American journal of infection control最新文献

Background: The importance of ethanol-based hand rubs (EBHRs) to prevent health care-associated infections is undisputed. However, there is a lack of meaningful data regarding the influence of EBHRs on skin microbiome.

Methods: Four nurses in a neonatal intensive care unit were included. After a leave of 14 days, samples were taken before the first hand rubbing action and at the end of shift, with continued sampling on days 1, 7, and 28. To analyze the hand microbiome, microbial cells were collected using the glove-juice technique. Pro- and eukaryotic community profiles were created using amplicon sequencing of 16S and 18S ribosomal RNA (rRNA) gene markers.

Results: On average, hand antisepsis was performed 108 times per 8-hour work shift. Microbial communities were dominated by typical taxa found on human skin. In addition, a clear nurse-specific (ie, individual) microbiome signature could be observed. For Prokaryota, daily exposure led to the end-of-the-day microbiomes being more similar to each other across nurses. In contrast, longitudinal effect of 28-day application revealed more similarity of the Eukaryotic community.

Conclusions: Frequent occupational use of EBHR did not adversely affect the composition of the human hand microbiome. Thus, daily hand antisepsis retains its significance as the most important procedure for infection control.

Background: Antimicrobial stewardship supports rational antibiotic use. However, balancing access to antibiotic treatment while controlling resistance is challenging. This research used a threshold logistic modeling approach to identify targets for antibiotic usage associated with carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Klebsiella pneumonia, and extended-spectrum β-lactamases-producing Escherichia coli incidence in hospitals.

Methods: This study utilizes an ecological population-level design. Monthly pathogen cases and antibiotic use were retrospectively determined for inpatients between January 2015 and December 2023. The hospital pharmacy and microbiology information systems were used to obtain this data. Thresholds were identified by applying nonlinear modeling and logistic regression.

Results: Incidence rates of 0.199, 0.175, and 0.146 cases/100 occupied bed-days (OBD) for carbapenem-resistant A baumannii, carbapenem-resistant K pneumonia, and extended-spectrum β-lactamases-producing E coli, respectively, were determined as the cutoff values for high (critical) incidence rates. Thresholds for aminoglycosides (0.59 defined daily dose [DDD]/100 OBD), carbapenems (6.31 DDD/100 OBD), piperacillin-tazobactam (3.71 DDD/100 OBD), third-generation cephalosporins (3.71 DDD/100 OBD), and fluoroquinolones (1.91 DDD/100 OBD), were identified. Exceeding these thresholds would accelerate the gram-negative pathogens' incidence rate above the critical incidence levels.

Conclusions: Threshold logistic models can help inform and implement effective antimicrobial stewardship interventions to manage resistance within hospital settings.

Background: The duration and magnitude of SARS-CoV-2 air dispersal during nosocomial outbreaks remain uncertain. This study evaluates the impact of mobile modular high-efficiency particulate air filter units (MMHUs) on SARS-CoV-2 air dispersal.

Methods: We investigated a nosocomial COVID-19 outbreak in an infirmary unit. The viral load (VL) of SARS-CoV-2 in air samples was correlated with the VL in nasopharyngeal swabs with or without MMHU. These samples underwent whole-genome sequencing and phylogenetic analysis.

Results: Upon outbreak declaration (August 2, 2024, day 0), 44 (69.8%) of 63 patients acquired COVID-19 in Ward 2B (19 male) and 2C (25 female) by day 4. The VL of SARS-CoV-2 remained detectable in air until day 11 (2B) and day 20 (2C). The VL of air samples was significantly correlated with the VL in nasopharyngeal swabs collected on days 5, 7, 10, and 13 in 2C (r = -0.975, P = .004). Using MMHU, the mean daily ratio of SARS-CoV-2 RNA (copies/1,000 L of air/patient) in 2B was 5 times lower than in 2C from days 5 to 10. Whole-genome sequencing revealed all 41 tested strains belonged to the Omicron variant, KP.3.1.1, phylogenetically related to the prevailing community strains.

Conclusions: Using MMHU mitigates the duration and magnitude of SARS-CoV-2 air dispersal during nosocomial outbreak.

Infection control measures may be disrupted by inter- or intra-hospital transfers after major disasters. We report the possible outbreak and prevention of vancomycin-resistant Enterococcus spp. (VRE) strains carried by infants transferred to our neonatal intensive care unit from another unit after the earthquake. Screening cultures (rectal swabs) were obtained from infants during hospitalisation and contact isolation was performed. We analysed the clonal analysis of VRE strains isolated from patients by pulse field gel electrophoresis.