Journal of Hospital Infection最新文献_第10页

A safety paradox in urinary catheterization: when national guidelines contradict manufacturer instructions. 导尿的安全悖论：当国家指南与制造商说明相矛盾时。

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection

Pub Date : 2026-01-22 DOI: 10.1016/j.jhin.2026.01.002

K E Horváthné, Z Balogh

引用次数: 0

Development and implementation of an electronic admission-screening tool for Candidozyma auris (formerly Candida auris) at a large healthcare system in Miami, FL, USA 在佛罗里达州迈阿密的一个大型医疗保健系统开发和实施耳念珠菌（以前的耳念珠菌）的电子住院筛查工具。

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection

Pub Date : 2026-01-01 Epub Date: 2025-09-20 DOI: 10.1016/j.jhin.2025.08.012

A. Jimenez , R. Rosa , N. Jean , A. Flanagan , K. Manzanillo , G. Rosello , L.M. Abbo

Objectives

Candidozyma auris (formerly Candida auris) is an urgent public health threat pathogen worldwide. This article describes using and implementing an electronic questionnaire to screen all patients for risk factors associated with C. auris upon admission to all facilities within a large healthcare system in Miami, FL, USA.

Methods

A screening questionnaire was implemented within the electronic medical record (EMR) applied at the point-of-entry to all inpatient admissions. The tool asked about risk factors for C. auris colonization and included: previous history of C. auris; overnight hospital stay outside the USA in the last 12 months; tracheostomy or mechanical ventilation present on admission; transfer from a healthcare facility with high risk for C. auris; or history of carbapenemase-producing organisms. Questionnaire responses triggered C. auris colonization testing using polymerase chain reaction (PCR) and initiation of contact precautions for those with identified risk(s).

Results

Over a 12-month period, the questionnaire was applied to 83,046 admissions. Of those, 4401 (5.3%) had at least one risk factor for C. auris colonization. Of those tested, 166 (6.1%) were PCR positive. The overall prevalence rate was 0.20%. The question with the highest percent positivity was ‘arriving from another healthcare facility’ (4.5%), and ‘previous history of multi-drug-resistant organism infection or colonization’ was the factor with the highest percent positivity on PCR (16%).

Conclusion

Screening questionnaires incorporated in the EMR are effective means to detect patients at risk for C. auris colonization, thus facilitating the early implementation of infection prevention and control measures aimed at avoiding the horizontal spread of highly transmissible organisms in healthcare facilities.

目的：耳念珠菌是一种紧迫的公共卫生威胁病原体。我们描述了在佛罗里达州迈阿密的一个大型医疗保健系统的所有设施中使用和实施电子问卷来筛查与C. auris相关的所有患者的风险因素。方法：我们在电子病历（EMR）中实施了一项筛选问卷，该问卷应用于所有住院患者的入境点。该工具询问了金黄色葡萄球菌定殖的危险因素，包括：金黄色葡萄球菌的既往病史，过去12个月内在美国境外住院过夜，入院时进行气管切开术或机械通气，从金黄色葡萄球菌高风险的医疗机构转院，或碳青霉烯酶产生生物的历史。该问卷触发了使用聚合酶链反应（PCR）对金黄色葡萄球菌定殖进行检测，并对确定有风险的人启动接触预防措施。结果：在12个月的时间里，问卷被应用于83046名招生。其中，4401人（5.3%）至少有一种金黄色葡萄球菌定植的危险因素。其中PCR阳性166例（6.1%）。总患病率为0.20%。阳性率最高的问题是“来自另一家医疗机构”（4.5%），既往MDRO史是PCR阳性率最高的因素（16%）。结论：电子病历中纳入筛查问卷是发现auris定植风险患者的有效手段，有助于早期实施感染防控措施，避免高传染性生物在医疗机构的水平传播。

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引用次数: 0

Economic impact of surgical site infection prevention across surgical units at Gemelli University Hospital: insights from a point prevalence survey 在Gemelli大学医院外科单位预防手术部位感染的经济影响：从点流行调查的见解。

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection

Pub Date : 2026-01-01 Epub Date: 2025-10-18 DOI: 10.1016/j.jhin.2025.10.007

M.G. Cacciuttolo , M.L. Specchia , M. Bonacquisti , L. Russo , R. Murri , M. Fantoni , M. Di Donato , M. Raponi , A. La Greca , G. Sganga , V. Cozza , P. Laurenti

Introduction

Healthcare-associated infections (HAIs) place a significant burden on healthcare systems, leading to increased morbidity, prolonged hospital stays, and elevated costs. Surgical site infections (SSIs) are among the most prevalent HAIs, often surpassing the cost of the surgical procedures themselves.

Aim

To evaluate the economic impact of a preventive intervention designed to reduce the prevalence of SSIs at Fondazione Policlinico A. Gemelli (FPG) IRCCS.

Methods

A point prevalence survey (PPS) was conducted in June 2023 and June 2024 at FPG IRCSS, following the protocol of the European Centre for Disease Prevention and Control. The study analysed data from hospitalized patients, comparing the prevalence of SSIs before and after implementation of a preventive intervention (bundle approach). An economic evaluation was performed using a budget impact model, estimating cost savings from the reduction in SSI cases. Sensitivity analysis was conducted to assess variations in the effectiveness of the intervention.

Results

The prevalence of SSIs decreased from 2.5% in 2023 to 1.4% in 2024, representing a 44% reduction. The estimated number of SSI cases decreased from 2287 to 1281, resulting in a cost reduction of approximately €31.6 million in direct healthcare expenses. The projected economic benefits for 2025 and 2026 suggest further savings if the downward trend continues.

Discussion

The findings indicate that targeted preventive measures reduce the prevalence and associated costs of SSIs significantly. The reduction rate exceeds previously reported figures in the literature, emphasizing the effectiveness of the intervention, and underline the need for broader implementation of prevention strategies to enhance patient safety and economic sustainability.

背景：卫生保健相关感染（HAIs）是卫生保健系统的一个重大负担，导致发病率增加、住院时间延长和费用增加。手术部位感染（ssi）是最普遍的hai之一，通常超过手术本身的费用。目的：本研究旨在评估旨在减少ssi患病率的预防性干预措施在Fondazione Policlinico a . Gemelli (FPG) IRCCS的经济影响。方法：根据ECDC方案，于2023年6月和2024年6月在FPG IRCSS进行点患病率调查（PPS）。该研究分析了住院患者的数据，比较了实施预防性干预（捆绑方法）前后SSI的发生率。使用预算影响模型进行经济评估，估计减少SSI病例所节省的成本。进行敏感性分析以评估干预效果的变化。结果：ssi的患病率从2023年的2.5%下降到2024年的1.4%，下降了44%。SSI病例的估计数量从2,287例下降到1,281例，直接医疗费用减少了约3,160万欧元。预计2025年和2026年的经济效益表明，如果这种下降趋势继续下去，将进一步节省成本。讨论：研究结果表明，有针对性的预防措施显著降低SSI患病率和相关费用。减少率超过了文献中先前报道的数字，强调了干预措施的有效性，并强调需要更广泛地实施预防战略，以提高患者安全和经济可持续性。

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引用次数: 0

Impact of rapid screening of respiratory viral infections on patient management in a healthcare facility 呼吸道病毒感染快速筛查对卫生保健机构患者管理的影响。

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection

Pub Date : 2026-01-01 Epub Date: 2025-10-30 DOI: 10.1016/j.jhin.2025.10.018

G. Cambien , J. Guihenneuc , L. Deroche , M. Garcia , J. Guenezan , A. Bousseau , C. Laland , N. Leveque , S. Ayraud-Thevenot

Background

In healthcare establishments, acute viral respiratory infections are a major cause of disorganization of care units, morbidity, and mortality among patients. Rapid diagnosis could improve patient management.

Aim

To assess the impact of rapid molecular screening of respiratory viruses on hospitalized patient management.

Methods

During a 4-year retrospective observational study conducted at the University Hospital of Poitiers, symptomatic adult patients were sampled at their entrance to the emergency department and tested for respiratory viruses with results available before hospitalization, with rapid multiplex PCR (R–PCR group; Biofire® FilmArray Respiratory panel 2 (Biomerieux, France)), or during hospitalization, with conventional multiplex PCR (C-PCR group; Respiratory Multi Well System MWS R-GENE® (Biomerieux, France)). Time to result, length of emergency department and hospital stays, hospitalization in a private/double room, the patient's room changes during the first 5 days following hospitalization, administration of antibiotics upon admission in the emergency department and reassessment, and outcomes due to the infection were compared.

Findings

Overall, 132 and 496 hospitalized patients were included in the C-PCR and R–PCR groups, respectively. Time to result (3.1 ± 2.7 h vs 22.2 ± 14.2 h (P<0.001)), administration of antibiotics upon admission in the emergency department (66.1% vs 80.3% (P<0.001)), and patient's room changes after admission (0.49 ± 0.57 vs 0.63 ± 0.76 (P<0.05)) were significantly lower in the R–PCR group.

Conclusion

This study confirmed that real-time screening of respiratory viruses with multiplex PCR upon admission provides essential assistance for healthcare workers in patient flow management.

背景：在卫生保健机构中，急性病毒性呼吸道感染是造成护理单位混乱、患者发病率和死亡率的主要原因。快速诊断可以改善病人的管理。目的：评价呼吸道病毒快速分子筛查对住院患者管理的影响。方法：在普瓦捷大学医院进行的一项为期4年的回顾性观察研究中，有症状的成年患者在进入急诊科时取样，并在住院前使用快速多重PCR （R-PCR组；Biofire®FilmArray respiratory panel 2 (Biomerieux, France)）或在住院期间使用常规多重PCR (C-PCR组；呼吸多井系统MWS R-GENE®（Biomerieux, France）比较到结果的时间、急诊科和住院时间、在单间/双人间的住院时间、住院后前5天患者的房间变化、在急诊科入院时抗生素的使用和重新评估，以及感染导致的结果。结果：总体而言，C-PCR组和R-PCR组分别纳入132和496名住院患者。结果时间（3.1±2.7小时）vs（22.2±14.2小时）结论：本研究证实，入院时多重PCR实时筛查呼吸道病毒为医护人员进行患者流管理提供了必要的帮助。

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引用次数: 0

How professions, the COVID-19 pandemic, and feedback influence alcohol-based hand-rub volumes per disinfection in functional units of a German hospital: a long-term evaluation 职业、COVID-19大流行和反馈如何影响德国医院功能单元每次消毒的酒精洗手量：一项长期评估。

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection

Pub Date : 2026-01-01 Epub Date: 2025-10-30 DOI: 10.1016/j.jhin.2025.10.017

C. Senges , M. Laatzen , C. Herzer , H. Niesalla , F. Oppenheimer

Background

Hand hygiene (HH) is the most important measure to reduce healthcare-associated infections. Most HH studies and interventions focus on HH on wards, neglecting the fact that many invasive procedures are performed in functional units (FUs).

Aim

To assess HH in FUs such as operating rooms, using disinfectant volumes (in mL) per disinfection, and to investigate how factors such as the COVID-19 pandemic and feedback influence it.

Methods

Using electronic monitoring, HH data were collected from five FUs of a German hospital over almost four years, including the COVID-19 pandemic, focusing on disinfectant volumes per hand disinfection (HD). The influence of the pandemic and feedback interventions on disinfectant volumes were investigated, taking into account task similarity and inter-professional collaboration.

Findings

Disinfectant volumes per HD varied between professional groups and FUs. Doctors in urological endoscopy used the largest median volume (3.41 mL). At the onset of the pandemic, volumes per HD increased and variability decreased, with 2.5–3.5 mL used most frequently. Subsequently, volumes decreased and increased again with the fourth wave in 2021. Post-pandemic volumes remained higher than pre-pandemic volumes. Only four of 147 ward-level feedback interventions significantly affected HH behaviour in FUs. Comparable HH behaviour was observed among healthcare workers with similar tasks or close collaboration.

Conclusion

The pandemic influenced HH and led to an up–down–up trend in disinfectant volumes per HD. We propose that interventions to improve HH in specific settings need to be tailored to those settings. Professional groups performing similar tasks or collaborating closely may be grouped.

背景：手部卫生（HH）是减少卫生保健相关感染的最重要措施。大多数HH研究和干预措施关注的是病房HH，忽视了许多侵入性手术是在功能单位（FUs）进行的事实。目的：评估FUs类手术室每次消毒使用的消毒液体积（mL），并探讨COVID-19大流行和反馈等因素对其的影响。方法：通过电子监测，我们收集了德国一家医院近四年的五个FUs（包括COVID-19大流行）的HH数据，重点是每手消毒消毒剂量（HD）。考虑到任务相似性和跨专业协作，我们调查了大流行和反馈干预对消毒剂量的影响。结果：每HD消毒剂量在专业组和FUs之间存在差异。泌尿内镜医生使用的中位容积最大（3.41 mL）。在大流行开始时，每HD的体积增加，变异性减少，最常用的是2.5至3.5 mL。随后，在2021年的第四次浪潮中，数量下降并再次增加。大流行后的数量仍高于大流行前的数量。147个病房水平反馈干预中只有4个显著影响FUs患者的HH行为。在具有相似任务或密切合作的卫生保健工作者中观察到可比的HH行为。结论：流感大流行对HH有影响，导致HH消毒液用量呈上升-下降-上升趋势。我们建议，在特定环境中改善健康的干预措施需要根据这些环境进行调整。执行类似任务或密切合作的专业小组可以分组。

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引用次数: 0

The experience paradox: a 12-year analysis reveals bimodal occupational exposure risk in a high-consequence infectious disease hospital 经验悖论：一项为期12年的分析揭示了一家高后果传染病医院的双峰职业暴露风险。

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection

Pub Date : 2026-01-01 Epub Date: 2025-10-30 DOI: 10.1016/j.jhin.2025.10.008

Q-Q. Jiang , X-Y. Zhang , X. Yu , J. Xue , W-Q. Li

Background

Conventional occupational exposure models neglect experience-dependent risk nuances in infectious disease hospitals, leading to persistent prevention gaps. This 12-year study redefines occupational exposure epidemiology in high-consequence settings.

Methods

We conducted a retrospective analysis of all 124 documented occupational exposure incidents from 2013 to 2024. To standardize risk assessment across a fluctuating workforce, we introduced ‘exposure density’ (events per 1000 healthcare workers) as a novel key metric. Statistical comparisons utilized χ² tests (P<0.05).

Findings

Our analysis revealed a striking ‘experience paradox’: occupational exposure risk follows a distinct bimodal curve. The highest exposure density occurred in early-career staff with less than 2 years of experience (81.90‰), driven by procedural errors. Paradoxically, risk resurged significantly in senior staff with over 10 years of experience (17.89‰), linked to complacency and burnout. This pattern was amplified by temporal peaks coinciding with the COVID-19 pandemic onset (2020) and post-policy transition (2023). Sharps injuries from hollow-bore needles were the primary mechanism (89.52%), with 66.67% attributable to operator error and 59.68% occurring without gloves. Critical system failures were evident, including a 54.54% underreporting rate among re-exposed staff and low post-exposure prophylaxis (PEP) uptake for unknown-source exposures (52.38%), largely due to financial barriers.

Conclusion

Occupational safety in high-consequence settings is not a linear function of experience. Both novice enthusiasm and veteran fatigue represent critical vulnerability points. We call for a paradigm shift from one-size-fits-all protocols to an experience-stratified safety model. Key actions include: (1) national PEP subsidies; (2) institution-level AI-training for novices and burnout screening for veterans; (3) resource targeting to high-risk units (hepatology/medical intensive care).

背景：传统的职业暴露模型忽略了传染病医院经验依赖风险的细微差别，导致持续的预防差距。这项为期12年的研究重新定义了高后果环境中的职业暴露流行病学。方法：对2013年至2024年记录的124起职业暴露事件进行回顾性分析。为了在波动的劳动力中标准化风险评估，我们引入了“暴露密度”（每1000名医护人员的事件数）作为一个新的关键指标。统计比较采用χ2检验(p发现：我们的分析揭示了一个惊人的“经验悖论”：职业暴露风险遵循明显的双峰曲线。暴露密度最高的是入职初期工作经验不足2年的工作人员（81.90‰），主要是程序性错误所致。矛盾的是，在拥有10年以上经验的高级员工中，风险显著回升（17.89‰），与自满和倦怠有关。与2019冠状病毒病大流行发病（2020年）和政策后过渡（2023年）相吻合的时间峰值放大了这一模式。其中，操作失误占66.67%，未戴手套占59.68%。严重的系统故障很明显，包括再暴露人员的漏报率为54.54%，暴露后预防（PEP）对未知源暴露的吸收率低（52.38%），主要是由于经济障碍。结论：高后果环境中的职业安全不是经验的线性函数。新手的热情和老手的疲劳都是关键的弱点点。我们呼吁从一刀切的协议到经验分层的安全模型的范式转变。重点行动包括：(1)国家PEP补贴；(2)机构级新手人工智能培训和退役军人职业倦怠筛查；(3)资源针对高危单位（肝病学/内科重症监护）。

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引用次数: 0

Analysis of an outbreak of echinocandin-resistant clonal Candida parapsilosis complex harbouring ERG11Y132F and FKS1S656P mutations 一起携带ERG11Y132F和FKS1S656P突变的耐棘白素克隆假丝酵母伴裂病复合体暴发分析

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection

Pub Date : 2026-01-01 Epub Date: 2025-10-28 DOI: 10.1016/j.jhin.2025.10.013

M. Kapmaz , Ö. Doğan , P. İrkören , K. Çam , E.S. Tanrıverdi , Z. Genç , E. Taş , B. Otlu , S. Tekin , Ö. Ergönül

Aim

We aimed to analyse echinocandin-resistant (ECR) Candida parapsilosis complex candidaemia episodes.

Methods

A retrospective cohort study was conducted at Koç University Hospital from 1^st January 2018 to 30^th March 2022, during the COVID-19 pandemic. A total of 307 candidaemia isolates were obtained from 249 patients. A total of 272 episodes had mono-candidaemia, while 16 episodes had poly-candidaemia. Antifungal susceptibility with broth microdilution with environmental microbiological sampling were obtained. Sequencing and amplification of the resistance genes with genotyping were carried out, and pulse field gel electrophoresis was performed in the isolates.

Results

Of the 272 isolates that caused mono-candidaemia, 139 (51.1%) were identified as C. parapsilosis complex, with 64 (46%) demonstrating micafungin resistance. The isolates yielded Y132F mutation in the ERG11, and S656P mutation in the FKS1 genes, primarily genotypes A and A1. The 30-day mortality rates were 51.6% (33/64) for ECR C. parapsilosis complex, 38.9% (14/36) for fluconazole-resistant C. parapsilosis complex, and 35.9% (14/39) for fluconazole-susceptible C. parapsilosis complex. Environmental cultures showed that 23 of 60 samples yielded ECR C. parapsilosis complex, predominantly from interior parts and handles of infusion pumps used in oncology wards with a total clonal similarity with the clinical isolates.

Conclusions

This is the first report of the FKS1^S656P mutation in ECR C. parapsilosis complex isolates from Turkey, and it highlights a significant outbreak associated with an unnoticed gap in cleaning of the interior parts of infusion pumps. Enhanced cleaning protocols, combined with on-site feedback, resulted in no new cases within the next 2 months.

目的：分析棘球白素耐药（ECR）假丝酵母病复合念珠菌血症发作情况。方法：回顾性队列研究于2018年1月1日至2022年3月30日在Koç大学医院进行。249例患者共分离到307株念珠菌血症。272例单念珠菌血症，16例多念珠菌血症。用肉汤微量稀释法和环境微生物取样法测定抗真菌敏感性。对耐药基因进行测序、扩增和分型，并对分离菌株进行脉冲场凝胶电泳。结果：272株引起单念珠菌血症的分离株中，139株（51.1%）鉴定为假丝酵母菌复合体，64株（46%）表现出耐药。分离株在ERG11基因上产生Y132F突变，在FKS1基因上产生S656P突变，主要是基因型A和A1。ECR旁枯菌复合体30天死亡率为51.6%(33/64)，氟康唑耐药旁枯菌复合体为38.9%(14/36)，氟康唑敏感旁枯菌复合体为35.9%（14/39）。环境培养显示，60份样本中有23份产生ECR C.旁裂复合体，主要来自肿瘤病房使用的输液泵的内部和手柄，与临床分离株具有完全克隆相似性。结论：这是来自土耳其的ECR c.s parapsilosis复合体分离株中首次报道FKS1S656P突变，它突出了与输液泵内部清洁未被注意到的间隙相关的重大暴发。加强清洁方案，结合现场反馈，在接下来的两个月内没有出现新的病例。

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引用次数: 0

Success rates of meticillin-resistant Staphylococcus aureus (MRSA) decolonization and factors associated with failure over a 16-year period – an observational study 一项为期16年的观察性研究：耐甲氧西林金黄色葡萄球菌（MRSA）去菌落的成功率和失败的相关因素

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection

Pub Date : 2026-01-01 Epub Date: 2025-10-14 DOI: 10.1016/j.jhin.2025.10.002

N. Bloch , M. Seneghini , G. Rettenmund, J. Männer, S.P. Kuster, D. Flury, M. Schlegel, P. Kohler

Background

Meticillin-resistant Staphylococcus aureus (MRSA) decolonization is used widely, and various success rates and risk factors for failure have been reported. The aims of this study were to evaluate the success rate of MRSA decolonization and to identify risk factors for failure.

Methods

Patients with MRSA colonization from 2007 to 2023 were registered prospectively, and anthropometric information, and data on comorbidities and colonization (e.g. circumstances of detection, number of colonized sites, date of decolonization) were collected, as well as the results of control swabs. The success rate of decolonization (i.e. two or more negative sets of swabs with minimal follow-up of 3 months) was assessed, and multi-variable regression was used to assess the risk factors for failure.

Results

In total, 1170 patients with MRSA were included in this study. Of these, 478 (41%) patients were decolonized within 728 cycles, with a success rate of 28%. On multi-variable analysis, male sex [adjusted odds ratio (aOR) 2.2, 95% confidence interval (CI) 1.4–3.4; P<0.01], older age (aOR 1.1 per 10 years, 95% CI 1.0–1.2), number of previous decolonizations (aOR 2.1 per cycle, 95% CI 1.2–3.5; P<0.01), and number of positive sites (aOR 1.5 per site, 95% CI 1.2–1.9, P<0.01) were risk factors for failure. Use of systemic antibiotics (aOR 1.6, 95% CI 0.8–3.3; P=0.2) was not associated with the outcome.

Conclusion

Over the 16-year period, 28% of patients were decolonized successfully. Male sex was identified as a novel risk factor for failure. The failure rate increased with every additional decolonization cycle, irrespective of the use of systemic antibiotics. These findings can inform patients and caregivers about the expected success rate based on individual risk profiles.

背景：耐甲氧西林金黄色葡萄球菌（MRSA）被广泛应用，有不同的成功率和失败的危险因素报道。目的是评估MRSA去菌落的成功率，并确定失败的风险因素。方法：前瞻性登记2007年至2023年MRSA定殖患者，收集人体测量数据、合并症、定殖数据（如检测情况、定殖地点数量、去殖日期）以及对照拭子结果。我们评估了去菌落的成功率（即≥2组阴性拭子，最少随访3个月），并使用多变量回归评估失败的危险因素。结果：我们登记了1170例MRSA患者。其中，478例（41%）患者在728个周期内去殖，成功率为28%。在多变量分析中，男性（aOR 2.2, 95% CI 1.4-3.4, p）结论：在16年的时间里，28%的患者成功去菌落。我们发现男性是失败的新风险因素；此外，无论是否使用全身性抗生素，失败率随着每增加一个去菌落周期而增加。这些发现可以让患者和护理人员了解基于个人风险概况的预期成功率。

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引用次数: 0

Preliminary cadaver study of Surgical Humidification (HumiGard™) demonstrating reduced intra-wound particle counts during total hip arthroplasty 手术湿化（HumiGard™）的初步尸体研究显示全髋关节置换术中伤口内颗粒计数减少。

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection

Pub Date : 2026-01-01 Epub Date: 2025-11-06 DOI: 10.1016/j.jhin.2025.10.025

M.I. Abraham , C.J.T. Spence , P.R. Riordan , R.P. Pitto

Background

Infection remains a clinically significant problem in orthopaedic surgery, particularly in joint arthroplasty. Current infection prevention protocols aim to provide an aseptic operating room environment. An intervention to further reduce airborne particles local to the surgical site may be valuable to protect against infection. Surgical Humidification (F&P HumiGard™) is a novel device designed to provide a warm and hydrated wound environment and reduce particles entering the orthopaedic surgical site.

Aim

This pilot study aimed to evaluate the ability of HumiGard to deflect airborne particles during a dynamic simulation of total hip arthroplasty, involving movement of tools, surgeon's hands, and tissue.

Methods

A cadaveric simulation of total hip arthroplasty was performed using the direct anterior approach. HumiGard was positioned at the surgical site prior to incision. Airborne particles (0.3–10 μm) were continuously measured at the wound using an optical particle sizer. Particle counts under standard care control and HumiGard conditions were compared using non-parametric statistical analysis.

Findings

HumiGard reduced median airborne particle counts by 61% compared with control conditions (P<0.0001), excluding bone saw use. Particle levels dropped immediately when HumiGard was activated and rose when deactivated, indicating active deflection of exogenous particles.

Conclusion

This pilot study demonstrates that HumiGard reduced airborne particle counts within the wound during a dynamic cadaveric model of total hip replacement. These findings suggest HumiGard may be a valuable addition to current infection prevention protocols to help minimize airborne particle contamination and reduce the risk of infection.

背景：在骨科手术中，感染仍然是一个重要的临床问题，尤其是在关节成形术中。目前的感染预防方案旨在提供无菌的手术室环境。进一步减少手术部位局部空气中颗粒的干预措施可能对防止感染有价值。手术加湿（F&P HumiGard™）是一种新型设备，旨在提供温暖和水合的伤口环境，减少进入骨科手术部位的颗粒。目的：本初步研究旨在评估HumiGard在全髋关节置换术动态模拟过程中转移空气中颗粒的能力，包括工具、外科医生的手和组织的运动。方法：采用直接前路进行全髋关节置换术的尸体模拟。HumiGard在切口前放置于手术部位。使用光学粒度仪连续测量伤口处的空气悬浮颗粒（0.3 ~ 10 μm）。使用非参数统计分析比较标准护理控制和HumiGard条件下的颗粒计数。研究结果：与对照条件相比，HumiGard减少了61%的空气中颗粒计数（p < 0.0001），不包括骨锯的使用。当HumiGard被激活时，颗粒水平立即下降，当停用时，颗粒水平上升，表明外源颗粒主动偏转。结论：这项初步研究表明，HumiGard在全髋关节置换术的动态尸体模型中减少了伤口内空气中的颗粒计数。这些发现表明，HumiGard可能是当前感染预防方案的一个有价值的补充，有助于最大限度地减少空气中的颗粒污染，降低感染风险。

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引用次数: 0

Prevention of microbiological contamination of drugs during their preparation for anaesthesia in the operating theatre: the Non-Touch trial 手术室麻醉准备过程中药物微生物污染的预防：NON-TOUCH试验。

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection

Pub Date : 2026-01-01 Epub Date: 2025-11-08 DOI: 10.1016/j.jhin.2025.10.028

S. Tafelski , S. Zeuch , R. Nagel , S. Spatz , B. Piening , C. Geffers , T. Adam , C. Spies , I. Nachtigall

Background

Aseptic techniques for preparing and administering injectable medicines remain under-studied, yet poor handling contributes substantially to healthcare-associated infections. Lipid-based formulations such as propofol pose an especially high risk of microbial contamination. The aseptic Non-Touch syringe preparation method may mitigate this risk but has not yet been evaluated.

Aim

This study aimed to develop and assess a procedure to reduce contamination of drugs in syringes in operating theatres and intensive care units.

Methods

We evaluated the aseptic Non-Touch method across 950 syringes in both preclinical and clinical settings. First, 450 syringes underwent membrane filtration and bacterial culture; 50 prefilled 0.9% sodium chloride syringes served as negative controls. A subset of 150 syringes was further tested using Bactec blood culture analytics. In a subsequent clinical experiment, 300 preservative-free propofol syringes were prepared by specialist anaesthesiology nurses, with holding times of 1, 2, and 6 h prior to culture.

Findings

In preclinical trials, the Non-Touch method yielded a contamination rate of 0.67% (3/450) by culture and 2.7% (4/150) by Bactec (odds ratio: 4.1; adapted 95% confidence interval: 0.67–22.34); all negative controls remained sterile. In clinical experiments, two out of 300 propofol preparations (0.67%) were contaminated. Extending the interval between preparation and culture up to 6 h had no effect on contamination rates.

Conclusion

The Non-Touch method demonstrated consistently low bacterial contamination (<1%) in both laboratory and clinical environments. Moreover, propofol syringe sterility was maintained for ≥6 h post preparation. These findings support further evaluation of Non-Touch as a practical strategy to enhance injection safety in routine anaesthetic and critical care settings.

背景：制备和注射药物的无菌技术仍未得到充分研究，但处理不当是导致卫生保健相关感染的主要原因。以脂质为基础的制剂，如异丙酚，具有特别高的微生物污染风险。非接触式注射器制备方法可以减轻这种风险，但尚未进行评估。目的：本研究旨在制定和评估一个程序，以减少在手术室和重症监护病房的注射器中药物的污染。方法：我们在临床前和临床设置中评估了950支注射器的无菌NON-TOUCH方法。首先，对450支注射器进行膜过滤和细菌培养；50支预充0.9%氯化钠注射器作为阴性对照。使用BACTEC血液培养分析进一步测试了150支注射器的子集。在随后的临床实验中，由专业麻醉护士准备了300支不含防腐剂的异丙酚注射器，在培养前分别保持1小时、2小时和6小时。结果：在临床前试验中，NON-TOUCH培养的污染率为0.67% (3/450)，BACTEC污染率为2.7% (4/150)(OR 4.1, CIa 0.67-22.34)；所有阴性对照保持无菌。在临床试验中，300个异丙酚制剂中有2个（0.67%）被污染。将制备和培养之间的间隔延长至6小时对污染率没有影响。结论：NON-TOUCH方法具有较低的细菌污染(

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