American journal of infection control最新文献

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.

Background: Pseudomonas aeruginosa can be found in pipes and mainly affects immunocompromised patients.

Methods: From March to September 2023, 393 drinking water samples were collected and analysed from taps of 21 hospital and 26 non-hospital facilities of Campania region. Antimicrobial susceptibility test was conducted by broth microdilution method and whole genome sequencing was carried out.

Results: The bacterium was detected in 47 samples (12.0%) (26 from hospitals and 21 from non-hospital facilities). All strains were resistant to 1^st and 2^nd generation cephalosporin, ampicillin and ampicillin/sulbactam. Some strains showed resistance to 4^th generation cephalosporin cefepime, and 16 of the 47 isolates were multi drug resistant (10 from hospitals and 6 from non-hospital setting). 13 distinct sequence types (STs) have been highlighted in this study revealing a heterogeneous population. ST 309 was the most common observed genotype. It was observed the presence of the same clone in different wards of the same hospital. The presence of the same clone in different facilities indicate P. aeruginosa diffusion in different pipelines.

Conclusions: This study revealed P. aeruginosa presence in hospital and non-hospital settings, highlighting the importance of conducting environmental monitoring, especially in locations hosting vulnerable people. Routinely performing this monitoring is important to prevent infections in humans.

Background: Microbial bioburden has been identified as a contributor to health care-associated infections. Disinfection with ultraviolet-C (UV-C) light can minimize bioburden, but targeted disinfection can be labor-intensive. We evaluated the effectiveness of wall-mounted autonomous and targeted UV-C disinfection device powered by artificial intelligence in reducing bioburden in a clinical setting.

Methods: Two endoscopy rooms were evaluated, a control room with standard disinfection/cleaning measures and another with 2 wall-mounted autonomous UV-C devices. To measure their impact on pathogenic bioburden levels, swab sampling was conducted on 10 preselected high-touch surfaces in each room over a period of 4 weeks and analyzed for microbial colony counts.

Results: Autonomous, targeted UV-C disinfection inactivated pathogens within 20 to 60 seconds from a distance of 6 to 8 ft. Longer UV-C exposure times were utilized to achieve a consistent level of pathogen inactivation. The autonomous UV-C room had a 99.7%, 84.3%, and 93.8% bioburden reduction compared to the control room (weeks 1, 2, and 4). Cumulative bioburden was 93.3% lower than that measured in the control room.

Conclusions: These data demonstrate that this novel, autonomous, and targeted UV-C disinfection approach is associated with effective surface decontamination and highlight the potential for this approach for broader use in healthcare settings.

Background: Surveillance for healthcare-associated infections (HAIs) is central to infection prevention but remains complex, resource-intensive, and variable. Large language models (LLMs) like ChatGPT offer potential support but have not been evaluated for applying National Healthcare Safety Network (NHSN) definitions.

Methods: This cross-sectional simulation assessed ChatGPT (GPT-4) accuracy and consistency in applying NHSN definitions. A 20-item test from a validated training bank was categorized by domain. Three independent runs were conducted using identical prompts and the 2024 NHSN manual, accessed through the ChatGPT Plus platform. ChatGPT's responses were compared to a validated answer key and benchmarked against infection preventionists (n = 22). Analyses included Wilcoxon signed-rank, Welch's t-test, and Spearman correlation.

Results: ChatGPT averaged 45% accuracy across runs, with only 20% of items correct in all three attempts. It was more reliable on laboratory-identified events but inconsistent on infections requiring temporal or multi-step logic. No significant correlation emerged between ChatGPT correctness and IP accuracy.

Conclusions: In this simulation-based proof-of-concept, ChatGPT-4 demonstrated limited reliability for complex NHSN surveillance tasks but showed potential in structured, lab-based scenarios. These findings highlight both the current constraints and future opportunities for generative artificial intelligence tools in infection prevention.

Background: Sepsis, a leading cause of mortality, is commonly caused by bacterial infections. Flavonifractor plautii is a rare anaerobic, Gram-positive rod bacterium that forms part of the human intestinal microbiota. This narrative review aims to summarize patient characteristics, diagnostic approaches, and antibiotic therapy in patients with Flavonifractor plautii infections, with a particular focus on its role as a potential pathogen in sepsis, in order to inform clinical decision-making.

Methods: The investigators conducted a systematic search of PubMed, MEDLINE and Embase databases to identify case reports and cohort studies involving Flavonifractor plautii.

Results: A wide range of comorbidities were observed, with immunocompromised patients predominating. Most infections originated from gastrointestinal tract and commonly presented as sepsis. Intensive care unit management was required in eight of the eleven case reports. In all the cases, the pathogen was isolated from blood cultures, and in some reports additionally from cerebrospinal, pleural and synovial fluid. Antibiotic therapy varied, with meropenem and metronidazole being the most commonly used agents, despite antibiotic resistance was rare.

Discussion: Flavonifractor plautii should be considered a potential pathogen in immunocompromised patients presenting with abdominal infections and sepsis.

Conclusion: This review illustrates Flavonifractor plautii`s ability to cause severe sepsis. No specific treatment recommendations beyond current sepsis guidelines were identified.

Background: Bacteremia is a common complication in burn patients. Hospital-onset bacteremia and fungemia (HOB) has been proposed as a quality measure for value-based purchasing programs. We sought to describe the characteristics of HOB in a regional burn center.

Methods: Patients admitted to the burn intensive care unit from September 2018 through December 2024 were identified through the burn registry. Microbiologic and patient data were extracted from the electronic medical record and Vizient database.

Results: One hundred seventy-nine (88.6%) of 202 bacteremia episodes were categorized as HOB in 1612 patients. The most common organisms isolated were Pseudomonas aeruginosa (18.2%), methicillin-resistant (15%) and methicillin sensitive (8%) Staphylococcus aureus and Klebsiella pneumoniae complex (6.6%). Seventy-two (35.6%) of the 202 bacteremia episodes, 66 (36.8%) of the 179 HOB episodes occurred within 2 days after a soft tissue surgical procedure.

Conclusions: HOB is common in burn patients and varies with total body surface area burned. In 36.8% of cases, HOB was associated with soft tissue with surgical procedures 2 days before the onset of bacteremia. HOB may not be an indicator of quality for burn patients. Further studies are needed to understand modifiable risk factors for bacteremia in this patient population.

Background: Leadership competencies among infection preventionists (IPs) are essential to improving patient safety and reducing healthcare-associated infections. The Advanced Leadership Certification in Infection Prevention and Control (AL-CIP) recognizes IPs demonstrating advanced leadership, yet little is known about the experiences of certified professionals or how the credential supports leadership development.

Methods: The Leadership Evaluation and Development for Infection Preventionists (LEAD-IP) study used an observational nested cohort design. Secondary data from all AL-CIP applicants across two 2025 certification cycles were analyzed. A nested cohort representing 18% of certified professionals completed a structured 60-minute qualitative interview. Data were analyzed using Braun and Clarke's inductive thematic analysis.

Results: Thirty AL-CIP-certified leaders participated. Seven themes emerged: transition from task-based to systems-level leadership; use of data and structured improvement models; communication and psychological safety as core leadership tools; persistent structural barriers; intentional inclusivity of under-represented teams; proactive risk management; and strengthened leadership identity, confidence, and professional growth through AL-CIP.

Conclusions: AL-CIP-certified professionals described leadership roles requiring systems thinking, data literacy, inclusive engagement, and anticipatory risk management. AL-CIP reinforced leadership confidence and credibility and supported career advancement. These findings highlight the value of leadership-focused training and certification in strengthening the IPC workforce.

Background: Hospital-acquired infections (HAIs) impose a major global burden, with hand hygiene (HH) a key preventive measure. Sustaining HH compliance often requires behavioral change. Motivational interviewing (MI), a technique fostering self-reflection and improvement, shows promise. This study evaluated MI's effectiveness in improving HH compliance among healthcare workers (HCW) and its impact on reducing HAI rates.

Methods: This prospective interventional study was conducted from June 2018 to February 2019 in a tertiary hospital MICU involving 29 doctors (8 consultants and 21 residents). Three-month pre-intervention phase recorded baseline HH compliance and HAI rates [central line-associated bloodstream infection (CLABSI), Ventilator-associated pneumonia (VAP), catheter-associated urinary tract infection (CAUTI)]. Intervention included educational and MI sessions plus promotional videos. Post-intervention, HH compliance, readiness to change, and HAI rates were reassessed. Compliance data were evaluated using a multilevel mixed-effects linear regression model, and product use before and after intervention was compared using the Wilcoxon rank-sum test. A p-value<0.05 was considered statistically significant.

Results: Among 650 observed opportunities, HH compliance improved significantly post-intervention (~41% to ~65-70%; p<0.001). Residents improved more than consultants. ABHR and soap use showed no significant change (p=0.521 and p=0.512). VAP and CAUTI rates decreased (p=0.0495), while CLABSI remained unchanged (p=0.184).

Conclusion: Multimodal strategy combining education and MI improved HH compliance among doctors. Its impact on reducing HAIs remains uncertain, warranting further investigation.

Background: Nosocomial transmission of varicella zoster virus (VZV), with susceptible health care workers (HCWs) playing a crucial role, poses a significant challenge in health care settings. This study aimed to assess immunity to VZV among HCWs in transplantation units and to identify susceptibility-associated factors. It also examined the characteristics of staff who contracted varicella during their working lives and the workdays lost.

Methods: A cross-sectional study included HCWs (n = 180) in 3 transplantation units at Mansoura University Hospitals. Participants completed a questionnaire that included sociodemographic and occupational details, as well as medical and vaccination histories. Participants' serum samples were tested for VZV antibodies.

Results: Among the participants, 78.3% tested positive for antibodies, 21.7% tested negative, and none had received a vaccination. A lack of prior varicella infection history significantly predicted susceptibility. Those who had chickenpox or herpes zoster while working lost an average of 14 and 8.8 workdays and an estimated 24.6 and 11.4 annual full-day equivalents, respectively.

Conclusions: Nearly a quarter of HCWs caring for transplantation patients are susceptible to VZV, below the recommended immunity threshold for preventing nosocomial transmission. Implementing a strategy to document immune status and vaccinate susceptible workers is essential.