Antimicrobial Resistance and Infection Control最新文献

{"title":"Hand and environmental hygiene: respective roles for MRSA, multi-resistant gram negatives, Clostridioides difficile, and Candida spp.","authors":"John M Boyce","doi":"10.1186/s13756-024-01461-x","DOIUrl":"https://doi.org/10.1186/s13756-024-01461-x","url":null,"abstract":"<p><p>Healthcare-associated infections (HAIs) caused by multidrug-resistant organisms (MDROs) represent a global threat to human health and well-being. Because transmission of MDROs to patients often occurs via transiently contaminated hands of healthcare personnel (HCP), hand hygiene is considered the most important measure for preventing HAIs. Environmental surfaces contaminated with MDROs from colonized or infected patients represent an important source of HCP hand contamination and contribute to transmission of pathogens. Accordingly, facilities are encouraged to adopt and implement recommendations included in the World Health Organization hand hygiene guidelines and those from the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America/Association for Professionals in Infection Control and Epidemiology. Alcohol-based hand rubs are efficacious against MDROs with the exception of Clostridiodes difficile, for which soap and water handwashing is indicated. Monitoring hand hygiene adherence and providing HCP with feedback are of paramount importance. Environmental hygiene measures to curtail MDROs include disinfecting high-touch surfaces in rooms of patients with C. difficile infection daily with a sporicidal agent such as sodium hypochlorite. Some experts recommend also using a sporicidal agent in rooms of patients colonized with C. difficile, and for patients with multidrug-resistant Gram-negative bacteria. Sodium hypochlorite, hydrogen peroxide, or peracetic acid solutions are often used for daily and/or terminal disinfection of rooms housing patients with Candida auris or other MDROs. Products containing only a quaternary ammonium agent are not as effective as other agents against C. auris. Portable medical equipment should be cleaned and disinfected between use on different patients. Detergents are not recommended for cleaning high-touch surfaces in MDRO patient rooms, unless their use is followed by using a disinfectant. Facilities should consider using a disinfectant instead of detergents for terminal cleaning of floors in MDRO patient rooms. Education and training of environmental services employees is essential in assuring effective disinfection practices. Monitoring disinfection practices and providing personnel with performance feedback using fluorescent markers, adenosine triphosphate assays, or less commonly cultures of surfaces, can help reduce MDRO transmission. No-touch disinfection methods such as electrostatic spraying, hydrogen peroxide vapor, or ultraviolet light devices should be considered for terminal disinfection of MDRO patient rooms. Bundles with additional measures are usually necessary to reduce MDRO transmission.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"110"},"PeriodicalIF":4.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339589","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":"Research priorities to strengthen environmental cleaning in healthcare facilities: the CLEAN Group Consensus.","authors":"Giorgia Gon, Angela Dramowski, Emilio Hornsey, Wendy Graham, Nasser Fardousi, Alexander Aiken, Benedetta Allegranzi, Darcy Anderson, James Bartram, Sanjay Bhattacharya, John Brogan, An Caluwaerts, Maria Clara Padoveze, Nizam Damani, Stephanie Dancer, Miranda Deeves, Lindsay Denny, Nicholas Feasey, Lisa Hall, Joost Hopman, Laxman Kharal Chettry, Martin Kiernan, Claire Kilpatrick, Shaheen Mehtar, Christine Moe, Stephen Nurse-Findlay, Folasade Ogunsola, Tochi Okwor, Bruno Pascual, Molly Patrick, Oliver Pearse, Alexandra Peters, Didier Pittet, Julie Storr, Sara Tomczyk, Thomas G Weiser, Habib Yakubu","doi":"10.1186/s13756-024-01463-9","DOIUrl":"10.1186/s13756-024-01463-9","url":null,"abstract":"<p><p>Environmental cleaning is essential to patient and health worker safety, yet it is a substantially neglected area in terms of knowledge, practice, and capacity-building, especially in resource-limited settings. Public health advocacy, research and investment are urgently needed to develop and implement cost-effective interventions to improve environmental cleanliness and, thus, overall healthcare quality and safety. We outline here the CLEAN Group Consensus exercise yielding twelve urgent research questions, grouped into four thematic areas: standards, system strengthening, behaviour change, and innovation.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"112"},"PeriodicalIF":4.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339591","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":"Federated systems for automated infection surveillance: a perspective.","authors":"Stephanie M van Rooden, Suzanne D van der Werff, Maaike S M van Mourik, Frederikke Lomholt, Karina Lauenborg Møller, Sarah Valk, Carolina Dos Santos Ribeiro, Albert Wong, Saskia Haitjema, Michael Behnke, Eugenia Rinaldi","doi":"10.1186/s13756-024-01464-8","DOIUrl":"https://doi.org/10.1186/s13756-024-01464-8","url":null,"abstract":"<p><p>Automation of surveillance of infectious diseases-where algorithms are applied to routine care data to replace manual decisions-likely reduces workload and improves quality of surveillance. However, various barriers limit large-scale implementation of automated surveillance (AS). Current implementation strategies for AS in surveillance networks include central implementation (i.e. collecting all data centrally, and central algorithm application for case ascertainment) or local implementation (i.e. local algorithm application and sharing surveillance results with the network coordinating center). In this perspective, we explore whether current challenges can be solved by federated AS. In federated AS, scripts for analyses are developed centrally and applied locally. We focus on the potential of federated AS in the context of healthcare associated infections (AS-HAI) and of severe acute respiratory illness (AS-SARI). AS-HAI and AS-SARI have common and specific requirements, but both would benefit from decreased local surveillance burden, alignment of AS and increased central and local oversight, and improved access to data while preserving privacy. Federated AS combines some benefits of a centrally implemented system, such as standardization and alignment of an easily scalable methodology, with some of the benefits of a locally implemented system including (near) real-time access to data and flexibility in algorithms, meeting different information needs and improving sustainability, and allowance of a broader range of clinically relevant case-definitions. From a global perspective, it can promote the development of automated surveillance where it is not currently possible and foster international collaboration.The necessary transformation of source data likely will place a significant burden on healthcare facilities. However, this may be outweighed by the potential benefits: improved comparability of surveillance results, flexibility and reuse of data for multiple purposes. Governance and stakeholder agreement to address accuracy, accountability, transparency, digital literacy, and data protection, warrants clear attention to create acceptance of the methodology. In conclusion, federated automated surveillance seems a potential solution for current barriers of large-scale implementation of AS-HAI and AS-SARI. Prerequisites for successful implementation include validation of results and evaluation requirements of network participants to govern understanding and acceptance of the methodology.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"113"},"PeriodicalIF":4.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339588","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":"Baseline evaluation of the World Health Organization (WHO) infection prevention and control (IPC) core components in Pacific Island Countries and Territories (PICTs).","authors":"Margaret Leong, Rochelle Picton, Melanie Wratten, Ana Mahe, Peta-Anne Zimmerman","doi":"10.1186/s13756-024-01447-9","DOIUrl":"https://doi.org/10.1186/s13756-024-01447-9","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive infection prevention and control (IPC) programmes are proven to reduce the spread of healthcare-associated infections (HAIs) and antimicrobial resistance (AMR). However, published assessments of IPC programmes against the World Health Organization (WHO) IPC Core Components in Pacific Island Countries and Territories (PICTs) at the national and acute healthcare facility level are currently unavailable.</p><p><strong>Methods: </strong>From January 2022 to April 2023, a multi-country, cross-sectional study was conducted in PICTs. The self reporting survey was based on the WHO Infection Prevention Assessment Framework (IPCAF) that supports implementing the minimum requirements of the WHO eight core components of IPC programmes at both the national and facility level. The results were presented as a 'traffic light' (present, in progress, not present) matrix. Each PICT's overall status in achieving IPC core components was summarised using descriptive statistics.</p><p><strong>Results: </strong>Fifteen PICTs participated in this study. Ten (67%) PICTs had national IPC programmes, supported mainly by IPC focal points (87%, n = 13), updated national IPC guidelines (80%, n = 12), IPC monitoring and feedback mechanisms (80%, n = 12), and waste management plans (87%, n = 13). Significant gaps were identified in education and training (20%, n = 3). Despite being a defined component in 67% (n = 10) of national IPC programmes, HAI surveillance and monitoring was the lowest scoring core component (13%, n = 2). National and facility level IPC guidelines had been adapted and implemented in 67% (n = 10) PICTs; however, only 40% (n = 6) of PICTs had a dedicated IPC budget, 40% (n = 6) had multimodal strategies for IPC, and 33% (n = 5) had daily environmental cleaning records.</p><p><strong>Conclusions: </strong>Identifying IPC strengths, gaps, and challenges across PICTs will inform future IPC programme priorities and contribute to regional efforts in strengthening IPC capacity. This will promote global public health through the prevention of HAIs and AMR.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"108"},"PeriodicalIF":4.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339584","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":"Occurrence of chlorine-resistant Pseudomonas aeruginosa in hospital water systems: threat of waterborne infections for patients.","authors":"Sahar Gholipour, Mahnaz Nikaeen, Mohammadmehdi Mehdipour, Farzaneh Mohammadi, Davarkhah Rabbani","doi":"10.1186/s13756-024-01468-4","DOIUrl":"https://doi.org/10.1186/s13756-024-01468-4","url":null,"abstract":"<p><strong>Background: </strong>Several healthcare-associated infection outbreaks have been caused by waterborne Pseudomonas aeruginosa exhibiting its ability to colonize water systems and resist conventional chlorine treatment. This study aims to investigate the occurrence of Pseudomonas aeruginosa in hospital drinking water systems and the antimicrobial resistance profiles (antibiotic and chlorine resistance) of isolated strains.</p><p><strong>Methods: </strong>We investigated the presence of Pseudomonas aeruginosa in water and biofilms developed in nine hospital water systems (n = 192) using culture-based and molecular methods. We further assessed the survival of isolated strains after exposure to 0.5 and 1.5 ppm concentrations of chlorine. The profile of antibiotic resistance and presence of antibiotic resistance genes in isolated strains were also investigated.</p><p><strong>Results: </strong>Using direct PCR method, Pseudomonas aeruginosa was detected in 22% (21/96) of water and 28% (27/96) of biofilm samples. However, culturable Pseudomonas aeruginosa was isolated from 14 samples. Most of P. aeruginosa isolates (86%) were resistant to at least one antibiotic (mainly β-lactams), with 50% demonstrating multidrug resistance. Moreover, three isolates harbored intI1 gene and two isolates contained bla_OXA-24,bla_OXA-48, and bla_OXA-58‌ genes. Experiments with chlorine disinfection revealed that all tested Pseudomonas aeruginosa strains were resistant to a 0.5 ppm concentration. However, when exposed to a 1.5 ppm concentration of chlorine for 30 min, 60% of the strains were eliminated. Interestingly, all chlorine-resistant bacteria that survived at 30-minute exposure to 1.5 ppm chlorine were found to harbor the intI1 gene.</p><p><strong>Conclusions: </strong>The detection of antimicrobial resistant Pseudomonas aeruginosa in hospital water systems raises concerns about the potential for infections among hospitalized patients. The implementation of advanced mitigation measures and targeted disinfection methods should be considered to tackle the evolving challenges within hospital water systems.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"111"},"PeriodicalIF":4.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339590","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":"Correction: Development and application of a risk nomogram for the prediction of risk of carbapenem-resistant Acinetobacter baumannii infections in neuro-intensive care unit: a mixed method study.","authors":"Yuping Li, Xianru Gao, Haiqing Diao, Tian Shi, Jingyue Zhang, Yuting Liu, Qingping Zeng, JiaLi Ding, Juan Chen, Kai Yang, Qiang Ma, Xiaoguang Liu, Hailong Yu, Guangyu Lu","doi":"10.1186/s13756-024-01469-3","DOIUrl":"https://doi.org/10.1186/s13756-024-01469-3","url":null,"abstract":"","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"109"},"PeriodicalIF":4.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339585","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":"The genetic relationship between human and pet isolates: a core genome multilocus sequence analysis of multidrug-resistant bacteria.","authors":"Antonia Genath, Carolin Hackmann, Luisa Denkel, Anna Weber, Friederike Maechler, Axel Kola, Stefan Schwarz, Petra Gastmeier, Rasmus Leistner","doi":"10.1186/s13756-024-01457-7","DOIUrl":"https://doi.org/10.1186/s13756-024-01457-7","url":null,"abstract":"<p><strong>Introduction: </strong>The global increase of multidrug-resistant organisms (MDROs) is one of the most urgent public health threats affecting both humans and animals. The One Health concept emphasizes the interconnectedness of human, animal and environmental health and highlights the need for integrated approaches to combat antimicrobial resistance (AMR). Although the sharing of environments and antimicrobial agents between companion animals and humans poses a risk for MDRO transmission, companion animals have been studied to a lesser extent than livestock animals. This study therefore used core genome multilocus sequence typing (cgMLST) to investigate the genetic relationships and putative transmission of MDROs between humans and pets.</p><p><strong>Methods: </strong>This descriptive integrated typing study included 252 human isolates, 53 dog isolates and 10 cat isolates collected from 2019 to 2022 at the Charité University Hospital in Berlin, Germany. CgMLST was performed to characterize methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci and multidrug-resistant gram-negative bacteria. The genetic diversity of the MDROs of the different host populations was determined and compared based on sequence type and core genome complex type.</p><p><strong>Results: </strong>Within this study the majority of samples from pets and humans was genetically distinct. However, for some isolates, the number of allelic differences identified by cgMLST was low. Two cases of putative household transmission or shared source of VR E. faecium and MDR E. coli between humans and pets were documented.</p><p><strong>Conclusions: </strong>The interaction between humans and their pets appears to play a minor role in the spread of the MDROs studied. However, further research is needed. This study emphasizes the importance of comprehensive molecular surveillance and a multidisciplinary One Health approach to understand and contain the spread of MDROs in human and animal populations.</p><p><strong>Trial registration: </strong>The study is registered with the German Clinical Trials Register (DRKS00030009).</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"107"},"PeriodicalIF":4.8,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279421","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":"Prevalence of self-medication practices with antibiotics and associated factors among students in five colleges in Eritrea: a cross-sectional study.","authors":"Nahom Kiros Gebregziabher, Tesfit Brhane Netsereab, Bethiel Tekie Franchesko, Hanna Habte Ghebreamlak, Natnael Mulugeta Yihdego","doi":"10.1186/s13756-024-01466-6","DOIUrl":"https://doi.org/10.1186/s13756-024-01466-6","url":null,"abstract":"<p><strong>Background: </strong>Despite their significant contribution to reducing mortality and morbidity from infectious diseases, antibiotics face challenges due to their inappropriate use, one of which is self-medication. This study assessed the prevalence of|| self-medication with antibiotics among Eritrean college students and its associated factors.</p><p><strong>Methods: </strong>An analytical cross-sectional study evaluated the prevalence of self-medication with antibiotics among students from five colleges from September 2019 to February 2020. Participants were selected through simple random sampling, and each participant completed a structured questionnaire covering socio-demographic characteristics, knowledge and attitudes toward antibiotics, and self-medication practices. Logistic regression analysis was employed to identify factors associated with self-medication with antibiotics.</p><p><strong>Results: </strong>The study distributed 380 questionnaires, with 375 returned, yielding a response rate of 98.68%. Findings revealed that 80.3% of participants were familiar with antibiotics. Additionally, 18.8% agreed with non-prescription antibiotic use for simple ailments. Of the 252 respondents who answered, 67.1% reported self-medication with antibiotics. Within the preceding six months, the prevalence of such self-medication was 34.3%. Factors associated with self-medication included college affiliation, with participants from the College of Science (COS) exhibiting lower odds (AOR = 0.38, 95% CI: 0.16-0.91, p = 0.03) compared to the College of Business and Social Sciences (CBSS) students. Those living in dormitories had 2.4 times higher odds (AOR = 2.42, 95% CI: 1.7-5.02, p = 0.017) to self-medicate compared to those living with family. Moreover, individuals unaware of antibiotic resistance had higher odds (AOR = 2.41, 95% CI: 1.24-4.7, p = 0.009) of self-medication. Attitude score was also significantly associated with self-medication (AOR = 0.88, 95% CI: 0.8-0.98, p = 0.027).</p><p><strong>Conclusions: </strong>These results highlight the necessity for tailored educational programs to advocate for appropriate antibiotic utilization and mitigate the prevalent misuse of antibiotics among college students. Initiatives focused on increasing knowledge about the dangers linked with self-medication and advocating for conscientious antibiotic usage are essential in combating the escalating challenge of antibiotic resistance and safeguarding public health.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"106"},"PeriodicalIF":4.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11414089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279420","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":"Molecular epidemiology, microbiological features and infection control strategies for carbapenem-resistant Acinetobacter baumannii in a German burn and plastic surgery center (2020-2022).","authors":"Marius Vital, Sabrina Woltemate, Dirk Schlüter, Nicco Krezdorn, Thorben Dieck, Khaled Dastagir, Franz-Christoph Bange, Ella Ebadi, Peter M Vogt, Leonard Knegendorf, Claas Baier","doi":"10.1186/s13756-024-01459-5","DOIUrl":"10.1186/s13756-024-01459-5","url":null,"abstract":"<p><strong>Background: </strong>Carbapenem-resistant Acinetobacter baumannii (CRAB) frequently causes both healthcare-associated infections and nosocomial outbreaks in burn medicine/plastic surgery and beyond. Owing to the high antibiotic resistance, infections are difficult to treat, and patient outcomes are often compromised. The environmental persistence capability of CRAB favors its transmission in hospitals. A comprehensive analysis and understanding of CRAB epidemiology and microbiology are essential for guiding management.</p><p><strong>Methods: </strong>A three-year retrospective cohort study (2020-2022) was conducted in a German tertiary burn and plastic surgery center. In addition to epidemiological analyses, microbiological and molecular techniques, including whole-genome sequencing, were applied for the comprehensive examination of isolates from CRAB-positive patients.</p><p><strong>Results: </strong>During the study period, eight CRAB cases were found, corresponding to an overall incidence of 0.2 CRAB cases per 100 cases and an incidence density of 0.35 CRAB cases per 1000 patient-days. Six cases (75%) were treated in the burn intensive care unit, and four cases (50%) acquired CRAB in the hospital. Molecular analyses comprising 74 isolates supported the epidemiologic assumption that hospital acquisitions occurred within two separate clusters. In one of these clusters, environmental CRAB contamination of anesthesia equipment may have enabled transmission. Furthermore, molecular diversity of CRAB isolates within patients was observed.</p><p><strong>Conclusions: </strong>CRAB can pose a challenge in terms of infection prevention and control, especially if cases are clustered in time and space on a ward. Our study demonstrates that high-resolution phylogenetic analysis of several bacterial isolates from single patients can greatly aid in understanding transmission chains and helps to take precision control measures.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"99"},"PeriodicalIF":4.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144984","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, attitudes, and readiness about critical antimicrobial resistant organisms among healthcare workers at colonial war memorial hospital in Fiji: a pre and post intervention study.","authors":"Kirsty Buising, Ravi Naidu, Shammi Prasad, Matthew Richards, Savneel Shivam Kumar, Alvina Lata, Ashlyn Datt, Sisilia Assisi Genaro, Timaima Ratusela, Ilisapeci Nabose, Donna Cameron, Ana Suka, Tracey Young-Sharma, Benjamin P Howden, Aneley Getahun Strobel","doi":"10.1186/s13756-024-01439-9","DOIUrl":"10.1186/s13756-024-01439-9","url":null,"abstract":"<p><strong>Background: </strong>Gram-negative bacteria resistant to carbapenems are also known as critical antimicrobial resistant organisms. Their emergence at Colonial War Memorial Hospital (CWMH), the largest hospital in Fiji, is a major clinical concern. This study was conducted to determine the knowledge, attitudes, and readiness of healthcare workers (HCW) at CWMH regarding management of patients with infections caused by critical antimicrobial resistant organisms.</p><p><strong>Methods: </strong>A questionnaire was designed using a Likert scale to assess knowledge, attitudes, and readiness. Two cross-sectional studies were conducted, before and after the implementation of targeted educational activities which were informed by the pre-intervention study findings.</p><p><strong>Results: </strong>A total of 393 and 420 HCW participated in the pre- and post-intervention studies, respectively. The majority of respondents were female (77.3%) and 18-34 years of age (67%). HCW professional roles included nurses (56.3%), doctors (31.6%), and laboratory personnel (12.2%). In the post-intervention study, significantly more HCW reported having received infection prevention and control (IPC) and antimicrobial resistance education and training (26.8% in pre to 45.5% in post intervention, p < 0.001). The majority of nurses and doctors (> 85% to ≥ 95%) were aware of how AMR organisms spread in healthcare settings and knew the IPC measures to prevent transmission of AMR infections including hand hygiene, standard and transmission-based precautions. Attitudes towards AMR were positive, with 84.2% pre intervention and 84.8% of HCW post intervention expressing their willingness to change their work environment to assist with AMR prevention. Perceived readiness to address the problem showed mixed results. Improvements in laboratory AMR surveillance data availability were noted (29.4-52.4%, p < 0001). Modest improvement in the hospital's capacity for outbreak response (44-51.9%, p = 0.01), and treatment of AMR infections (38.9-44.4%, p = 0.01) was reported.</p><p><strong>Conclusions: </strong>Our data revealed high levels of staff awareness and knowledge about AMR and IPC. However, readiness for outbreak response and treatment of critical AMR infections requires more attention. Improving AMR prevention and containment in CWMH will likely require sustained and multisectoral interventions with strong administrative commitment.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"98"},"PeriodicalIF":4.8,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124593","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}