterogeneity in physicians' approaches to decision-making around application of IPC. Some physicians relied on heuristics, while others applied logical reasoning. The latter group made an autonomous assessment of the risks for infection associated with a situation and traded off the costs and benefits of IPC application. The decision was further influenced by personal beliefs about the value of IPC and a supporting physical and social environment. Eighteen out of 26 mechanisms of action underlying the influences on IPC behavior were matched to our results; most important are \"memory, attention and decision processes\", \"behavioral cueing\", \"beliefs about consequences\", \"values\", \"norms\", \"social influences\", \"social learning/imitation\" and \"environmental context and resources\". These findings suggest that interventions are most likely to be beneficial if these focus on developing heuristics, changing risk beliefs, using social norms and imitation and generating a supportive environment.</p><p><strong>Conclusion: </strong>The heterogeneity in physicians' decision-making and autonomous risk assessment which is different from other healthcare professionals calls for tailored interventions targeting heuristic decision making, personal beliefs, social norms and the environmental context.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"50"},"PeriodicalIF":4.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075418","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 and outcome for bloodstream infections due to fluconazole-resistant Candida parapsilosis: a 22-year single-center retrospective study.","authors":"Cihan Semet, Esra Kazak, Beyza Ener, Seçil Ak, Güven Özkaya, Harun Ağca, Yasemin Heper, Emel Yılmaz, Halis Akalın","doi":"10.1186/s13756-025-01559-w","DOIUrl":"https://doi.org/10.1186/s13756-025-01559-w","url":null,"abstract":"<p><p>Candidemia ranks among the top causes of nosocomial bloodstream infections, significantly increasing hospital stays and costs. Rapid and effective empirical antifungal therapy is crucial. The Candida parapsilosis species complex, the second most common cause of candidemia, has shown rising fluconazole resistance globally and in our country. Additionally, echinocandins exhibit higher minimum inhibitory concentrations (MICs) for C. parapsilosis, complicating empirical treatment decisions. This retrospective study analyzed 173 C. parapsilosis candidemia cases over 22 years in a tertiary care hospital. We compared 88 fluconazole non-susceptible (minimum inhibitory concentration [MIC] = 4 µg/mL: susceptible dose dependent; MIC ≥ 8 µg/ml resistant) and 85 fluconazole susceptible cases, examining demographics, clinical characteristics, risk factors, and 28-day mortality. Independent risk factors for fluconazole non-susceptibilty included age ≥ 66 years (p = 0.016), central venous catheter use (p < 0.001), total parenteral nutrition (p = 0.003), and colostomy (p = 0.049). Fluconazole non-susceptible cases had lower microbiological cure rates and higher mortality. Mortality in this group was independently associated with microbiological cure failure (p < 0.001). This study highlights the importance of identifying risk factors to estimate the likelihood of resistant pathogens, initiating targeted antifungal therapy, and providing individualized management. Monitoring local resistance patterns is essential to guide empirical therapy. Further multicenter research is needed to validate findings and optimize treatment for fluconazole resistant candidemia. Clinical trial number: Not applicable.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"49"},"PeriodicalIF":4.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075425","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 control interventions against carbapenem-resistant Acinetobacter baumannii and Klebsiella pneumoniae in an Iranian referral university hospital: A quasi-experimental study.","authors":"Mojtaba Akbari, Christian G Giske, Malihe Alenaseri, Ahmad Zarei, Narjes Karimi, Hamid Solgi","doi":"10.1186/s13756-025-01569-8","DOIUrl":"10.1186/s13756-025-01569-8","url":null,"abstract":"<p><strong>Background: </strong>In the past decades, the prevalence of carbapenem-resistant Gram-negative bacteria (CR-GNB) has increased on a global scale. Here, we outline the infection prevention and control (IPC) interventions for addressing the prevalence of carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Klebsiella pneumoniae (CRKP).</p><p><strong>Methods: </strong>A quasi-experimental study design was performed during the seven periods of 6-months from September 2018 to September 2021 in a large ICU in an Iranian hospital. IPC interventions were implemented from period 2 onward, with the exception of period 4 (March-September 2020) due to COVID-19 pandemic-related service disruptions. CRKP and CRAB prevalence and antibiotic resistance of GNB were compared across the seven periods.</p><p><strong>Results: </strong>In total, 1,862 GNB isolates were identified across seven periods, with K. pneumoniae (41%) being the most prevalent pathogen, followed by Escherichia coli (24.6%) and A. baumannii (14%). The highest antibiotic resistance rates, including 65.5% for meropenem, were observed during the fourth period. From September 2019 to March 2022, 178 CRKP and 97 CRAB isolates were identified, with infection rates of 78.1% and 62.9%, respectively. Following IPC interventions, a significant reduction in CRKP and CRAB prevalence was noted in the second and third periods, although an increase occurred during the fourth period. By the seventh period, the lowest prevalence of CRKP (26 isolates) and CRAB (5 isolates) was observed. Finally, a moderate inverse correlation (-0.571) was found between hand hygiene compliance and mortality incidence.</p><p><strong>Conclusion: </strong>The implementation of targeted IPC interventions significantly reduced the prevalence of CRKP and CRAB infections in the ICU, demonstrating their effectiveness in controlling antibiotic-resistant pathogens. However, the resurgence of these infections during the COVID-19 pandemic highlights the need for continuous monitoring and adaptation of IPC strategies. Ongoing training and adherence to hygiene protocols are essential to sustain improvements and prevent future outbreaks. Our findings underscore the importance of proactive infection control measures in managing antibiotic resistance in critical care settings.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"48"},"PeriodicalIF":4.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966487","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}