American journal of infection control最新文献

The IR Biotyper (IR-BT) was evaluated for its performance in typing Candida parapsilosis strains, in comparison to a short tandem repeat analysis. Although the IR-BT offers advantages such as speed and ease of use for routine applications, it demonstrated lower discriminatory power and concordance with our short tandem repeat analysis. These results suggest that IR-BT needs further optimization for the characterization of C parapsilosis strains.

Exposure to tuberculosis (TB) in healthcare settings can pose a significant risk to patients, families, and health care personnel. The Centers for Disease Control and Prevention recommend that healthcare facilities perform an annual TB risk assessment but do not offer methods to encompass larger health care systems with geographically diverse facilities. We sought to develop a supplemental risk assessment strategy utilizing ICD-10-CM codes to quantify TB risk for individual sites across our health care system.

Background: Infection preventionists (IPs) are critical to reducing healthcare-associated infections, yet orientation and training remain inconsistent. CIC is the professional standard, but variability in training may affect exam preparedness and certification outcomes.

Methods: A cross-sectional survey of 128 Texas IPs (October 2023-January 2024) evaluated training experiences, CIC certification status, and resource utilization. Logistic regression identified predictors of exam preparedness and certification.

Results: Of respondents, 60.3% were CIC certified, although 58.5% reported feeling unprepared for the exam. On-the-job training was the primary method across most competency areas. Rural IPs were significantly less likely to be certified compared with urban peers (OR, 2.99; 95% CI, 1.14-7.82; P = .026). Inadequate training predicted failure to achieve certification (OR, 0.21; 95% CI, 0.06-0.67; P = .008). Use of the APIC and Epidemiology Roadmap and APIC and Epidemiology Text was associated with greater perceived preparedness.

Conclusions: Training gaps, particularly in rural settings, limit CIC readiness. Expanding access to structured educational programs and standardized resources may improve certification success and strengthen the infection prevention workforce.

Background: Policy change by the South Korean government in 2024 led to mass resignations of medical fellows and residents, resulting in the temporary suspension of the antimicrobial stewardship program (ASP). This study aimed to evaluate the association of ASP suspension with hospital-wide antibiotic consumption.

Methods: This retrospective single-center study analyzed monthly antibiotic use as days of therapy per 1,000 patient-days from January 2021 to November 2024. Interrupted time-series analysis using segmented regression was applied to evaluate changes before and after suspension.

Results: After ASP suspension, restricted antibiotic use significantly increased in both level (coefficient: 15.998; 95% CI, 3.492-28.504; P = .013) and trend (coefficient: 2.475; 95% CI, 0.326-4.625; P = .025). Preauthorization antibiotics showed significant increases in both level (coefficient: 12.501; 95% CI, 4.692-20.310; P = .002) and trend (coefficient: 1.497; 95% CI, 0.133-2.862; P = .032). Prospective audit and feedback-targeted antibiotics exhibited no level change but a significant postsuspension trend increase (coefficient: 1.337; 95% CI, 0.531-2.143; P = .002). Nonrestricted antibiotics did not show significant changes.

Conclusions: The suspension of ASP was associated with a marked increase in restricted antibiotic use, particularly those subject to preauthorization. These findings underscore the critical role of ASP in regulating antibiotic use.

Background: Measles, a highly infectious virus, can cause outbreaks in low-vaccinated communities. In January 2025, a community-wide outbreak in the South Plains of Texas prompted a hospital serving pediatric and women's patients to rapidly develop and implement infection prevention protocols to treat measles patients while protecting patients, visitors, and staff within the hospital. This article explains infection prevention and control strategies utilized by the hospital during a community-wide measles outbreak and processes implemented to mitigate exposures.

Methods: A multidisciplinary team collaborated to educate staff on the Centers for Disease Control and Prevention (CDC) measles infection prevention guidance and ensured access to necessary resources for protection. The hospital temporarily converted rooms to negative pressure, constructed a screening shed for patients arriving at the emergency department, developed signage to direct measles patients, provided roving fit testing, and worked with public health officials.

Results: Ninety-eight patients presented to the hospital for measles. Fifty eight were confirmed via reverse transcription-polymerase chain reaction or IgM tests, and 9 were diagnosed clinically. There were 810 patients hospitalized simultaneously with the measles patients, and none returned or were reported as secondary cases linked to hospital exposure.

Conclusions: The implemented interventions successfully prevented measles secondary cases associated with the hospital.

Following two potential endoscope-related patient exposures, a multidisciplinary team, led by Infection Prevention, conducted a Failure Mode and Effects Analysis to identify and address high-risk steps in endoscope reprocessing. Four key vulnerabilities were identified, leading to targeted actions with equipment, competencies, and process verification. Since implementation, no exposures have occurred, underscoring the value of Failure Mode and Effects Analysis in Infection Prevention.

Background: Surgical site infections (SSIs) are a common complication in colorectal surgery. In colorectal cancer (CRC), SSIs increase recurrence and mortality. This study aimed to describe the frequency, risk factors, and mortality of patients with SSIs at a cancer center.

Methods: An observational, retrospective study was conducted from 2018 to 2022, including patients with CRC who underwent elective colorectal surgery. Risk factors for SSI were assessed using multivariable logistic regression analysis. A 5-year survival analysis was performed using the Kaplan-Meier curves, and hazard ratios were calculated using the Cox proportional hazards method.

Results: We included 712 patients; SSI occurred in 28%. Risk factors included preoperative hemoglobin ≤ 8.5g/dL (OR 3.21, P = .04) and intraoperative mean arterial blood pressure < 65 mm Hg (OR 5.12, P < .001). Adequate perioperative antimicrobial prophylaxis reduced the SSI risk (OR 0.53, P = .04). Increased mortality was associated with surgical diversion (HR 2.54, P < .001), hospital-acquired pneumonia (HR 4.02, P < .001), and septic shock (HR 14.21, P < .001). Overall 5-year survival was lower in SSI patients (70% vs 82%; log-rank, P = .021).

Conclusions: SSIs in CRC were higher compared with other series. Preoperative anemia and intraoperative low perfusion were strong predictors of SSI development. An adequate perioperative antimicrobial prophylaxis significantly reduced SSIs. Patients with SSIs experienced higher mortality rates.

Some recent studies have raised concern that Clostridioides difficile with reduced susceptibility to chlorine-releasing disinfectants may be emerging. We found that a commercial sodium hypochlorite disinfectant was consistently effective against spores from 18 environmental C difficile isolates at the recommended 3-minute exposure time, but not after a 1-minute exposure. These results suggest that commercial chlorine-releasing disinfectants remain active against C difficile spores but highlight the importance of achieving the recommended exposure time.

Background: Infection preventionists' (IPs) role can be jeopardized by imbalance between expanding responsibilities and limited resources. Challenges of stress and burnout among IPs can lead to turnover and struggles with staffing and workloads. The goal of this project was to measure burnout and evaluate the impact of a burnout assessment on a population of IPs.

Methods: IPs from Association for Professionals in Infection Control and Epidemiology were recruited to participate. Participants completed a pre-survey, the Maslach Burnout Inventory (MBI) assessment, and a post-survey. Results from the pre- and post-survey were compared to determine changes in burnout awareness and perception following completion of the MBI. Results from the MBI were compared with the general population and between chapters.

Results: There were 65 participants who completed all 3 phases of the project. The MBI scores revealed patterns in burnout indicators within respondents. Almost 75% (73.9%, n=48) of participants reported the MBI tool provided useful information and almost 70% (67.7%, n=44) believed the MBI tool increased self-awareness about burnout.

Conclusions: Burnout is a significant challenge for this pilot IP population. This project highlights the need for continued burnout evaluation and resource provision. Organizations and IP leaders must proactively support IPs to prevent burnout.