Infection Prevention in Practice最新文献_第2页

Patient-reported education regarding hand hygiene and use of non-sterile clinical gloves in an emergency department observation unit 在急诊科观察单元中，患者报告的关于手部卫生和使用非无菌临床手套的教育

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2026-03-01 Epub Date: 2025-11-24 DOI: 10.1016/j.infpip.2025.100501

Hanna-Leena Melender , Elina Koota , Katariina Kainulainen , Karoliina Aho , Marja Mäkinen , Johanna Kaartinen

Background

Patient education regarding hand hygiene (HH) and the correct use of non-sterile clinical gloves (NSCGs) are important parts of infection prevention and control. Unnecessary use of NSCGs can be harmful, has associated financial costs, and harms the environment. This study aimed to explore healthcare workers' (HCWs) adherence to patient education regarding HH and the correct use of NSCGs in an observation unit.

Methods

Data in this observational descriptive cross-sectional study were collected from patients using a questionnaire. The questionnaire asked about the patient education received and the use of NSCGs by HCWs. The correctness of NSCG use was determined by the investigators based on standard precautions on infection prevention and control. Statistical analysis and qualitative content analysis were performed.

Results

The convenience sample consisted of 174 patients in an observation unit at Helsinki University Hospital, and 600 care, examination or test procedures conducted for patients. The response rate was 87%. Of the participating patients, 8.6% reported that they had received patient education on HH. Eighteen different procedures were conducted for the study patients. The use of NSCGs was always correct for six procedures. Unnecessary use of NSCGs was found (to varying degrees) for nine procedures, and insufficient use of NSCGs was found for three procedures. An association was found between a procedure/procedure type conducted for a patient and the correct use of NSCGs (P<0.001).

Conclusions

Deviations from the standard precautions existed. Interventions for HCWs are needed to support routine patient education on HH and evidence-based use of NSCGs.

背景对患者进行手部卫生教育和正确使用非无菌临床手套是预防和控制感染的重要组成部分。不必要地使用nscg可能是有害的，有相关的财务成本，并损害环境。本研究旨在探讨观察单位医护人员（HCWs）对患者HH教育的依从性和正确使用nscg的情况。方法本观察性描述性横断面研究采用问卷调查方式收集患者数据。问卷调查了医护人员对患者的教育程度和对NSCGs的使用情况。调查人员根据感染预防和控制的标准预防措施确定NSCG使用的正确性。进行统计分析和定性含量分析。结果方便样本包括赫尔辛基大学医院某观察室174例患者，对患者进行了600次护理、检查或测试程序。有效率为87%。在参与研究的患者中，8.6%的人表示他们接受过HH患者教育。对研究患者进行了18种不同的手术。nscg的使用在6个程序中始终是正确的。在9个手术中（不同程度地）发现了不必要使用nscg，在3个手术中发现了nscg使用不足。研究发现，为患者进行的手术/手术类型与nscg的正确使用之间存在关联（P<0.001）。结论与标准预防措施存在偏差。需要对卫生保健工作者进行干预，以支持对HH患者进行常规教育，并以证据为基础使用nscg。

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引用次数: 0

One-year epidemiological analysis of nosocomial infections and antimicrobial resistance in a Hungarian intensive care unit 匈牙利重症监护病房院内感染和抗菌药物耐药性一年流行病学分析

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2026-03-01 Epub Date: 2025-12-06 DOI: 10.1016/j.infpip.2025.100505

Agnes Csörnyei-Kelemen , Laszlo Marcell Repasi , Janos Leszkoven , Viktor Misak , Zoltan Balogh

Background

Healthcare-associated infections (HAIs) acquired in intensive care units (ICUs) represent a major burden of morbidity and mortality worldwide. However, national data in Hungary are limited, and few studies compare local findings with national and international surveillance systems.

Methods

We conducted a retrospective longitudinal study involving 1002 patients admitted to ICUs between 1^st May 2023 and 30^th April 2024. We analysed the prevalence, types and distribution of pathogens responsible for HAIs. Data were compared with national reports from the Hungarian National Nosocomial Surveillance System and international reports from the Centers for Disease Control and Prevention and European Centre for Disease Prevention and Control.

Results

The overall prevalence of HAIs was 16.9% (169/1002 patients). The most frequent infection types were lower respiratory tract infections (9.2%), ventilator-associated pneumonia (4.3%), urinary tract infections (UTIs, 3.8%) and Clostridioides difficile infections (2.5%). All UTIs identified during the study period were catheter-associated urinary tract infection, attributable to the high device utilisation rate in the ICU, where all patients had an indwelling urinary catheter during their stay. The leading pathogens were Pseudomonas aeruginosa (23.7%), Clostridioides difficile (13.0%), Klebsiella pneumoniae (13.0%), Enterococcus faecalis (11.6%) and Escherichia coli (5.8%). Overall, 30.9% (64/207) of isolates were multi-drug resistant (MDR).

Conclusion

Our study highlighted the considerable prevalence of HAIs and the dominance of MDR Gram-negative bacteria. Comparison with international data helps identify areas requiring targeted infection control measures.

背景：在重症监护病房（icu）获得的卫生保健相关感染（HAIs）是世界范围内发病率和死亡率的主要负担。然而，匈牙利的国家数据是有限的，很少有研究将当地的发现与国家和国际监测系统进行比较。方法对2023年5月1日至2024年4月30日入住icu的1002例患者进行回顾性纵向研究。我们分析了导致HAIs的病原体的流行、类型和分布。数据与匈牙利国家医院监测系统的国家报告以及疾病控制和预防中心和欧洲疾病预防和控制中心的国际报告进行了比较。结果HAIs总患病率为16.9%（169/1002例）。最常见的感染类型为下呼吸道感染（9.2%）、呼吸机相关性肺炎（4.3%）、尿路感染（uti, 3.8%）和艰难梭菌感染（2.5%）。在研究期间发现的所有尿路感染都是导尿管相关的尿路感染，这是由于ICU的设备使用率很高，所有患者在住院期间都有留置导尿管。主要病原菌为铜绿假单胞菌（23.7%）、艰难梭菌（13.0%）、肺炎克雷伯菌（13.0%）、粪肠球菌（11.6%）和大肠杆菌（5.8%）。总体而言，30.9%（64/207）的分离株具有多重耐药（MDR）。结论本研究强调了HAIs的普遍存在和耐多药革兰氏阴性菌的优势。与国际数据的比较有助于确定需要采取有针对性的感染控制措施的地区。

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引用次数: 0

A quality improvement initiative to reduce central line-associated bloodstream infection rates in the polytrauma intensive care unit of a tertiary care trauma hospital in India 一项质量改进倡议，旨在降低印度一家三级创伤医院多创伤重症监护病房中与中央静脉相关的血流感染率

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2026-03-01 Epub Date: 2025-07-14 DOI: 10.1016/j.infpip.2025.100478

Projoyita Samanta , Kapil Dev Soni , Rasna Parveen , Arpan Kumar Thakur , Bharat Chandra Das , Vanlal Tluanpuii , Kamran Farooque , Kamini Walia , Purva Mathur

Background

Central line–associated bloodstream infections (CLABSIs) pose a significant risk to patients and contribute to increased healthcare costs. They are largely preventable through evidence-based quality improvement (QI) initiatives.

Aim

In the polytrauma ICU, the CLABSI rate suddenly increased to 14/1000 central line days in the latter half of 2023. This QI initiative aimed to identify the root causes and reduce the CLABSI rates by 30% (targeting 10/1000 central line days) by June 2024.

Methods

A multidisciplinary team tested several interventions using small Plan-Do-Study-Act cycles. CLABSI prevention bundles were introduced and refined, including: the use of maximum barrier precautions during line insertion, adherence to the Central Line Insertion Practice (CLIP) tool, standardized and real time bundle monitoring via direct observation, regular training and education sessions for staff. Surveillance methods and modified CLABSI definitions from the Healthcare-Associated Infection Surveillance Network were applied.

Results

The CLABSI rate dropped from 14 to 8 per 1,000 central line days, with 49 consecutive CLABSI-free days. Regular monitoring improved staff compliance with central line insertion and maintenance bundles including the completion of the central line (CL) insertion checklist (100%), use of full body drape (78.4%), chlorhexidine for site cleaning, aseptic conditions during CL insertion (75%) and “scrub the hub” technique (65%). Staff awareness of healthcare-associated infections (HAIs) improved through regular refresher classes, bedside teaching sessions, and daily rounds by Infection Control Nurses (HCNs) and the Quality Improvement (QI) team.

Conclusions

Implementation of an evidence-based CLABSI prevention bundle, combined with direct process monitoring, led to significant and sustained reduction in CLABSI rates in the polytrauma ICU.

背景：中心线相关血流感染（CLABSIs）对患者构成重大风险，并导致医疗成本增加。它们在很大程度上可以通过循证质量改进（QI）举措加以预防。在多伤ICU， CLABSI率在2023年下半年突然上升到14/1000中心线日。该QI计划旨在确定根本原因，并在2024年6月之前将CLABSI率降低30%（目标是10/1000中心线日）。方法一个多学科团队采用计划-执行-研究-行动的小循环测试了几种干预措施。引入并完善了CLABSI预防捆绑包，包括：在输油管插入过程中使用最大限度的屏障预防措施，遵守中央输油管插入实践（CLIP）工具，通过直接观察进行标准化和实时的捆绑包监测，对工作人员进行定期培训和教育。监测方法和修改后的CLABSI定义来自医疗保健相关感染监测网络。结果CLABSI发生率由14 / 1000中心线d降至8 / 1000中心线d，连续49天无CLABSI。定期监测提高了工作人员对中心静脉导管插入和维护包的依从性，包括完成中心静脉导管插入检查表（100%）、使用全身悬垂（78.4%）、氯己定用于现场清洁、中心静脉导管插入期间的无菌条件（75%）和“擦洗中心”技术（65%）。通过感染控制护士（HCNs）和质量改进（QI）团队的定期复习课程、床边教学课程和每日查房，员工对医疗保健相关感染（HAIs）的认识得到了提高。结论：实施循证CLABSI预防方案，结合直接过程监测，可显著且持续地降低多发创伤ICU的CLABSI发生率。

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引用次数: 0

Evaluation of the efficacy of the automatic ozone decontamination device in a real-life setting of an intravitreal injection room 在玻璃体内注射室的实际环境中评价自动臭氧去污装置的效果。

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2026-03-01 Epub Date: 2026-01-08 DOI: 10.1016/j.infpip.2026.100507

D. Salom , A. Adloff-Alonso , M. Salvador Aguilá , C. Martínez-Rubio , A. Janicka-Caulineau , M. Moro-Muniz , R. Rodrigo

Objective

The objective of this study was to evaluate the efficacy of an ozonation system for disinfecting intravitreal injection rooms.

Design

A prospective intervention pilot study was conducted with a ‘before-and-after’ design.

Setting

The study was conducted in an intravitreal injection room at Hospital de Manises.

Methods

Air and surface samples were taken before and after ozonation using a remote-controlled ozonation system. The room was treated with ozone at a concentration of 9–10 ppm for 20 min. Measurements were taken immediately after, 12 h, and 24 h post ozonation. Statistical analysis was performed using the Wilcoxon signed-rank test.

Results

At 24 h post ozonation, significant reductions in microbial load were observed: in the centre of the room, the bacterial load reduced from >250 colony-forming units (cfu) to 10 cfu (96%) and fungi from 14 cfu to <1 cfu (93.1%) (P < 0.05); in the diffuser, the bacterial load reduced from 61 cfu to 24 cfu (60.7%) and fungi from 6 cfu to <1 cfu (100%) (P < 0.05) and on the procedure chair, the bacterial load reduced from 51 cfu to 7 cfu (86.3%) and fungi from 6 cfu to 3 cfu (50%) (P < 0.05).

Conclusions

In a dedicated intravitreal injection room, a remotely controlled ozonation cycle at 9–10 ppm for 20 min was associated with substantial short-term reductions in airborne and selected surface microbial load under unoccupied conditions. Automated ozonation may complement routine cleaning and ventilation to maintain low environmental bioburden; its clinical impact remains to be determined.

目的：评价臭氧化系统用于玻璃体内注射室消毒的效果。设计：前瞻性干预试点研究采用“前后对照”设计。环境：本研究在马尼塞斯医院的玻璃体内注射室进行。方法：采用遥控臭氧化系统对臭氧化前后的空气和地表进行采样。房间用浓度为9- 10ppm的臭氧处理20分钟。在臭氧化后立即、12小时和24小时进行测量。采用Wilcoxon符号秩检验进行统计分析。结果：臭氧化24 h后，微生物负荷显著降低：房间中央，细菌负荷从50 250菌落形成单位（cfu）降至10 cfu(96%)，真菌负荷从14 cfu降至P < 0.05)；在扩散器中，细菌负荷从61 cfu降至24 cfu(60.7%)，真菌从6 cfu降至P < 0.05)；在手术椅上，细菌负荷从51 cfu降至7 cfu(86.3%)，真菌从6 cfu降至3 cfu (50%) （P < 0.05）。结论：在专用的玻璃体内注射室中，远程控制臭氧化循环在9- 10ppm下持续20分钟，与空环境下空气和选定表面微生物负荷的短期大幅减少有关。自动臭氧化可以补充常规清洁和通风，以保持低环境生物负荷；其临床影响仍有待确定。

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引用次数: 0

Determinants of hand hygiene compliance among healthcare workers in public and private hospitals of Addis Ababa, Ethiopia 埃塞俄比亚亚的斯亚贝巴公立和私立医院医护人员手部卫生依从性的决定因素

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2026-03-01 Epub Date: 2025-11-05 DOI: 10.1016/j.infpip.2025.100488

A. Melaku , T. Admasu , A. Ambelu

Introduction

Hand hygiene is crucial for preventing hospital-acquired infections (HAIs), but compliance and resource availability still fall short in developing countries. This study examined hand hygiene compliance and its determinants among healthcare workers in selected hospitals in Addis Ababa, Ethiopia.

Methods

A mixed-methods, cross-sectional study was conducted in both public and private hospitals from December 2024 to January 2025, involving 506 healthcare workers across 19 hospitals. Twenty in-depth interviews were conducted with healthcare workers. Kobo Toolbox was used for quantitative data collection, and SPSS was used for analysis. Binary and multi-nomial logistic regression identified determinants of hand hygiene compliance (P<0.05). Thematic analysis was used to analyse qualitative data.

Results

Hand hygiene compliance showed a disparity: self-reported compliance was 71% (54.7% in public hospitals vs 87.3% in private hospitals), while observed compliance was much lower at 20.4% (11% public vs 29.8% private). Infrastructural assessment found that 79.2% of hospitals had handwashing sinks (70.9% public vs 98.6% private), 16% of which were non-functional (24.7% public vs 1.3% private). Additionally, 49.4% of hospitals lacked running water (66.8% public vs 8.6% private), and 54.6% lacked soap (79.5% public vs 9.8% private). Compliance was significantly associated with availability of a functional sink [adjusted odds ratio (AOR) 2.29, 95% confidence interval (CI) 1.17–4.51], touch-free taps (AOR 3.39, 95% CI 1.6–7.17), soap (AOR 2.11, 95% CI 1.05–4.25), training (AOR 2.39, 95% CI 1.43–4.00), and a hand hygiene protocol (AOR 7.50, 95% CI 2.84–19.81). The main barriers to compliance were infrastructural deficits, glove dependency, low risk perception, and insufficient institutional prioritization.

Conclusion

Hand hygiene compliance and material provision in hospitals in Addis Ababa are low, with a notable disparity between public and private hospitals. As the presence of infrastructure alone does not ensure compliance, the availability of a functional sink with water and soap at the point of care (or alcohol-based hand rub), regular hygiene training, adequate WASH funding, and strong institutional commitment are essential.

手部卫生对于预防医院获得性感染至关重要，但在发展中国家，遵守卫生要求和资源供应仍然不足。本研究考察了埃塞俄比亚亚的斯亚贝巴选定医院的卫生保健工作者的手卫生依从性及其决定因素。方法采用混合方法，于2024年12月至2025年1月在公立和私立医院进行横断面研究，涉及19家医院的506名医护人员。对医护人员进行了20次深度访谈。采用Kobo Toolbox进行定量数据收集，采用SPSS进行分析。二元和多元逻辑回归确定了手卫生依从性的决定因素（P<0.05）。采用专题分析对定性数据进行分析。结果口腔卫生依从性存在差异：自我报告的依从性为71%（公立医院为54.7%，私立医院为87.3%），而观察到的依从性为20.4%（公立医院为11%，私立医院为29.8%）。基础设施评估发现，79.2%的医院有洗手槽（70.9%的公立医院对98.6%的私立医院），其中16%的医院没有功能（24.7%的公立医院对1.3%的私立医院）。此外，49.4%的医院没有自来水（66.8%的公立医院比8.6%的私立医院），54.6%的医院没有肥皂（79.5%的公立医院比9.8%的私立医院）。依从性与功能水槽的可用性显著相关[调整优势比（AOR） 2.29, 95%可信区间（CI） 1.17-4.51]、免触水龙头（AOR 3.39, 95% CI 1.6-7.17）、肥皂（AOR 2.11, 95% CI 1.05-4.25）、训练（AOR 2.39, 95% CI 1.43-4.00）和手卫生方案（AOR 7.50, 95% CI 2.84-19.81）。合规的主要障碍是基础设施缺陷、手套依赖、低风险认知和机构优先级不足。结论亚的斯亚贝巴市医院的手卫生依从性和用品供应较低，公立医院与私立医院之间存在显著差异。由于仅有基础设施并不能确保遵守规定，因此必须在护理点提供带水和肥皂（或含酒精的洗手液）的功能性洗涤槽、定期的卫生培训、充足的讲卫生资金以及强有力的机构承诺。

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引用次数: 0

Comparison of bacterial contamination between disposable and cloth caps in an operating theatre setting 手术室一次性帽与布帽细菌污染比较

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2026-03-01 Epub Date: 2025-11-08 DOI: 10.1016/j.infpip.2025.100497

S. Kenny , K. Kuan , A. Walsh , S.F. FitzGerald

引用次数: 0

Association between antimicrobial use and the detection rates of carbapenem-resistant Enterobacterales: long-term surveillance results from a single centre 抗微生物药物使用与碳青霉烯耐药肠杆菌检出率之间的关系：来自单一中心的长期监测结果

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2026-03-01 Epub Date: 2025-11-24 DOI: 10.1016/j.infpip.2025.100500

Shinobu Hirayama , Mariko Otani , Hinako Murakami , Maki Sakamoto , Kazuhiro Tateda , Takahiro Matsumoto , Takashi Sugita

Background

Carbapenems are vital for treating Enterobacterales infections. However, the emergence of carbapenem-resistant Enterobacterales (CRE), mediated by carbapen-emases or otherwise, has become a global concern due to increased morbidity and mortality. In Japan, metallo-β-lactamase was found to be the predominant carbapenemase, notably imipenemase. Both carbapenem-susceptible and carbapenem-resistant strains of carbapenemase-producing Enterobacterales exist, which complicates the identification of carbapenemase production through susceptibility testing alone. Infection control measures, such as contact precautions and antimicrobial stewardship, are recommended to combat resistant strains. Since carbapenem use is a risk factor for resistance, reducing its consumption is a key strategy for resistance management.

Aim

To elucidate the impact of antimicrobial use on CRE detection rates and antimicrobial resistance trends and to propose a risk assessment framework for antimicrobial resistance surveillance.

Methods

We analysed the relationship between antimicrobial use density (AUD), days of therapy (DOT) and CRE detection among inpatients at Toho University Omori Medical Centre between 2014 and 2022.

Results

Overall, AUD and DOT increased, notably for piperacillin/tazobactam (TZP), cefmetazole, ceftriaxone (CRO) and cefepime. Conversely, AUD and DOT for flomoxef, cefoperazone/sulbactam, cefozopran, ciprofloxacin, levofloxacin, doripenem, aztreonam and fosfomycin decreased. AUD of meropenem (MEM) increased, but its overall proportion decreased. TZP and CRO correlated with resistance rates, while MEM did not. Carbapenemase-producing carbapenem-non-susceptible Enterobacterales (CP-CNSE) detection was associated with TZP usage, and non-carbapenemase-producing (NCP)-CNSE detection correlated with overall AUD, TZP, and CRO use.

Conclusion

Reducing TZP and cephalosporin usage, in addition to carbapenems, is crucial for preventing resistant strains.

碳青霉烯类药物对肠杆菌感染的治疗至关重要。然而，碳青霉烯抗性肠杆菌（CRE）的出现，由碳青霉烯酶介导或以其他方式，由于发病率和死亡率的增加而成为全球关注的问题。在日本，金属β-内酰胺酶被发现是主要的碳青霉烯酶，特别是亚胺烯酶。产碳青霉烯酶肠杆菌中既有碳青霉烯敏感菌株，也有耐药菌株，这使得仅通过药敏试验鉴定产碳青霉烯酶变得更加复杂。建议采取感染控制措施，如接触预防措施和抗菌药物管理，以对抗耐药菌株。由于碳青霉烯类药物的使用是耐药性的一个危险因素，因此减少其用量是耐药性管理的一项关键战略。目的探讨抗生素使用对CRE检出率和耐药趋势的影响，提出耐药监测的风险评估框架。方法分析2014 - 2022年东宝大学大森医学中心住院患者抗菌药物使用密度（AUD）、治疗天数（DOT）与CRE检测的关系。结果总体而言，AUD和DOT均升高，以哌拉西林/他唑巴坦（TZP）、头孢美唑、头孢曲松（CRO）和头孢吡肟的AUD和DOT升高最为明显。相反，氟莫西、头孢哌酮/舒巴坦、头孢opran、环丙沙星、左氧氟沙星、多利培南、氮曲南和磷霉素的AUD和DOT下降。美罗培南（MEM）的AUD增加，但总体比例下降。TZP和CRO与耐药率相关，而MEM与耐药率无关。产碳青霉烯酶的碳青霉烯非敏感肠杆菌（CP-CNSE）检测与TZP使用相关，而非产碳青霉烯酶(NCP)-CNSE检测与总体AUD、TZP和CRO使用相关。结论除碳青霉烯类外，减少TZP和头孢菌素的使用是预防耐药菌株的关键。

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引用次数: 0

Application of the Blood Culture Train model based on procedural and behavioural interventions to improve the quality of blood culture collection 应用基于程序和行为干预的血液培养训练模型来提高血液培养收集的质量

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2026-03-01 Epub Date: 2026-01-16 DOI: 10.1016/j.infpip.2026.100509

N. Wang , T. Huang , M. Hu , X. Jiang , H. Wu , J. Wang , Z. Sun , B. Liu

Objective

This study evaluated whether a multi-modal intervention based on the ‘Blood Culture Train’ (BCT) framework could enhance blood culture collection compliance and diagnostic yield in adult inpatients.

Methods

We conducted a single-centre, before-and-after quasi-experimental study that compared key collection indicators in 2023 (before the intervention) and 2024 (after the intervention). The intervention consisted of a Clinical and Laboratory Standards Institute M47-A–compliant standardized workflow, blockchain-enabled traceability, virtual reality–based simulation training and a closed-loop quality feedback system. Primary outcomes were the bilateral collection rate and achievement of target blood volume; secondary outcomes included culture positivity, contamination and staff knowledge proficiency. Multi-variable logistic regression and a difference-in-differences (DID) analysis were used to test the independence and causality of observed effects.

Results

After implementation, the bilateral collection rate rose from 44.5% to 89.9%, and blood-volume compliance increased from 62.0% to 92.5% (both P < 0.001). Culture positivity improved from 6.56% to 9.43% (P < 0.001), whereas the contamination rate decreased from 2.28% to 0.72% (P = 0.02). Staff knowledge scores increased by >25%. BCT exposure was independently associated with compliance (adjusted odds ratio = 5.67, 95% confidence interval: 4.53–7.09, P < 0.001), and the DID analysis confirmed a causal link between the intervention and outcome gains.

Conclusion

The BCT-based multi-modal strategy significantly improved blood culture collection compliance, reduced contamination and enhanced diagnostic yield. Its scalable design, underpinned by digital technologies, may be applicable to other primary and secondary healthcare settings.

目的评价基于“血培养训练”（BCT）框架的多模式干预是否能提高成人住院患者的血培养采集依从性和诊断率。方法采用单中心、干预前后准实验研究，比较2023年（干预前）和2024年（干预后）的关键采集指标。干预包括符合临床和实验室标准协会m47 - a标准的标准化工作流程，支持区块链的可追溯性，基于虚拟现实的模拟培训和闭环质量反馈系统。主要观察指标为双侧采血率和达标血容量；次要结果包括培养阳性、污染和员工知识熟练程度。采用多变量逻辑回归和差异中差（DID）分析来检验观察到的效应的独立性和因果关系。结果实施后，双侧采集率由44.5%提高到89.9%，血容量顺应性由62.0%提高到92.5% （P均为0.001）。培养阳性率从6.56%提高到9.43% (P < 0.001)，而污染率从2.28%下降到0.72% （P = 0.02）。员工的知识得分增加了25%。BCT暴露与依从性独立相关（调整后的优势比= 5.67,95%可信区间：4.53-7.09,P < 0.001）， DID分析证实干预与结果增益之间存在因果关系。结论基于bct的多模式采集策略显著提高了血培养采集依从性，减少了污染，提高了诊断率。其可扩展的设计以数字技术为基础，可能适用于其他初级和二级医疗保健环境。

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引用次数: 0

Whole-genome sequencing reveals a unique outbreak of methicillin-resistant Staphylococcus aureus clone USA400/J in Japan 全基因组测序揭示了一种独特的耐甲氧西林金黄色葡萄球菌克隆USA400/J在日本爆发

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2026-03-01 Epub Date: 2025-12-13 DOI: 10.1016/j.infpip.2025.100506

Takuma Yoshida , Yuka Yamagishi , Hiroshi Kaneko , Shunsuke Takadama , Hiroshige Mikamo , Hidemasa Nakaminami

Objectives

Panton-Valentine leukocidin (PVL)-negative, sequence type 1-staphylococcal cassette chromosome mec (SCCmec) type IV (ST1-IV) methicillin-resistant Staphylococcus aureus (MRSA) is prevalent in Japanese hospitals. The PVL-negative ST1-IV MRSA strain is known as USA400/J in Japan. In this study, we analysed an MRSA outbreak at a Japanese university hospital using conventional methods, SCCmec typing, pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS).

Methods

We analysed 12 MRSA strains isolated from the neonatal intensive care unit of Aichi Medical University Hospital. SCCmec typing and gene detection were performed using polymerase chain reaction. Molecular epidemiological analyses were performed using multi-locus sequence typing and PFGE. Genome-based phylogenetic analyses were performed for some strains.

Results

The isolated MRSA strains were classified as ST1-IV (N = 4), ST8-IV (N = 1), ST764-II (N = 6) and ST89-V (N = 1). PFGE analysis showed that the ST1-IV and ST764-II strains exhibited high homology within their clones. Phylogenetic analysis based on the genomes of the USA400/J strains isolated in this study and ST1-IV isolates from overseas showed that clonal complex 1-SCCmec type IV (CC1-IV) strains isolated in Japan formed a unique cluster that was distinct from the ST1-IV strains from overseas. This suggests that CC1-IV evolved and spread independently in Japan.

Conclusion

These findings highlight the need for increased surveillance and infection control measures that specifically target USA400/J.

目的探讨抗甲氧西林金黄色葡萄球菌（MRSA） IV型（ST1-IV）耐甲氧西林金黄色葡萄球菌（MRSA）在日本医院的流行情况。pvl阴性的ST1-IV MRSA菌株在日本被称为USA400/J。在这项研究中，我们使用常规方法、SCCmec分型、脉冲场凝胶电泳（PFGE）和全基因组测序（WGS）分析了日本一家大学医院的MRSA暴发。方法对爱知医科大学附属医院新生儿重症监护病房分离的12株MRSA进行分析。采用聚合酶链反应进行SCCmec分型和基因检测。采用多位点序列分型和PFGE进行分子流行病学分析。对部分菌株进行了基因组系统发育分析。结果MRSA分离株分为ST1-IV型（N = 4）、ST8-IV型（N = 1）、ST764-II型（N = 6）和ST89-V型（N = 1）。PFGE分析表明，ST1-IV和ST764-II菌株在其克隆内具有高度同源性。基于本研究分离的USA400/J株和海外ST1-IV株基因组的系统发育分析表明，日本分离的克隆复合体1-SCCmec IV型（CC1-IV）与海外ST1-IV株形成独特的集群。这表明CC1-IV在日本独立进化和传播。结论有必要加强针对USA400/J的监测和感染控制措施。

{"title":"Whole-genome sequencing reveals a unique outbreak of methicillin-resistant Staphylococcus aureus clone USA400/J in Japan","authors":"Takuma Yoshida , Yuka Yamagishi , Hiroshi Kaneko , Shunsuke Takadama , Hiroshige Mikamo , Hidemasa Nakaminami","doi":"10.1016/j.infpip.2025.100506","DOIUrl":"10.1016/j.infpip.2025.100506","url":null,"abstract":"<div><h3>Objectives</h3><div>Panton-Valentine leukocidin (PVL)-negative, sequence type 1-staphylococcal cassette chromosome <em>mec</em> (SCC<em>mec</em>) type IV (ST1-IV) methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) is prevalent in Japanese hospitals. The PVL-negative ST1-IV MRSA strain is known as USA400/J in Japan. In this study, we analysed an MRSA outbreak at a Japanese university hospital using conventional methods, SCC<em>mec</em> typing, pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS).</div></div><div><h3>Methods</h3><div>We analysed 12 MRSA strains isolated from the neonatal intensive care unit of Aichi Medical University Hospital. SCC<em>mec</em> typing and gene detection were performed using polymerase chain reaction. Molecular epidemiological analyses were performed using multi-locus sequence typing and PFGE. Genome-based phylogenetic analyses were performed for some strains.</div></div><div><h3>Results</h3><div>The isolated MRSA strains were classified as ST1-IV (<em>N</em> = 4), ST8-IV (<em>N</em> = 1), ST764-II (<em>N</em> = 6) and ST89-V (<em>N</em> = 1). PFGE analysis showed that the ST1-IV and ST764-II strains exhibited high homology within their clones. Phylogenetic analysis based on the genomes of the USA400/J strains isolated in this study and ST1-IV isolates from overseas showed that clonal complex 1-SCC<em>mec</em> type IV (CC1-IV) strains isolated in Japan formed a unique cluster that was distinct from the ST1-IV strains from overseas. This suggests that CC1-IV evolved and spread independently in Japan.</div></div><div><h3>Conclusion</h3><div>These findings highlight the need for increased surveillance and infection control measures that specifically target USA400/J.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"8 1","pages":"Article 100506"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Are hospital environments an underestimated source for Gram-negative infections in critically ill patients? A non-multi-drug-resistant Klebsiella pneumoniae outbreak in an Irish intensive care unit 医院环境是危重病人革兰氏阴性感染的低估来源吗？非多重耐药肺炎克雷伯菌在爱尔兰重症监护病房暴发

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2026-03-01 Epub Date: 2025-11-21 DOI: 10.1016/j.infpip.2025.100499

S. Ali , G. Macori , N. Mullane , B. Jayaseelan , O. Donoghue , S. Fanning , K. Schaffer

Klebsiella pneumoniae is a major cause of healthcare-associated infections. Although colonisation with Gram-negative bacteria in hospitalised patients is well recognised, the relative contributions of patient-to-patient versus environment-to-patient transmission remain unclear. Most outbreak investigations focus on multi-drug-resistant (MDR) strains. This study investigates a non-MDR K. pneumoniae outbreak in an intensive care unit (ICU) to examine the role of the hospital environment in nosocomial transmission. Clinical isolates of Klebsiella spp. were obtained from six patients between January 2021 and June 2021. Environmental swabs were collected from handwashing sinks in patient and preparation rooms, 3 months apart. Whole-genome sequencing (WGS) assessed singlenucleotide polymorphism (SNP)-based relatedness using literature-informed thresholds. WGS identified five distinct clusters of genetically related K. pneumoniae isolates, linking clinical and environmental sources. The closest relationships (2—5 SNPs) were observed between patient and sink isolates within the same room, consistent with recent transmission or a shared source. Additional clusters (5—23 SNPs) involved isolates from sinks in different rooms, indicating environmental persistence and potential inter-room dissemination. Two Klebsiella varicola subspecies variicola bloodstream isolates from spatially distinct patients differed by only 2 SNPs, forming an additional cluster consistent with a common clonal lineage. Following enhanced daily sink disinfection and staff education, no further clinical acquisitions were identified. WGS demonstrated genetic relatedness between nonMDR Klebsiella spp. strains and ICU environmental isolates, underscoring the role of environmental reservoirs in transmitting antimicrobial-susceptible Gram-negative organisms and the importance of targeted surveillance beyond MDR settings.

肺炎克雷伯菌是卫生保健相关感染的主要原因。虽然革兰氏阴性菌在住院患者中的定植已得到充分认识，但患者与患者之间的传播与环境与患者之间的传播的相对贡献仍不清楚。大多数疫情调查的重点是耐多药菌株。本研究调查了重症监护病房（ICU）的非耐多药肺炎克雷伯菌暴发，以检查医院环境在医院传播中的作用。在2021年1月至2021年6月期间从6例患者中分离出克雷伯氏菌。每隔3个月从病人室和准备室的洗手池收集环境拭子。全基因组测序（WGS）使用文献信息阈值评估基于单核苷酸多态性（SNP）的相关性。WGS鉴定出五个不同的遗传相关肺炎克雷伯菌分离群，将临床和环境来源联系起来。在同一房间的患者和水槽分离株之间观察到最密切的关系（2-5个snp），与最近的传播或共享源一致。其他群集（5-23个snp）涉及来自不同房间水槽的分离株，表明环境持久性和潜在的房间间传播。从空间上不同的患者中分离的两个水痘克雷伯菌亚种水痘血液分离株仅存在2个snp差异，形成了一个与共同克隆谱系一致的额外集群。在加强日常水池消毒和对工作人员进行教育后，没有发现进一步的临床感染病例。WGS显示了非耐多药克雷伯氏菌菌株与ICU环境分离株之间的遗传相关性，强调了环境宿主在传播抗菌敏感革兰氏阴性菌方面的作用，以及在耐多药环境之外进行靶向监测的重要性。

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引用次数: 0