Pub Date : 2025-09-01Epub Date: 2025-07-10DOI: 10.1016/j.infpip.2025.100477
Doris Lutkam , Niranjan Konduri , Joseph C. Hokororo , Eliudi S. Eliakimu , Fozo Alombah , Stephano Simba , Cecilia Muiva , Ruth R. Ngowi , Radenta P. Bahegwa , Yohannes S. Msigwa , Dan Schwarz , Edgar Lusaya , Mohan P. Joshi
To ensure the effectiveness of its infection prevention and control (IPC) programs, Tanzania recognised a need to revise IPC guidelines and standards; upgrade IPC training materials to address knowledge gaps among preservice health care students and health workers; improve IPC governance and practice at the national and health facility levels; and improve monitoring of IPC program performance and surveillance of healthcare associated infections (HAIs). Overall, our work addressed 20 out of 21 IPC-related actions in the World Health Organisation Benchmarks for International Health Regulations capacities tool between 2018 and 2024. Over a one-year period, we found that the percentage of patients developing surgical site infections remained at 1% on average in the 10 intervention hospitals, which is lower than the global average of around 2.5%. The Ministry of Health subsequently scaled up HAI surveillance to 69 additional hospitals. As a result, Tanzania achieved a score of 3 (developed capacity) for HAI surveillance specifically in the Joint External Evaluation conducted in August 2023. Building on this progress, the Ministry of Health will continue to scale up IPC programs in all public and private health facilities. Given the health security risks associated with Ebola, Marburg, Mpox, and other pathogens, significant efforts are needed to educate the public on the importance of practicing IPC measures to protect themselves from infectious diseases.
{"title":"Multi-pronged system strengthening approach to improving infection prevention and control practices in Tanzania","authors":"Doris Lutkam , Niranjan Konduri , Joseph C. Hokororo , Eliudi S. Eliakimu , Fozo Alombah , Stephano Simba , Cecilia Muiva , Ruth R. Ngowi , Radenta P. Bahegwa , Yohannes S. Msigwa , Dan Schwarz , Edgar Lusaya , Mohan P. Joshi","doi":"10.1016/j.infpip.2025.100477","DOIUrl":"10.1016/j.infpip.2025.100477","url":null,"abstract":"<div><div>To ensure the effectiveness of its infection prevention and control (IPC) programs, Tanzania recognised a need to revise IPC guidelines and standards; upgrade IPC training materials to address knowledge gaps among preservice health care students and health workers; improve IPC governance and practice at the national and health facility levels; and improve monitoring of IPC program performance and surveillance of healthcare associated infections (HAIs). Overall, our work addressed 20 out of 21 IPC-related actions in the World Health Organisation Benchmarks for International Health Regulations capacities tool between 2018 and 2024. Over a one-year period, we found that the percentage of patients developing surgical site infections remained at 1% on average in the 10 intervention hospitals, which is lower than the global average of around 2.5%. The Ministry of Health subsequently scaled up HAI surveillance to 69 additional hospitals. As a result, Tanzania achieved a score of 3 (developed capacity) for HAI surveillance specifically in the Joint External Evaluation conducted in August 2023. Building on this progress, the Ministry of Health will continue to scale up IPC programs in all public and private health facilities. Given the health security risks associated with Ebola, Marburg, Mpox, and other pathogens, significant efforts are needed to educate the public on the importance of practicing IPC measures to protect themselves from infectious diseases.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100477"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757565","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 : 2025-09-01Epub Date: 2025-07-05DOI: 10.1016/j.infpip.2025.100475
Ezekiel Gamuya , Mulki S. Salum , Beatrice Augustino Mtewele , Baraka Minja , Prisca Damiano , Conjester I. Mtemisika , Kulwa P. Mnibi , Reuben N. Abednego , Bernard C. Okamo , Vitus Silago , Stephen E. Mshana , Heike Claus , Jeremiah Seni
Background
Hospital surfaces are critical reservoirs of multidrug-resistant pathogens, including third-generation cephalosporin-resistant Gram-negative bacteria (3GC-R-GNB), significantly contributing to healthcare-associated infections (HCAIs). This challenge is pronounced in low- and middle-income countries, where resource constraints limit effective infection prevention and control (IPC) measures. This study screened hospital surfaces for 3GC-R-GNB in selected District Hospitals (DHs) in Mwanza, Tanzania.
Methods
This cross-sectional hospital-based study was conducted between June and July, 2023. Door handles, hand-washing sinks, patients' beds, and ward floors were sampled. Isolation of 3GC-R-GNB was done on MacConkey agar supplemented with cefotaxime (2 μg/ml). Bacterial identification was done by MALDI-TOF on Vitek MS while antimicrobial susceptibility testing was done by the Kirby-Bauer method. A multiplex PCR assay was applied for the detection of extended-spectrum beta-lactamase (ESBL) genes (blaCTX-M, blaSHV, and blaTEM).
Results
A total of 892 swabs were collected from hospital surfaces, of which 243 (27.2%) were 3GC-R-GNB positive. From the 243 positive samples, 55 samples exhibited polymicrobial growth making a total of 300 bacterial isolates. The most prevalent species was Acinetobacter baumannii (26.0%, 78/300), followed by Klebsiella pneumoniae (11.0%, 33/300), Escherichia coli (8.0%, 24/300), and Leclercia adecarboxylata (7.0%, 21/300). Multiplex PCR of selected isolates (n=243) revealed that 99.6% (242/243), 93.4% (227/243), and 2.9% (7/243) 3GC-R-GNB harbored blaTEM, blaCTX-M, and blaSHV genes encoding ESBLs, respectively.
Conclusion
This study reveals substantial dispersion of highly resistant Gram-negative bacteria to hospital surfaces, showing the need to prevent dispersion of such contamination and targeted hospital hygiene measures to protect patients.
{"title":"Contamination of hospital surfaces by third-generation cephalosporin-resistant gram-negative bacteria in district hospitals in Mwanza, Tanzania: Urgent need for enhanced infection prevention and control","authors":"Ezekiel Gamuya , Mulki S. Salum , Beatrice Augustino Mtewele , Baraka Minja , Prisca Damiano , Conjester I. Mtemisika , Kulwa P. Mnibi , Reuben N. Abednego , Bernard C. Okamo , Vitus Silago , Stephen E. Mshana , Heike Claus , Jeremiah Seni","doi":"10.1016/j.infpip.2025.100475","DOIUrl":"10.1016/j.infpip.2025.100475","url":null,"abstract":"<div><h3>Background</h3><div>Hospital surfaces are critical reservoirs of multidrug-resistant pathogens, including third-generation cephalosporin-resistant Gram-negative bacteria (3GC-R-GNB), significantly contributing to healthcare-associated infections (HCAIs). This challenge is pronounced in low- and middle-income countries, where resource constraints limit effective infection prevention and control (IPC) measures. This study screened hospital surfaces for 3GC-R-GNB in selected District Hospitals (DHs) in Mwanza, Tanzania.</div></div><div><h3>Methods</h3><div>This cross-sectional hospital-based study was conducted between June and July, 2023. Door handles, hand-washing sinks, patients' beds, and ward floors were sampled. Isolation of 3GC-R-GNB was done on MacConkey agar supplemented with cefotaxime (2 μg/ml). Bacterial identification was done by MALDI-TOF on Vitek MS while antimicrobial susceptibility testing was done by the Kirby-Bauer method. A multiplex PCR assay was applied for the detection of extended-spectrum beta-lactamase (ESBL) genes (<em>bla</em><sub>CTX-M</sub>, <em>bla</em><sub>SHV</sub>, and <em>bla</em><sub>TEM</sub>).</div></div><div><h3>Results</h3><div>A total of 892 swabs were collected from hospital surfaces, of which 243 (27.2%) were 3GC-R-GNB positive. From the 243 positive samples, 55 samples exhibited polymicrobial growth making a total of 300 bacterial isolates. The most prevalent species was <em>Acinetobacter baumannii</em> (26.0%, 78/300), followed by <em>Klebsiella pneumoniae</em> (11.0%, 33/300), <em>Escherichia coli</em> (8.0%, 24/300), and <em>Leclercia adecarboxylata</em> (7.0%, 21/300). Multiplex PCR of selected isolates (n=243) revealed that 99.6% (242/243), 93.4% (227/243), and 2.9% (7/243) 3GC-R-GNB harbored <em>bla</em><sub>TEM</sub>, <em>bla</em><sub>CTX-M</sub>, and <em>bla</em><sub>SHV</sub> genes encoding ESBLs, respectively.</div></div><div><h3>Conclusion</h3><div>This study reveals substantial dispersion of highly resistant Gram-negative bacteria to hospital surfaces, showing the need to prevent dispersion of such contamination and targeted hospital hygiene measures to protect patients.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100475"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879765","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}
In 2024, a worldwide shortage of blood culture bottles prompted efforts to mitigate its impact, including strategies to reduce blood culture orders. This study aimed to evaluate the effect of the shortage on the two-set blood culture rate in a single center in Japan.
Methods
In this retrospective, single-center, observational study, blood culture data from April 2019 to January 2025 were analyzed. An interrupted time-series (ITS) analysis was performed to assess changes in the two-set blood culture rate, a key quality indicator. A Poisson segmented regression model was employed, with the shortage period as the breakpoint.
Results
The ITS analysis revealed a significant immediate reduction in the level of two-set blood cultures following the shortage (risk ratio [RR]: 0.22, P < 0.01), with a subsequent significant rise in the trend (RR: 1.25, P < 0.01). The two-set blood culture rate gradually improved after the supply restriction was lifted in October, returning to pre-shortage levels by December, following an intervention by the infection control team. The total blood culture test numbers remained stable during the study period (P = 0.64).
Conclusions
The blood culture bottle shortage led to a significant reduction in the two-set blood culture rate, demonstrating adaptation to shortage mitigation strategies. Monitoring the two-set blood culture rate served as an effective quality measure, enabling timely intervention by the infection control team and subsequent recovery of appropriate blood culture practices.The blood culture bottle shortage significantly reduced two-set blood culture rates. An interrupted time-series analysis showed an immediate drop, followed by recovery after an intervention. Monitoring enabled appropriate interventions to improve practices. Adapting strategies during shortages with continuous monitoring can optimize resources and patient care.
2024年，全球血液培养瓶短缺促使人们努力减轻其影响，包括采取减少血液培养订单的策略。本研究旨在评估短缺对日本单一中心两套血培养率的影响。方法对2019年4月至2025年1月的血培养数据进行回顾性、单中心、观察性研究。采用中断时间序列（ITS）分析来评估两组血培养率的变化，这是一个关键的质量指标。采用泊松分段回归模型，以短缺期为断点。结果ITS分析显示，短缺后两套血培养水平立即显著下降(风险比[RR]: 0.22, P <；0.01)，随后趋势显著上升(RR: 1.25, P <；0.01)。在10月解除供应限制后，两套血培养率逐渐提高，在感染控制小组的干预下，到12月恢复到短缺前的水平。总血培养试验数在研究期间保持稳定（P = 0.64）。结论血培养瓶短缺导致两套血培养率显著降低，表明对短缺缓解策略的适应。监测两组血培养率是有效的质量措施，使感染控制小组能够及时干预，并随后恢复适当的血培养方法。血培养瓶短缺显著降低了两组血培养率。一项中断时间序列分析显示，该指标立即下降，随后在干预后恢复。监测有助于采取适当的干预措施来改进实践。在短缺期间通过持续监测调整策略可以优化资源和患者护理。
{"title":"Impact of the acute national blood culture bottle shortage on the two-set blood culture rate in a single center in Japan: Insights from an interrupted time-series analysis","authors":"Tetsuji Morishita , Masao Kuwabara , Masayoshi Monji , Shin Lee , Makoto Hayashi , Hisashi Tsurumi , Hidetoshi Matsunami","doi":"10.1016/j.infpip.2025.100479","DOIUrl":"10.1016/j.infpip.2025.100479","url":null,"abstract":"<div><h3>Background</h3><div>In 2024, a worldwide shortage of blood culture bottles prompted efforts to mitigate its impact, including strategies to reduce blood culture orders. This study aimed to evaluate the effect of the shortage on the two-set blood culture rate in a single center in Japan.</div></div><div><h3>Methods</h3><div>In this retrospective, single-center, observational study, blood culture data from April 2019 to January 2025 were analyzed. An interrupted time-series (ITS) analysis was performed to assess changes in the two-set blood culture rate, a key quality indicator. A Poisson segmented regression model was employed, with the shortage period as the breakpoint.</div></div><div><h3>Results</h3><div>The ITS analysis revealed a significant immediate reduction in the level of two-set blood cultures following the shortage (risk ratio [RR]: 0.22, <em>P</em> < 0.01), with a subsequent significant rise in the trend (RR: 1.25, <em>P</em> < 0.01). The two-set blood culture rate gradually improved after the supply restriction was lifted in October, returning to pre-shortage levels by December, following an intervention by the infection control team. The total blood culture test numbers remained stable during the study period (<em>P</em> = 0.64).</div></div><div><h3>Conclusions</h3><div>The blood culture bottle shortage led to a significant reduction in the two-set blood culture rate, demonstrating adaptation to shortage mitigation strategies. Monitoring the two-set blood culture rate served as an effective quality measure, enabling timely intervention by the infection control team and subsequent recovery of appropriate blood culture practices.The blood culture bottle shortage significantly reduced two-set blood culture rates. An interrupted time-series analysis showed an immediate drop, followed by recovery after an intervention. Monitoring enabled appropriate interventions to improve practices. Adapting strategies during shortages with continuous monitoring can optimize resources and patient care.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100479"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144813870","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 : 2025-09-01Epub 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":"2025-09-01","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 : 2025-09-01Epub Date: 2025-07-09DOI: 10.1016/j.infpip.2025.100476
Brianna Tsuyuki , Dena Shahriari
Purpose
Disinfecting urine-contaminated floors, surfaces and objects is a persistent challenge in healthcare. While chlorine-based compounds such as bleach are often used to decontaminate surfaces, they are known to degrade plastics and may leave harmful residues and release potentially irritant vapors making them unsuitable disinfectants for materials that come in direct contact with humans. The objective of this study was to evaluate an alternative urine disinfection procedure. Treating urine-contaminated surfaces with 3% hydrogen peroxide (H2O2) was hypothesized to remove bacteria. Furthermore, when applicable, the efficacy of the same H2O2 stock solution for its repeated use over time was assessed further increasing simplicity and accessibility.
Materials and methods
The effectiveness of disinfecting two materials, a flat plastic surface and a long lumen representing a more challenging surface to clean, was evaluated with a commonly used method of water and soap versus using a 3% H2O2 solution.
Results
Contamination persisted when washing with soap and water but was effectively removed after one hour of H2O2 storage for flat plastic surfaces and after 3 hours for lumen surfaces. The same stock of H2O2 solution could be reused for up to three weeks with no colony formation.
Conclusions
The results show that bacteria can be removed from a urine-contaminated surface by being soaked in 3% H2O2 for one to three hours based on the surface type without the need for scrubbing or rinsing. The same stock solution can be used for repeated washes for up to three weeks to expand its sustainability and accessibility.
{"title":"3% hydrogen peroxide to disinfect urine-contaminated surfaces","authors":"Brianna Tsuyuki , Dena Shahriari","doi":"10.1016/j.infpip.2025.100476","DOIUrl":"10.1016/j.infpip.2025.100476","url":null,"abstract":"<div><h3>Purpose</h3><div>Disinfecting urine-contaminated floors, surfaces and objects is a persistent challenge in healthcare. While chlorine-based compounds such as bleach are often used to decontaminate surfaces, they are known to degrade plastics and may leave harmful residues and release potentially irritant vapors making them unsuitable disinfectants for materials that come in direct contact with humans. The objective of this study was to evaluate an alternative urine disinfection procedure. Treating urine-contaminated surfaces with 3% hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>) was hypothesized to remove bacteria. Furthermore, when applicable, the efficacy of the same H<sub>2</sub>O<sub>2</sub> stock solution for its repeated use over time was assessed further increasing simplicity and accessibility.</div></div><div><h3>Materials and methods</h3><div>The effectiveness of disinfecting two materials, a flat plastic surface and a long lumen representing a more challenging surface to clean, was evaluated with a commonly used method of water and soap versus using a 3% H<sub>2</sub>O<sub>2</sub> solution.</div></div><div><h3>Results</h3><div>Contamination persisted when washing with soap and water but was effectively removed after one hour of H<sub>2</sub>O<sub>2</sub> storage for flat plastic surfaces and after 3 hours for lumen surfaces. The same stock of H<sub>2</sub>O<sub>2</sub> solution could be reused for up to three weeks with no colony formation.</div></div><div><h3>Conclusions</h3><div>The results show that bacteria can be removed from a urine-contaminated surface by being soaked in 3% H<sub>2</sub>O<sub>2</sub> for one to three hours based on the surface type without the need for scrubbing or rinsing. The same stock solution can be used for repeated washes for up to three weeks to expand its sustainability and accessibility.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100476"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703799","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":"2025-09-01","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}
Pub Date : 2025-09-01Epub 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":"2025-09-01","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 : 2025-06-01Epub 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":"2025-06-01","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 : 2025-06-01Epub 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":"2025-06-01","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 : 2025-06-01Epub Date: 2025-03-29DOI: 10.1016/j.infpip.2025.100460
Hui Jin , Qun Lu , Kaiwen Ni , Xiaoping Ni
{"title":"A new classification of personal protective equipment in healthcare settings: Enhancing infection control and prevention","authors":"Hui Jin , Qun Lu , Kaiwen Ni , Xiaoping Ni","doi":"10.1016/j.infpip.2025.100460","DOIUrl":"10.1016/j.infpip.2025.100460","url":null,"abstract":"","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100460"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830093","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}
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