American journal of infection control最新文献

Background: Prior data suggest that surgical site infections (SSIs) occur more frequently in warmer months. Although several studies have shown this, most do not adequately account for confounding factors or the non-parametric nature of seasonal trends. This study examined SSI rates across multiple hospitals within a single healthcare system, using previously published statistical models applied to electronic health record (EHR) data.

Methods: We retrospectively analyzed all surgeries from 2014 to 2019. Preoperative risk and postoperative probabilities of SSIs were estimated using our Automated Surveillance of Postoperative Infections (ASPIN) models. Observed to expected (O/E) ratios were calculated and plotted by week, with cubic smoothing splines visualizing trends. Seasonality was modeled using generalized linear mixed models with sine and cosine transformations of the week of the year or quadratic transformations as predictors.

Results: 348,289 surgeries were analyzed. Most SSIs occurred between July and August. The risk-adjusted O/E ratio and postoperative SSI probabilities significantly increased (P < 0.05) during the summer in Region 1, an academic hospital, but not in the other two regions.

Conclusions: Our study supports prior work suggesting a summer peak in SSIs but not a distinct July spike. We incorporated novel statistical models to predict preoperative risk and postoperative probability of SSI.

Background: Fluoroquinolones (FQs) are widely used in empiric treatment with progressively rising resistance. Using in-hospital surveillance and following the recommendations of the US Food and Drug Administration and European Medicines Agency, our Antibiotic Stewardship Team(AST) decided to pursue a restrictive policy for FQ utilization. The aim of this study was to evaluate AST intervention restricting FQ use with preauthorization to determine its effectiveness in decreasing consumption and resistance.

Methods: This study was conducted in a 650-bed hospital in Poland during 2018 to 2019 and 2022 (preintervention) and 2023 (postintervention). Antibiotic consumption (ABC) and antibiotic resistance were compared for both periods. ABC was expressed as a defined daily doses (DDD) per 1,000 pds, and antibiotic resistance was expressed as a resistance rate parameter to FQ in select gram-negative bacilli.

Results: The ABC of all antibiotics varied significantly from 2,987.7 DDD/1,000 pds to 3,741.1 DDD/1,000 pds (2018 vs. 2023). The urology ward showed decreasing FQ consumption from 358.9 DDD/1,000 pds to 43.4 DDD/1,000 pds (from 2018 to 2023, P < .001). A 25% reduction in the resistance rate to FQ was observed, with the greatest difference between 2022 (69.9%) and 2023 (52.6%).

Conclusions: This study demonstrates the effectiveness of FQ restriction and preauthorization in a hospital.

A certified nursing assistant at a long-term care facility worked 3 shifts while infectious with monkeypox virus providing direct care to facility residents. Despite exposures and a delay of 16days from symptom onset to diagnosis and public health notification, there is no evidence of transmission. We describe details of this health care-associated exposure, public health response, situational risk factors for transmission, and discuss factors that might have contributed to the lack of transmission.

Background: This study aimed to determine the frequency of compliance with surgical antimicrobial prophylaxis (SAP) in Turkey and to identify the causes for noncompliance.

Methods: This multicenter, prospective, point prevalence study was conducted in 8 hospitals from different regions of Turkey. Patients over 18years who underwent SAP in all hospital surgical units were included. The SAP compliance assessment was carried out under 5 headings: unnecessary prophylaxis, inappropriate drug choice, prolonged prophylaxis, inappropriate dose interval, and inappropriate dosage.

Results: The study included 541 patients from 8 centers. About 52.7% (n=285) were female and the median age was 54years (min-max: 18-94). Orthopedics (23.7%) and general surgery (22.2%) were the most common specialties. SAP compliance was 14%. The specialty with the highest rate of inappropriate SAP was orthopedics (97%) and the lowest rate was in ophthalmology (25%). The most common causes of inappropriate SAP were prolonged prophylaxis (92.0%) and inappropriate dose interval (84.6%). Multivariate logistic regression analysis revealed that prolonged surgical time, American Society of Anaesthesiologists (ASA) score 3, and some specialties increased the risk of noncompliance with surgical prophylaxis.

Conclusions: This study showed that SAP compliance is low in Turkey and that inappropriateness is caused mostly by prolonged and inappropriate antimicrobial use.

Background: Twelve bacterial families identified as global priority pathogens (GPPs) pose the greatest threat to human health due to declining antibiotic efficacy. Robotics, a swift and contactless tool for disinfecting hospital surfaces, was sought to compare with manual disinfection.

Methods: The disinfection efficacy of a robot was compared with manual disinfection for multiple clinical surfaces and inanimate objects at two hospitals in Nepal using bleach (NaOCl). Surfaces were swabbed pre- and post-disinfection and total heterotrophic plate count evaluated, and bacterial pathogens identified using Gram's staining and biochemical characteristics. Disinfection outcomes were reported as log reduction (log10 CFU/inch²) of heterotrophic count and presence or absence of GPPs: Staphylococcus aureus, Escherichia coli, Acinetobacter spp., and Klebsiella pneumoniae, among others.

Results: Both robotic and manual disinfection significantly reduced the microbial load (log 2.3 to log 5.8) on hospital surfaces. No pathogens were detected post-disinfection using the robot. Robotic disinfection was more effective, significantly reducing the bacterial load (log 5.8) compared to manual disinfection (log 3.95).

Conclusions: Our results showed better efficacy of robotic disinfection over manual disinfection of hospital surfaces, and thus contactless robotic disinfection is recommended for disinfecting surfaces in the hospital and clinical settings as it favors patient safety against GPPs.

In a culture survey of 30 hospitals, rates of Clostridioides difficile spore contamination after cleaning and disinfection of non-C difficile infection rooms were lower in facilities using sporicidal disinfectants in all postdischarge rooms versus only in C difficile infection rooms (3.6% vs 5.1%, respectively), but the difference was not statistically significant. Additional studies are needed to determine why contamination was not reduced more effectively and to develop interventions to ensure spore eradication in real-world settings.

Infection prevention observations in clinic and procedure areas is a growing area of interest and concern. Infection prevention guidance for observations in an in vitro fertilization clinic are challenging. This is related to care of the mom and the embryo. This article introduces an in vitro fertilization clinic and areas of consideration when performing an observation of best practices.