Pub Date : 2025-07-03DOI: 10.1016/j.infpip.2025.100469
I. González-Gómez , G. Ruíz-Carrascoso , R. Herruzo-Cabrera
Background
Carbapenemase-producing Enterobacterales (CPE) are a growing issue that healthcare systems all over the world are facing and which have been producing clinical cases for >20 years, with a spike in incidence in the last decade. In the Universitary Hospital of La Paz (HULP), the first CPE outbreak occurred in 2011 and incidence has been variable since then.
Aim
To conduct an epidemiological analysis of the distribution and microbiological characteristics of the four main types of carbapenemases (OXA-48, VIM, KPC, and NDM) obtained from bacteria isolated in the HULP, a tertiary hospital north of the city of Madrid, between 2012 and 2022.
Methods
An observational retrospective analysis was performed to attain the incidence characteristics of CPE and their associated outbreaks. The study used data from 5723 individual cases for which the sex and age of the patient, type of sample, isolated bacteria, type of carbapenemase, type of case (infection or colonization) and where and when the isolate was obtained.
Results
Since the first outbreak of CPE was detected in 2011, contain-and-response protocols were put in place to avoid the spread of CPE within the hospital setting.
Conclusion
The implementation of CPE infection preventention and control guidance since 2013 and (in 2022) updated protocols has impacted the number of cases, but further incidence studies should be conducted to analyse the effectiveness of these measures and assess the patterns of carbapenemase genes over time.
{"title":"A decade of epidemiology and incidence of carbapenemase-producing bacteria in a tertiary hospital in southern Europe","authors":"I. González-Gómez , G. Ruíz-Carrascoso , R. Herruzo-Cabrera","doi":"10.1016/j.infpip.2025.100469","DOIUrl":"10.1016/j.infpip.2025.100469","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenemase-producing Enterobacterales (CPE) are a growing issue that healthcare systems all over the world are facing and which have been producing clinical cases for >20 years, with a spike in incidence in the last decade. In the Universitary Hospital of La Paz (HULP), the first CPE outbreak occurred in 2011 and incidence has been variable since then.</div></div><div><h3>Aim</h3><div>To conduct an epidemiological analysis of the distribution and microbiological characteristics of the four main types of carbapenemases (OXA-48, VIM, KPC, and NDM) obtained from bacteria isolated in the HULP, a tertiary hospital north of the city of Madrid, between 2012 and 2022.</div></div><div><h3>Methods</h3><div>An observational retrospective analysis was performed to attain the incidence characteristics of CPE and their associated outbreaks. The study used data from 5723 individual cases for which the sex and age of the patient, type of sample, isolated bacteria, type of carbapenemase, type of case (infection or colonization) and where and when the isolate was obtained.</div></div><div><h3>Results</h3><div>Since the first outbreak of CPE was detected in 2011, contain-and-response protocols were put in place to avoid the spread of CPE within the hospital setting.</div></div><div><h3>Conclusion</h3><div>The implementation of CPE infection preventention and control guidance since 2013 and (in 2022) updated protocols has impacted the number of cases, but further incidence studies should be conducted to analyse the effectiveness of these measures and assess the patterns of carbapenemase genes over time.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100469"},"PeriodicalIF":1.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549512","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}
Pub Date : 2025-06-14DOI: 10.1016/j.infpip.2025.100473
Ana C. Lorenzo-Leal, Donald Tam, Horacio Bach
{"title":"Antiviral effect of 222 nm far-UVC light against human coronavirus and rhinovirus, and murine norovirus using dried inocula","authors":"Ana C. Lorenzo-Leal, Donald Tam, Horacio Bach","doi":"10.1016/j.infpip.2025.100473","DOIUrl":"10.1016/j.infpip.2025.100473","url":null,"abstract":"","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100473"},"PeriodicalIF":1.8,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490290","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}
Pub Date : 2025-06-12DOI: 10.1016/j.infpip.2025.100472
Pascal De Waegemaeker, Thomas Snoeij, Isabel Leroux-Roels
Introduction
For a vulnerable hospital population, hospital ventilation systems can pose a risk if not maintained correctly. Dust accumulation in air ducts can create environments that allow fungal spores, such as Aspergillus.spp, to thrive, potentially leading to severe infections like invasive aspergillosis. Our study aimed to develop a safe protocol for cleaning ventilation systems on an active ward in healthcare settings.
Methods
We conducted a comparative evaluation of ventilation duct cleaning in adjacent hospital rooms. In one room, the ducts were accessed from within the room using a traditional brushing method, while in the other room, the ducts were primarily accessed from outside using a novel method including the use of newly developed low speed brushes and point extraction of debris. Air quality was monitored by counting particles every 15 minutes in 100-liter samples using a calibrated air sampler and collecting microbiological specimens before and after the cleaning process.
Results
In-room cleaning caused a significant spike in airborne particles of all sizes, along with a modest increase in Aspergillus spp. spores, which took an hour to return to baseline levels. Conversely, external access for cleaning did not notably impact room air quality.
Conclusion
These findings highlight the risks associated with internal duct cleaning, especially for patients who are vulnerable to airborne fungal infections. External duct access proves to be a safer alternative, ensuring minimal disruption to the air quality in patient care areas. This study supports the necessity of strategic planning in hospital ventilation maintenance to protect vulnerable populations.
{"title":"Improving ventilation hygiene in wards for immunocompromised patients: a workflow comparison of traditional and innovative duct cleaning methods","authors":"Pascal De Waegemaeker, Thomas Snoeij, Isabel Leroux-Roels","doi":"10.1016/j.infpip.2025.100472","DOIUrl":"10.1016/j.infpip.2025.100472","url":null,"abstract":"<div><h3>Introduction</h3><div>For a vulnerable hospital population, hospital ventilation systems can pose a risk if not maintained correctly. Dust accumulation in air ducts can create environments that allow fungal spores, such as <em>Aspergillus.spp</em>, to thrive, potentially leading to severe infections like invasive aspergillosis. Our study aimed to develop a safe protocol for cleaning ventilation systems on an active ward in healthcare settings.</div></div><div><h3>Methods</h3><div>We conducted a comparative evaluation of ventilation duct cleaning in adjacent hospital rooms. In one room, the ducts were accessed from within the room using a traditional brushing method, while in the other room, the ducts were primarily accessed from outside using a novel method including the use of newly developed low speed brushes and point extraction of debris. Air quality was monitored by counting particles every 15 minutes in 100-liter samples using a calibrated air sampler and collecting microbiological specimens before and after the cleaning process.</div></div><div><h3>Results</h3><div>In-room cleaning caused a significant spike in airborne particles of all sizes, along with a modest increase in <em>Aspergillus spp.</em> spores, which took an hour to return to baseline levels. Conversely, external access for cleaning did not notably impact room air quality.</div></div><div><h3>Conclusion</h3><div>These findings highlight the risks associated with internal duct cleaning, especially for patients who are vulnerable to airborne fungal infections. External duct access proves to be a safer alternative, ensuring minimal disruption to the air quality in patient care areas. This study supports the necessity of strategic planning in hospital ventilation maintenance to protect vulnerable populations.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100472"},"PeriodicalIF":1.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144597158","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}
Pub Date : 2025-06-06DOI: 10.1016/j.infpip.2025.100464
Muhammad Kiddeer , Aamir Abbas , Abdul Basit , Tawseef Ahmad , Imran Masood
Background
Inadequate infection control in healthcare settings can increase healthcare-associated infections and worsen morbidity and mortality rates. Standard precautions, applicable to all patients with suspected or confirmed infections, safeguard both healthcare personnel and patients. This study aimed to evaluate knowledge, attitudes and practices regarding standard precautions among healthcare personnel in tertiary care hospitals across Punjab, Pakistan.
Methods
This multi-centre cross-sectional study, conducted from May to July 2019, included 600 healthcare personnel recruited via convenience sampling from tertiary care hospitals in six cities selected at random.
Results
Out of 533 healthcare personnel, the response rate was 88.8%. Most respondents were female (N=341, 64.2%), mean ± standard deviation (SD) age was 28.85 ±7.08 years, and mean ± SD length of service was 5.58 ± 5.78 years. Knowledge, attitudes and practices regarding standard precautions were poor, and only 37.5%, 46.7% and 46.3% of respondents had good knowledge, positive attitudes and safe practices, respectively. Healthcare personnel with >10 years of experience [adjusted odds ratio (AOR) 2.98, 95% confidence interval (CI) 1.60–5.55], previous infection control training (AOR 1.96, 95% CI 1.30–2.94), professional degrees (AOR 2.04, 95% CI 1.16–3.60), and availability of infection control guidelines in their work department were more likely to have good knowledge regarding standard precautions. The availability of infection control guidelines in the work department was also significantly associated with positive attitudes (AOR 2.83, 95% CI 1.76–4.56) and safe practices (AOR 3.46, 95% CI 1.94–6.14).
Conclusion
Knowledge, attitudes and practices of healthcare personnel regarding standard precautions were inadequate. Continuous education and certified training for healthcare personnel can improve infection control measures substantially in public healthcare settings.
背景:在卫生保健机构中,适当的感染控制可增加卫生保健相关感染,并使发病率和死亡率恶化。适用于所有疑似或确诊感染患者的标准预防措施可保护医护人员和患者。本研究旨在评估巴基斯坦旁遮普省三级医院医护人员关于标准预防措施的知识、态度和做法。方法本多中心横断面研究于2019年5月至7月进行,随机抽取6个城市三级医院的600名医护人员进行方便抽样。结果533名医护人员中,应答率为88.8%。女性居多(N=341, 64.2%),平均±标准差(SD)年龄为28.85±7.08岁,平均±SD工龄为5.58±5.78岁。受访者对标准预防措施的了解、态度和做法较差,分别只有37.5%、46.7%和46.3%的受访者对标准预防措施有良好的了解、积极的态度和安全的做法。具有10年经验的卫生保健人员[调整优势比(AOR) 2.98, 95%可信区间(CI) 1.60-5.55]、既往感染控制培训(AOR 1.96, 95% CI 1.30-2.94)、专业学位(AOR 2.04, 95% CI 1.16-3.60)以及其工作部门感染控制指南的可获得性更可能对标准预防措施有良好的了解。工作部门感染控制指南的可获得性也与积极态度(AOR 2.83, 95% CI 1.76-4.56)和安全操作(AOR 3.46, 95% CI 1.94-6.14)显著相关。结论卫生保健人员对标准预防措施的知识、态度和实践不足。对卫生保健人员的持续教育和认证培训可以大大改善公共卫生保健机构的感染控制措施。
{"title":"Assessment of knowledge, attitude and practices regarding standard precautions of infection prevention and control and associated factors among healthcare personnel working at tertiary care hospitals in Punjab, Pakistan","authors":"Muhammad Kiddeer , Aamir Abbas , Abdul Basit , Tawseef Ahmad , Imran Masood","doi":"10.1016/j.infpip.2025.100464","DOIUrl":"10.1016/j.infpip.2025.100464","url":null,"abstract":"<div><h3>Background</h3><div>Inadequate infection control in healthcare settings can increase healthcare-associated infections and worsen morbidity and mortality rates. Standard precautions, applicable to all patients with suspected or confirmed infections, safeguard both healthcare personnel and patients. This study aimed to evaluate knowledge, attitudes and practices regarding standard precautions among healthcare personnel in tertiary care hospitals across Punjab, Pakistan.</div></div><div><h3>Methods</h3><div>This multi-centre cross-sectional study, conducted from May to July 2019, included 600 healthcare personnel recruited via convenience sampling from tertiary care hospitals in six cities selected at random.</div></div><div><h3>Results</h3><div>Out of 533 healthcare personnel, the response rate was 88.8%. Most respondents were female (<em>N</em>=341, 64.2%), mean ± standard deviation (SD) age was 28.85 ±7.08 years, and mean ± SD length of service was 5.58 ± 5.78 years. Knowledge, attitudes and practices regarding standard precautions were poor, and only 37.5%, 46.7% and 46.3% of respondents had good knowledge, positive attitudes and safe practices, respectively. Healthcare personnel with >10 years of experience [adjusted odds ratio (AOR) 2.98, 95% confidence interval (CI) 1.60–5.55], previous infection control training (AOR 1.96, 95% CI 1.30–2.94), professional degrees (AOR 2.04, 95% CI 1.16–3.60), and availability of infection control guidelines in their work department were more likely to have good knowledge regarding standard precautions. The availability of infection control guidelines in the work department was also significantly associated with positive attitudes (AOR 2.83, 95% CI 1.76–4.56) and safe practices (AOR 3.46, 95% CI 1.94–6.14).</div></div><div><h3>Conclusion</h3><div>Knowledge, attitudes and practices of healthcare personnel regarding standard precautions were inadequate. Continuous education and certified training for healthcare personnel can improve infection control measures substantially in public healthcare settings.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100464"},"PeriodicalIF":1.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338639","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}
Vaccinations are considered one of the most effective medical interventions. Among other benefits, certain vaccinations help reduce antimicrobial resistance by decreasing antibiotic use. Considering reports of increased antimicrobial resistance during the COVID-19 pandemic, this study aimed to explore the relationship between COVID-19 vaccination status and antibiotic use in COVID-19 patients.
Methods
A systematic literature search was conducted in PubMed, Scopus, Web of Science, Embase, and Google Scholar between January 1, 2021, and November 6, 2024. The included studies were assessed for risk of bias using the Newcastle-Ottawa tool. Narrative synthesis and random-effects meta-analysis were employed to synthesize the evidence.
Results
Eight studies were included in this systematic review and meta-analysis (134,022 participants). COVID-19 vaccination was significantly associated with a 34% reduction in the odds of antibiotic use (OR: 0.662; 95% CI: 0.540–0.811) in COVID-19 patients. These findings were supported by the sensitivity analyses. In the subgroup analysis, a significant negative association was observed between COVID-19 vaccination and antibiotic use among COVID-19 patients across all study designs. A major limitation of this study is that most of the included studies did not adjust for confounders.
Conclusions
COVID-19 vaccination was associated with a significant reduction in antibiotic use among COVID-19 patients. COVID-19 vaccination status may have influenced healthcare providers' decisions regarding antibiotic use in this group. Further large-scale cohort studies are needed to confirm these findings.
Other
The study protocol is registered with PROSPERO (ID: CRD42023449625). No funding was provided for this study. The APCs were covered by the Karolinska Institute.
疫苗接种被认为是最有效的医疗干预措施之一。除其他益处外,某些疫苗通过减少抗生素的使用有助于减少抗菌素耐药性。考虑到COVID-19大流行期间抗生素耐药性增加的报道,本研究旨在探讨COVID-19疫苗接种状况与COVID-19患者抗生素使用之间的关系。方法系统检索PubMed、Scopus、Web of Science、Embase、谷歌Scholar等于2021年1月1日至2024年11月6日的相关文献。纳入的研究使用纽卡斯尔-渥太华工具评估偏倚风险。采用叙事综合和随机效应荟萃分析进行证据综合。结果本系统评价和荟萃分析共纳入8项研究(134,022名受试者)。COVID-19疫苗接种与COVID-19患者抗生素使用几率降低34%显著相关(OR: 0.662; 95% CI: 0.540-0.811)。这些发现得到敏感性分析的支持。在亚组分析中,在所有研究设计中,观察到COVID-19疫苗接种与COVID-19患者抗生素使用之间存在显著的负相关。本研究的一个主要局限性是大多数纳入的研究没有对混杂因素进行调整。结论COVID-19疫苗接种与COVID-19患者抗生素使用显著减少相关。COVID-19疫苗接种状况可能影响了医疗保健提供者在该组中使用抗生素的决定。需要进一步的大规模队列研究来证实这些发现。其他研究方案在PROSPERO注册(ID: CRD42023449625)。本研究未获资助。这些装甲运兵车由卡罗林斯卡研究所负责。
{"title":"COVID-19 vaccination and use of antibiotics in COVID-19 patients: a systematic review and meta-analysis","authors":"Marios Politis , Ioanna Chatzichristodoulou , Varvara A. Mouchtouri , Georgios Rachiotis","doi":"10.1016/j.infpip.2025.100461","DOIUrl":"10.1016/j.infpip.2025.100461","url":null,"abstract":"<div><h3>Background</h3><div>Vaccinations are considered one of the most effective medical interventions. Among other benefits, certain vaccinations help reduce antimicrobial resistance by decreasing antibiotic use. Considering reports of increased antimicrobial resistance during the COVID-19 pandemic, this study aimed to explore the relationship between COVID-19 vaccination status and antibiotic use in COVID-19 patients.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in PubMed, Scopus, Web of Science, Embase, and Google Scholar between January 1, 2021, and November 6, 2024. The included studies were assessed for risk of bias using the Newcastle-Ottawa tool. Narrative synthesis and random-effects meta-analysis were employed to synthesize the evidence.</div></div><div><h3>Results</h3><div>Eight studies were included in this systematic review and meta-analysis (134,022 participants). COVID-19 vaccination was significantly associated with a 34% reduction in the odds of antibiotic use (OR: 0.662; 95% CI: 0.540–0.811) in COVID-19 patients. These findings were supported by the sensitivity analyses. In the subgroup analysis, a significant negative association was observed between COVID-19 vaccination and antibiotic use among COVID-19 patients across all study designs. A major limitation of this study is that most of the included studies did not adjust for confounders.</div></div><div><h3>Conclusions</h3><div>COVID-19 vaccination was associated with a significant reduction in antibiotic use among COVID-19 patients. COVID-19 vaccination status may have influenced healthcare providers' decisions regarding antibiotic use in this group. Further large-scale cohort studies are needed to confirm these findings.</div></div><div><h3>Other</h3><div>The study protocol is registered with PROSPERO (ID: CRD42023449625). No funding was provided for this study. The APCs were covered by the Karolinska Institute.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100461"},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907624","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}
Pub Date : 2025-05-22DOI: 10.1016/j.infpip.2025.100466
Wen-Chang Tseng , Yung-Cheng Wang , Wei-Chi Chen , Kang-Ping Lin
{"title":"Corrigendum to ‘Utilizing an adenosine triphosphate bioluminescence assay as an indicator of instrument and environmental cleanliness in the radiology department – a pilot study’ Infect Prev Pract, Volume 7 (2025) 100449","authors":"Wen-Chang Tseng , Yung-Cheng Wang , Wei-Chi Chen , Kang-Ping Lin","doi":"10.1016/j.infpip.2025.100466","DOIUrl":"10.1016/j.infpip.2025.100466","url":null,"abstract":"","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100466"},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106225","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}
Pub Date : 2025-05-19DOI: 10.1016/j.infpip.2025.100468
Nasstasja Wassilew , Alexandra Zehnder , Andrew Atkinson , Andreas Kronenberg , Jonas Marschall
Background
Clostridioides difficile infection (CDI) is a common gastrointestinal disease in healthcare settings, ranging from uncomplicated diarrhoea to life-threatening pseudomembranous colitis. It is associated with increased morbidity, mortality and healthcare costs. The aim of the study was to correlate CDI incidence with total and specific antibiotic consumption across 17 clinical departments of an academic hospital.
Methods
This retrospective correlation study used data on CDI and antibiotic prescriptions from 1.1.2008 to 31.12.2021. CDI episodes were defined using CDC criteria. Antibiotic consumption was reported per WHO in defined daily doses (DDD). A mixed effects logistic regression model was fitted with each department as random effect to determine CDI incidence as a function of year and adjusted for antibiotic consumption.
Results
Amoxicillin-clavulanate showed the highest annual consumption across the 17 departments (median 13.5 DDD/100 patient-days). The average CDI incidence was highest in nephrology (22.3/10′000 patient-days) and lowest in otorhinolaryngology (0.1/10′000 patient-days). We observed an association between overall antimicrobial consumption and CDI incidence (incidence risk ratio (IRR) per 10 DDD/100 patient-days of 1.16, 95% confidence interval (1.09, 1.23), P<0.001). When plotting each department's CDI incidence against the departmental average annual consumption, no significant trend was found; however, there was a trend for the association between CDI and selected antibiotic usage, such as carbapenems (P=0.003), ceftriaxone (P=0.04), cefepime (P<0.001), macrolides (P<0.001) and piperacillin/tazobactam (P=0.03).
Conclusions
We detected an association between antibiotic consumption and CDI incidence across the departments of an academic hospital; however, we could only correlate departmental CDI incidence with the usage of select antibiotics.
{"title":"Association of antimicrobial consumption with Clostridioides difficile incidence across the departments of an academic medical centre","authors":"Nasstasja Wassilew , Alexandra Zehnder , Andrew Atkinson , Andreas Kronenberg , Jonas Marschall","doi":"10.1016/j.infpip.2025.100468","DOIUrl":"10.1016/j.infpip.2025.100468","url":null,"abstract":"<div><h3>Background</h3><div><em>Clostridioides difficile</em> infection <em>(CDI)</em> is a common gastrointestinal disease in healthcare settings, ranging from uncomplicated diarrhoea to life-threatening pseudomembranous colitis. It is associated with increased morbidity, mortality and healthcare costs. The aim of the study was to correlate CDI incidence with total and specific antibiotic consumption across 17 clinical departments of an academic hospital.</div></div><div><h3>Methods</h3><div>This retrospective correlation study used data on CDI and antibiotic prescriptions from 1.1.2008 to 31.12.2021. CDI episodes were defined using CDC criteria. Antibiotic consumption was reported per WHO in defined daily doses (DDD). A mixed effects logistic regression model was fitted with each department as random effect to determine CDI incidence as a function of year and adjusted for antibiotic consumption.</div></div><div><h3>Results</h3><div>Amoxicillin-clavulanate showed the highest annual consumption across the 17 departments (median 13.5 DDD/100 patient-days). The average CDI incidence was highest in nephrology (22.3/10′000 patient-days) and lowest in otorhinolaryngology (0.1/10′000 patient-days). We observed an association between overall antimicrobial consumption and CDI incidence (incidence risk ratio (IRR) per 10 DDD/100 patient-days of 1.16, 95% confidence interval (1.09, 1.23), <em>P</em><0.001). When plotting each department's CDI incidence against the departmental average annual consumption, no significant trend was found; however, there was a trend for the association between CDI and selected antibiotic usage, such as carbapenems (<em>P</em>=0.003), ceftriaxone (<em>P</em>=0.04), cefepime (<em>P</em><0.001), macrolides (<em>P</em><0.001) and piperacillin/tazobactam (<em>P</em>=0.03).</div></div><div><h3>Conclusions</h3><div>We detected an association between antibiotic consumption and CDI incidence across the departments of an academic hospital; however, we could only correlate departmental CDI incidence with the usage of select antibiotics.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100468"},"PeriodicalIF":1.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490289","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}
Pub Date : 2025-05-08DOI: 10.1016/j.infpip.2025.100463
Sélilah Amour , Elisabetta Kuczewski , Elodie Marion , Laurent Argaud , Julien Crozon-Clauzel , Anne Claire Lukaszewicz , Philippe Vanhems , Nagham Khanafer
Background
Hospital-Acquired Pneumonia (HAP) are common in intensive care units (ICUs). The COVID-19 pandemic led to a global increase in healthcare-associated infections (HAI) among ICU patients. The aim of this study was to evaluate the trends in HAP incidence over a seven-year period of surveillance in two ICUs at a French University Hospital, and to assess the impact of COVID-19 (as well as the associated bacterial ecology).
Methods
A prospective surveillance of HAI in ICUs was conducted during the 1st quarter of each year between 2016 and 2022 (2020: reference year). Socio-demographic, clinical and bacteriological data were collected and the incidence of HAP was calculated. Poisson regressions were done and crude and adjusted incidence rate ratio were calculated.
Results
1,797 patients were included, with 61.3% of male and a median age of 67 years. The median duration of intubation was 4 days (7 days in 2021 and 5 days in 2022). The proportion of COVID-19 patients was 45.7% in 2021 and 24.1% in 2022. Compared to 2020, the incidence of HAP increased in both 2021 [cIRR: 2.34 (95%CI: 1.30–4.23) and aIRR: 2.26 (95%CI: 1.25–4.08)] and 2022 [cIRR: 1.79 (95%CI: 0.97–3.32) and aIRR: 1.66 (95%CI: 0.90–3.07)]. The most commonly identified microorganisms were Enterobacteriaceae (42.4%), with a significantly higher incidence of HAP due to Enterobacteriaceae in COVID-19 patients.
Conclusions
These results indicate an increase of HAP incidence in 2021 and 2022, mainly caused by Enterobacteriaceae in COVID-19 patients. This trend needs to be confirmed or refuted in the post-pandemic era.
{"title":"Incidence of nosocomial pneumonia in two intensive care units of a French University Hospital from 2016 to 2022 in the era of COVID-19 pandemic","authors":"Sélilah Amour , Elisabetta Kuczewski , Elodie Marion , Laurent Argaud , Julien Crozon-Clauzel , Anne Claire Lukaszewicz , Philippe Vanhems , Nagham Khanafer","doi":"10.1016/j.infpip.2025.100463","DOIUrl":"10.1016/j.infpip.2025.100463","url":null,"abstract":"<div><h3>Background</h3><div>Hospital-Acquired Pneumonia (HAP) are common in intensive care units (ICUs). The COVID-19 pandemic led to a global increase in healthcare-associated infections (HAI) among ICU patients. The aim of this study was to evaluate the trends in HAP incidence over a seven-year period of surveillance in two ICUs at a French University Hospital, and to assess the impact of COVID-19 (as well as the associated bacterial ecology).</div></div><div><h3>Methods</h3><div>A prospective surveillance of HAI in ICUs was conducted during the 1<sup>st</sup> quarter of each year between 2016 and 2022 (2020: reference year). Socio-demographic, clinical and bacteriological data were collected and the incidence of HAP was calculated. Poisson regressions were done and crude and adjusted incidence rate ratio were calculated.</div></div><div><h3>Results</h3><div>1,797 patients were included, with 61.3% of male and a median age of 67 years. The median duration of intubation was 4 days (7 days in 2021 and 5 days in 2022). The proportion of COVID-19 patients was 45.7% in 2021 and 24.1% in 2022. Compared to 2020, the incidence of HAP increased in both 2021 [cIRR: 2.34 (95%CI: 1.30–4.23) and aIRR: 2.26 (95%CI: 1.25–4.08)] and 2022 [cIRR: 1.79 (95%CI: 0.97–3.32) and aIRR: 1.66 (95%CI: 0.90–3.07)]. The most commonly identified microorganisms were Enterobacteriaceae (42.4%), with a significantly higher incidence of HAP due to Enterobacteriaceae in COVID-19 patients.</div></div><div><h3>Conclusions</h3><div>These results indicate an increase of HAP incidence in 2021 and 2022, mainly caused by <em>Enterobacteriaceae</em> in COVID-19 patients. This trend needs to be confirmed or refuted in the post-pandemic era.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100463"},"PeriodicalIF":1.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083689","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}
Pub Date : 2025-04-26DOI: 10.1016/j.infpip.2025.100465
Siobhain Kelly , Gemma Winzor , Simon Ching Lam
{"title":"World Hand Hygiene Day 2025: A perspective from the Infection Prevention in Practice Editors","authors":"Siobhain Kelly , Gemma Winzor , Simon Ching Lam","doi":"10.1016/j.infpip.2025.100465","DOIUrl":"10.1016/j.infpip.2025.100465","url":null,"abstract":"","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100465"},"PeriodicalIF":1.8,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916621","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}
Bloodstream infections (BSIs) and urinary tract infections (UTIs) caused by antibiotic resistant bacteria (ARB) have unfavourable treatment outcomes and negative economic impacts.
Objectives
The main objective of this study was to determine antibiotic resistance profiles in Gram-negative bacteria (GNB) causing BSIs and UTIs.
Method
A prospective study from October 2020 to January 2021 at Ndola Teaching Hospital and Arthur Davison Children's Hospital in the Ndola district, Zambia. Blood and urine samples collected from inpatients and outpatients presenting with fever and/or urinary tract infection symptoms were submitted for microbiological analysis. Pathogen identification and antibiotic susceptibility was determined by the automated VITEK 2 Compact machine. Resistance genes to commonly used antibiotics were determined using polymerase chain reaction. Data were analysed using SPSS version 28.0.
Results
One hundred and ten GNB were isolated, E. coli (45.5%) was predominant, with varying resistance profiles to different antibiotic classes. Resistance to third-generation cephalosporin was highest in Enterobacter cloacae (75%) and Klebsiella pneumoniae (71%), respectively. Emergence of carbapenem resistance was noted with the highest being 17% in Acinetobacter baumannii. Notably, the prevalence of multi-drug resistance was 63% and extensively drug-resistance was 32%. Resistance gene determinants identified included blaCTX-M,qnrA and blaNDM.
Conclusion
High level antibiotic resistance was observed in GNB known to be prevalent causative agents of BSIs and UTIs locally in Zambia. Improving microbiology diagnostic capacity, strengthening antimicrobial stewardship programs and enforcing infection prevention and control measures are of utmost importance in promoting rational use of antibiotics and preventing the spread and emergence of resistant pathogens.
{"title":"Antibiotic resistance profiles in Gram-negative bacteria causing bloodstream and urinary tract infections in paediatric and adult patients in Ndola District, Zambia, 2020–2021","authors":"Kaunda Yamba , Joseph Yamweka Chizimu , Raphael Chanda , Mirfin Mpundu , Mulemba Tillika Samutela , Duncan Chanda , Steward Mudenda , Misa Finjika , Bweendo Nduna Chansa , Amon Siame , Fanny Mbewe , Moses Chakopo , Andrew Mukubesa , Patrice Mukomena , Flavien Nsoni Bumbangi , John Bwalya Muma","doi":"10.1016/j.infpip.2025.100462","DOIUrl":"10.1016/j.infpip.2025.100462","url":null,"abstract":"<div><h3>Background</h3><div>Bloodstream infections (BSIs) and urinary tract infections (UTIs) caused by antibiotic resistant bacteria (ARB) have unfavourable treatment outcomes and negative economic impacts.</div></div><div><h3>Objectives</h3><div>The main objective of this study was to determine antibiotic resistance profiles in Gram-negative bacteria (GNB) causing BSIs and UTIs.</div></div><div><h3>Method</h3><div>A prospective study from October 2020 to January 2021 at Ndola Teaching Hospital and Arthur Davison Children's Hospital in the Ndola district, Zambia. Blood and urine samples collected from inpatients and outpatients presenting with fever and/or urinary tract infection symptoms were submitted for microbiological analysis. Pathogen identification and antibiotic susceptibility was determined by the automated VITEK 2 Compact machine. Resistance genes to commonly used antibiotics were determined using polymerase chain reaction. Data were analysed using SPSS version 28.0.</div></div><div><h3>Results</h3><div>One hundred and ten GNB were isolated, <em>E. coli</em> (45.5%) was predominant, with varying resistance profiles to different antibiotic classes. Resistance to third-generation cephalosporin was highest in <em>Enterobacter cloacae</em> (75%) and <em>Klebsiella pneumoniae</em> (71%), respectively. Emergence of carbapenem resistance was noted with the highest being 17% in <em>Acinetobacter baumannii</em>. Notably, the prevalence of multi-drug resistance was 63% and extensively drug-resistance was 32%. Resistance gene determinants identified included <em>bla</em><sub>CTX-M,</sub> <em>qnr</em>A and <em>bla</em><sub>NDM</sub>.</div></div><div><h3>Conclusion</h3><div>High level antibiotic resistance was observed in GNB known to be prevalent causative agents of BSIs and UTIs locally in Zambia. Improving microbiology diagnostic capacity, strengthening antimicrobial stewardship programs and enforcing infection prevention and control measures are of utmost importance in promoting rational use of antibiotics and preventing the spread and emergence of resistant pathogens.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100462"},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279432","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}