American journal of infection control最新文献_第8页

Prevalence of bacteremia and antimicrobial resistance pattern among patients in South Lebanon 黎巴嫩南部患者菌血症流行情况和抗菌药耐药性模式。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.09.023

Zahra Hnaineh MSc, Elie Salem Sokhn PhD

Background

Bacteremia is a leading cause of morbidity and mortality worldwide. Rising prevalence and antimicrobial resistance (AMR) are critical public health issues. This study aims to determine the prevalence of bacteremia and the AMR pattern among patients in South Lebanon.

Methods

A cross-sectional study analyzed 76 positive blood cultures from Hammoud and Labib Hospitals in South Lebanon between September 2023 and March 2024. The phenotype and antimicrobial susceptibility of gram-positive and gram-negative were determined by using disk diffusion. Genotypically, polymerase chain reaction was used to detect the carbapenemase-resistant Enterobacterales (CRE), extended-spectrum β-lactamases (ESBL), and methicillin-resistant Staphylococcus aureus genes.

Results

Out of 76 isolates, 38 (50%) were gram-positive and 38 (50%) were gram-negative. Escherichia coli was the most common among gram-negative (18. 42%), with 10.52% ESBL and 3.94% CRE. Staphylococcus coagulase negative was the most common among gram-positive (40.78%), followed by Staphylococcus aureus (6.57%), with 3.94% methicillin-resistant S. aureus. The prevalent ESBL gene was CTX-M (100%), and for the CRE, NDM (66.66%) was the most common gene. Regarding S. aureus, 66.66% were mecA.

Discussion

The diverse bacteremia isolates and resistance genes in South Lebanon reflect global variability in incidence and resistance profiles.

Conclusions

High rates of bacteremia and AMR in South Lebanon underscore the need for effective antibiotic stewardship programs.

背景：菌血症是全球发病和死亡的主要原因。发病率上升和抗菌药耐药性（AMR）是关键的公共卫生问题。本研究旨在确定黎巴嫩南部患者的菌血症发病率和抗菌药耐药性模式：这项横断面研究分析了 2023 年 9 月至 2024 年 3 月期间黎巴嫩南部哈穆德医院和拉比布医院的 76 份阳性血培养物。在基因型方面，使用 PCR 检测耐碳青霉烯酶肠杆菌（CRE）、广谱 β 内酰胺酶（ESBL）和耐甲氧西林金黄色葡萄球菌（MRSA）基因：在 76 个分离菌株中，38 个（50%）为革兰氏阳性菌，38 个（50%）为革兰氏阴性菌。革兰氏阴性菌中最常见的是大肠埃希菌（18.42%），其中有 10.52% 的 ESBL 和 3.94% 的 CRE。在革兰氏阳性菌中，凝固酶阴性葡萄球菌最常见（40.78%），其次是金黄色葡萄球菌（6.57%），MRSA 占 3.94%。金黄色葡萄球菌（66.66%）的基因为 mecA：讨论：南黎巴嫩的菌血症分离菌株和耐药基因多种多样，反映了全球发病率和耐药情况的差异：结论：南黎巴嫩菌血症和 AMR 的高发率凸显了有效抗生素管理计划的必要性。

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引用次数: 0

Spine surgical site infection outcome with preoperative application of a presaturated 10% povidone-iodine nasal decolonization product in a 32-bed surgical hospital 在一家拥有 32 张病床的外科医院，术前使用 10%聚维酮碘鼻腔去菌产品对脊柱手术部位感染的疗效。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.09.016

Patti S. Grant RN, BSN, MS, CIC, FAPIC , Caitlin Crews-Stowe PhD, MPH, CPH, CPHQ, VA-VC, CIC

Background

To pursue an irreducible minimum overall surgical site infection (SSI) rate, a 32-bed surgical hospital employed an outside consultant and performed sterile processing and surgery internal audits: No obvious improvements were identified. A 10-year review determined that 70% of SSI’s were spine procedure patients. After a nasal decolonization product literature review, an intervention was implemented. The purpose of this study was to assess if the intervention impacted spine SSI rates.

Methods

A 36-month implementation science study was conducted. The 18-month intervention was the immediate preoperative application of a manufactured presaturated 10% povidone-iodine nasal decolonization product in spine surgery patients, with monthly product application documentation surveillance feedback to the preoperative staff. Chi-square test was used to determine the difference in types of spine SSI surgery rates pre and post intervention.

Results

Overall spine SSI decreased 35.7% (P = .04) with a 58.7% reduction in superficial incisional SSI (P = .02). The 16.1% decline in deep incisional SSI was not significant (P = .29).

Conclusions

Within this hospital, conducting 7,576 surgical spine procedures over 36 months, with the immediate preoperative application of a presaturated 10% povidone-iodine nasal decolonization product, the only intervention in SSI prevention protocol, produced a statistically significant decrease in spine patient SSI rate percent.

背景：一家拥有 32 张床位的外科医院为了追求不可复制的最低手术部位感染率（SSI），聘请了一名外部顾问，并进行了无菌处理和手术内部审核：结果没有发现明显的改进。一项为期十年的审查结果显示，70% 的 SSI 患者都是脊柱手术患者。在对鼻腔去菌产品进行文献回顾后，医院实施了一项干预措施。本研究的目的是评估该干预措施是否对脊柱 SSI 感染率产生影响：方法：进行了为期 36 个月的实施科学研究。为期 18 个月的干预措施是在脊柱手术患者术前立即使用 10%聚维酮碘鼻腔消毒产品，并每月向术前工作人员提供产品使用记录和监督反馈。采用卡方检验确定干预前后脊柱 SSI 手术类型的差异：结果：脊柱SSI总体下降了35.7%（P=0.04），浅切口SSI下降了58.7%（P=0.02）。深部切口 SSI 下降 16.1%，但下降幅度不大（P=0.29）：该医院在36个月内进行了7576例脊柱外科手术，术前立即使用10%的聚维酮碘鼻腔去菌产品（SSI预防方案中唯一的干预措施），脊柱患者的SSI率在统计学上显著下降。

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引用次数: 0

National trends and disparities in herpes zoster vaccination among US older adults with chronic obstructive pulmonary disease, 2008 to 2022 2008-2022 年美国患有慢性阻塞性肺病的老年人接种带状疱疹疫苗的全国趋势和差异。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.08.010

Chun-Tse Hung PharmD , Li-Min Wang BSPharm, RPh , Chi-Won Suk MD

Background

Chronic obstructive pulmonary disease (COPD) is a risk factor for herpes zoster. Vaccination can prevent or attenuate herpes zoster and its related complications. However, evidence regarding vaccine uptake among patients with COPD is limited. Therefore, this study aimed to evaluate trends in herpes zoster vaccination and characteristics associated with vaccination among US older adults with COPD.

Methods

Data from the 2008 to 2022 National Health Interview Survey were used. Participants aged ≥50 years were included. Joinpoint regression analysis was performed to analyze trends in herpes zoster vaccination. A multivariable logistic regression model was used to identify factors associated with vaccination.

Results

From 2008 to 2022, an increasing trend in herpes zoster vaccination was observed (average annual percent change = 15.10, P < .01). This increasing trend was also observed when stratified by age groups. Disparities in vaccination were found across several factors, including age, sex, race or ethnicity, region, educational level, health insurance, income, smoking status, perceived health status, and flu and pneumococcal vaccination.

Conclusions

There has been an upward trend in herpes zoster vaccination over the past 15 years among older adults with COPD. Disparities across several characteristics existed, underscoring the necessity for targeted policies and interventions to promote equity in vaccination.

背景：慢性阻塞性肺病（COPD）是带状疱疹的一个危险因素。接种疫苗可以预防或减轻带状疱疹及其相关并发症。然而，有关慢性阻塞性肺病患者接种疫苗的证据却很有限。因此，本横断面研究旨在评估美国患有慢性阻塞性肺病的老年人接种带状疱疹疫苗的趋势以及与接种疫苗相关的特征：方法：采用 2008-2022 年全国健康访谈调查的数据。纳入了年龄≥50 岁的参与者。对带状疱疹疫苗接种趋势进行了连接点回归分析。使用多变量逻辑回归模型确定与带状疱疹疫苗接种相关的因素：这项研究包括 22853 名慢性阻塞性肺病患者，代表了约 980 万患有慢性阻塞性肺病的美国老年人。从 2008 年到 2022 年，带状疱疹疫苗接种率呈上升趋势（年均百分比变化=15.10，PConclusions.COPD）：虽然在过去 15 年中，患有慢性阻塞性肺病的老年人接种带状疱疹疫苗的比例呈上升趋势，但仍发现了几个特征之间的差异。这些发现强调了有必要制定有针对性的政策和干预措施，以促进疫苗接种的公平性。

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引用次数: 0

Letter to the editor in response to “Response to ‘Influenza vaccination and COVID-19 infection risk and disease severity: A systematic review and multilevel meta-analysis of prospective studies’” by Babar Babar对“流感疫苗接种与COVID-19感染风险和疾病严重程度的反应：前瞻性研究的系统回顾和多水平荟萃分析”的回复。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.09.015

Marco Del Riccio MD

引用次数: 0

Experiences when using different EHMR models: Implications for different designs and meeting user expectations 使用不同 EHMR 模型的经验：不同设计和满足用户期望的意义。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.08.019

Emily J. Haas PhD , Mihili Edirisooriya PhD , Rohan Fernando MS, CEng MIMechE , Caitlin McClain MS, GSP , Margaret Sietsema PhD , Adam Hornbeck MSN, APRN, FNP-BC, FNP-C , Paul Thurman PhD, RN, ACNPC, CCNS, CCRN , Sara Angelilli DNP, MS, RN, CNOR, NPD-BC, NE-BC , Hope Waltenbaugh MSN, RN, CNOR, NE-BC , Sricharan Chalikonda MD, MHA, FACS , Stella E. Hines MD, MSPH

Background

New elastomeric half-mask respirator (EHMR) models without exhalation valves (EVs) or with exhalation valve filters (EVFs) are facilitating expanded use in health settings to reduce workers’ exposure to airborne hazards while acting as source control to prevent pathogen spread. The physical comfort of new models has not been assessed in comparison to previously used EHMRs with EVs.

Methods

Researchers assessed 1,962 health care and emergency medical service personnels’ self-reported adverse experiences from 2 cohorts while wearing EHMR models with EVs (cohort 1, n = 1,080) and without EVs or with EVFs (cohort 2, n = 882). Fisher exact test identified differences between the cohorts accounting for organizational factors when possible.

Results

Cohort 1 respondents experienced communication challenges and discomfort when wearing the EHMR > 1 hour statistically significantly more often than cohort 2. Cohort 2 respondents reported statistically significantly more instances of difficulty breathing, moisture buildup, being uncomfortable to wear < 1 hour, and being uncomfortably warm.

Conclusions

Discomfort is prevalent among end users and more often among those wearing EHMRs without an EV/with an EVF. As EHMR research and development advances, prevalence in use may increase for emergency and routine situations. Organizations may not only need guidance about respirator selection but also model-specific selection.

背景：不带呼气阀（EV）或带呼气阀过滤器（EVF）的新型弹性半面罩呼吸器（EHMR）有助于扩大在卫生环境中的使用，以减少工人暴露于空气传播的危害，同时起到源头控制的作用，防止病原体传播。与以前使用的带 EV 的超高压呼吸器相比，新型号的身体舒适度尚未得到评估：研究人员评估了来自两个队列的1962名医疗保健和紧急医疗服务人员在佩戴带EV（队列1，n=1,080）和不带EV或带EVF（队列2，n=882）的超高强度呼吸机时自我报告的不良体验。费雪精确检验确定了组群之间的差异，并在可能的情况下考虑了组织因素：组群 1 的受访者在佩戴超高清血压计超过 1 小时后出现交流障碍和不适的频率明显高于组群 2。第 2 组受访者报告的呼吸困难、湿气积聚、佩戴不舒适的情况明显多于第 2 组：不适感在最终用户中非常普遍，在佩戴无 EV/ 有 EVF 的 EHMR 的用户中更为常见。随着环境健康监测仪研发工作的推进，紧急情况和日常情况下的使用率可能会增加。各组织可能不仅需要呼吸器选择指导，还需要特定型号的选择指导。

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引用次数: 0

Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mupirocin and biocide resistance genes in a large health care system 一个大型医疗系统中携带莫匹罗星和杀菌剂耐药基因的耐甲氧西林金黄色葡萄球菌（MRSA）的流行情况。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.09.002

Rossana Rosa MD, MSc , Rodrigo de Paula Baptista PhD , Truc T. Tran PharmD , Renzo O. Cifuentes MD , Kelley Manzanillo RN, CIC , Gemma Rosello MPH, CIC , Chris Ghaemmaghami MD , David Zambrana RN, PhD , Octavio V. Martinez PhD , Cesar A. Arias MD, MSc, PhD , Lilian M. Abbo MD, MBA

Background

We aimed to determine the prevalence of genes associated with high-level mupirocin and biocide resistance in methicillin-resistant Staphylococcus aureus (MRSA) isolates among hospitalized patients and to characterize their genomic and epidemiologic features.

Methods

Study conducted on an integrated health system. Clinical cultures with MRSA from hospitalized patients collected between March 1, 2023, and January 20, 2024 underwent prospective whole-genome sequencing, including assessment for the presence of markers of resistance against mupirocin (mupA) and biocides (qac). Demographic and clinical characteristics were reviewed.

Results

We analyzed 463 MRSA isolates. The overall prevalence of mupA(+), qacA(+), and qacC(+) genes was 22.0%, 2.4%, and 19.0%, respectively. Most mupA(+) isolates belonged to ST8, but ST8732 (a novel variant of ST8) had the highest prevalence of mupA(+) isolates at 95%. Patients mupA(+) were older, and none of the isolates from pediatric patients harbored this gene.

Discussion

Through prospective whole-genome sequencing of MRSA isolates, we detected a prevalence of genes conferring mupirocin resistance considerably higher than previously reported, particularly among MRSA ST8 variants.

Conclusions

Our findings highlight the need for monitoring resistance to agents used for the prevention of S aureus infections, as these trends have implications for infection prevention programs and public health at large.

背景：我们旨在确定住院患者中耐甲氧西林金黄色葡萄球菌（MRSA）分离株中与高水平莫匹罗星和杀菌剂耐药性相关的基因的流行率，并描述其基因组和流行病学特征：方法：在一个综合医疗系统中进行研究。对 2023 年 3 月 1 日至 2024 年 1 月 20 日期间收集的住院患者 MRSA 临床培养物进行了前瞻性全基因组测序（WGS），包括评估是否存在对莫匹罗星（mupA）和杀菌剂（qac）的耐药性标记。我们还回顾了人口统计学和临床特征：我们分析了 463 例 MRSA 分离物。mupA（+）、qacA（+）和 qacC（+）基因的总体流行率分别为 22.0%、2.4% 和 19.0%。大多数 mupA(+) 分离物属于 ST8，但 ST8732（ST8 的新型变种）的 mupA(+) 分离物感染率最高，达到 95%。mupA(+)患者年龄较大，而来自儿童患者的分离株中没有一个携带该基因：讨论：通过对 MRSA 分离物进行前瞻性 WGS 检测，我们发现赋予莫匹罗星耐药性的基因的流行率大大高于之前的报道，尤其是在 MRSA ST8 变体中：我们的研究结果强调了监测用于预防金黄色葡萄球菌感染的药物耐药性的必要性，因为这些趋势对感染预防计划和整个公共卫生都有影响。

{"title":"Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mupirocin and biocide resistance genes in a large health care system","authors":"Rossana Rosa MD, MSc , Rodrigo de Paula Baptista PhD , Truc T. Tran PharmD , Renzo O. Cifuentes MD , Kelley Manzanillo RN, CIC , Gemma Rosello MPH, CIC , Chris Ghaemmaghami MD , David Zambrana RN, PhD , Octavio V. Martinez PhD , Cesar A. Arias MD, MSc, PhD , Lilian M. Abbo MD, MBA","doi":"10.1016/j.ajic.2024.09.002","DOIUrl":"10.1016/j.ajic.2024.09.002","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to determine the prevalence of genes associated with high-level mupirocin and biocide resistance in methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) isolates among hospitalized patients and to characterize their genomic and epidemiologic features.</div></div><div><h3>Methods</h3><div>Study conducted on an integrated health system. Clinical cultures with MRSA from hospitalized patients collected between March 1, 2023, and January 20, 2024 underwent prospective whole-genome sequencing, including assessment for the presence of markers of resistance against mupirocin (<em>mupA</em>) and biocides (<em>qac</em>). Demographic and clinical characteristics were reviewed.</div></div><div><h3>Results</h3><div>We analyzed 463 MRSA isolates. The overall prevalence of <em>mupA</em>(+), <em>qacA</em>(+), and <em>qacC</em>(+) genes was 22.0%, 2.4%, and 19.0%, respectively. Most <em>mupA</em>(+) isolates belonged to ST8, but ST8732 (a novel variant of ST8) had the highest prevalence of <em>mupA</em>(+) isolates at 95%. Patients <em>mupA</em>(+) were older, and none of the isolates from pediatric patients harbored this gene.</div></div><div><h3>Discussion</h3><div>Through prospective whole-genome sequencing of MRSA isolates, we detected a prevalence of genes conferring mupirocin resistance considerably higher than previously reported, particularly among MRSA ST8 variants.</div></div><div><h3>Conclusions</h3><div>Our findings highlight the need for monitoring resistance to agents used for the prevention of <em>S aureus</em> infections, as these trends have implications for infection prevention programs and public health at large.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":"53 1","pages":"Pages 105-109"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Integration of an electronic hand hygiene auditing system with electronic health records using machine learning to predict hospital-acquired infection in a health care setting 利用机器学习将电子手部卫生审核系统与电子健康记录整合，预测医疗机构中的医院感染。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.09.012

André Luís Franco Cotia MD, MS, MBA , Anderson Paulo Scorsato MS , Elivane da Silva Victor MS , Marcelo Prado PhD , Guilherme Gagliardi MS , José Edgar Vieira de Barros BBA , José R. Generoso Jr MD, PhD , Fernando Gatti de Menezes MD, PhD , Mariana Kim Hsieh MD , Gabriel O.V. Lopes , Michael B. Edmond MD, MPH, MPA , Eli N. Perencevich MD, MS , Michihiko Goto MD, MSCI , Sérgio B. Wey MD, PhD , Alexandre R. Marra MD, PhD

Background

Hospital-acquired infections (HAIs) increase morbidity, mortality, and health care costs. Effective hand hygiene (HH) is crucial for prevention, but achieving high compliance remains challenge. This study explores using machine learning to integrate an electronic HH auditing system with electronic health records to predict HAIs.

Methods

A retrospective cohort study was conducted at a Brazilian hospital during 2017-2020. HH compliance was recorded electronically, and patient data were collected from electronic health records. The primary outcomes were HAIs per CDC/National Healthcare Safety Network surveillance definitions. Machine learning algorithms, balanced with Random Over Sampling Examples (ROSE), were utilized for predictive modeling, including generalized linear models (GLM); generalized additive models for location, scale, and shape (GAMLSS); random forest; support vector machine; and extreme gradient boosting (XGboost).

Results

125 of 6,253 patients (2%) developed HAIs and 920,489 HH opportunities (49.3% compliance) were analyzed. A direct correlation between HH compliance and HAIs was observed. The GLM algorithm with ROSE demonstrated superior performance, with 84.2% sensitivity, 82.9% specificity, and a 93% AUC.

Conclusions

Integrating electronic HH auditing systems with electronic health records and using machine learning models can enhance infection control surveillance and predict patient outcomes. Further research is needed to validate these findings and integrate them into clinical practice.

背景：医院获得性感染（HAIs）会增加发病率、死亡率和医疗成本。有效的手部卫生（HH）是预防感染的关键，但实现高依从性仍是一项挑战。本研究探讨了如何利用机器学习将手部卫生电子审核系统与电子健康记录整合，以预测 HAIs：方法：2017-2020年间，巴西一家医院开展了一项回顾性队列研究。HH 合规性以电子方式记录，患者数据则从电子健康记录中收集。主要结果是根据 CDC/NHSN 监测定义得出的 HAIs。预测建模采用了机器学习算法，与随机过度采样实例（ROSE）相平衡，包括广义线性模型（GLM）；位置、规模和形状的广义加性模型（GAMLSS）；随机森林；支持向量机和极端梯度提升（XGboost）：对 6,253 名患者中的 125 人（2%）发生 HAIs，以及 920,489 次 HH 机会（49.3% 合规）进行了分析。观察到 HH 合规性与 HAI 之间存在直接关联。采用 ROSE 的 GLM 算法表现优异，灵敏度为 84.2%，特异度为 82.9%，AUC 为 93%：结论：将电子卫生保健审计系统与电子健康记录整合并使用机器学习模型可以加强感染控制监测并预测患者的预后。要验证这些发现并将其融入临床实践，还需要进一步的研究。

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引用次数: 0

Organizational and infrastructural risk factors for health care–associated Clostridioides difficile infections or methicillin-resistant Staphylococcus aureus in hospitals 医院中与医疗保健相关的艰难梭菌感染或耐甲氧西林金黄色葡萄球菌的组织和基础设施风险因素。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.08.013

Xuetao Wang MPH, Matthew Garrod MPH, Tamara Duncombe MSc, CIC, Eunsun Lee BSc, Joyce Ng BTech, Katy Short MPH

Background

This study explores the infrastructural and organizational risk factors for health care–associated (HCA) Clostridioides difficile infections (CDIs) and methicillin-resistant Staphylococcus aureus (MRSA) in hospitals.

Methods

This is a retrospective observational study involving all eligible inpatient units from 12 hospitals in British Columbia, Canada, from April 1, 2020 to September 16, 2021. The outcomes were the average HCA CDI or MRSA rates. Covariates included, but were not limited to, infection control factors (eg, hand hygiene rate), infrastructural factors (eg, unit age), and organizational factors (eg, hallway bed utilization). Multivariable regression was performed to identify statistically significant risk factors.

Results

Older units were associated with higher HCA CDI rates (adjusted relative risk [aRR]: 0.012; 95% confidence interval (CI) [0.004, 0.020]). Higher HCA MRSA rates were associated with decreased hand hygiene rate (aRR: −0.035; 95% CI [−0.063, −0.008]), higher MRSA bioburden (aRR: 9.008; 95% CI [5.586, 12.429]), increased utilization of hallway beds (aRR: 0.680; 95% CI [0.094, 1.267]), increased nursing overtime rate (aRR: 5.018; 95% CI [1.210, 8.826]), and not keeping the clean supply room door closed (aRR: −0.283; 95% CI [−0.536, −0.03]).

Conclusions

The study confirmed the multifaceted nature of infection prevention and emphasized the importance of interdepartmental collaboration to improve patient safety.

研究目的本研究探讨了医院中与医疗保健相关的艰难梭菌感染（CDI）和耐甲氧西林金黄色葡萄球菌（MRSA）的基础设施和组织风险因素：这是一项回顾性观察研究，涉及加拿大不列颠哥伦比亚省 12 家医院所有符合条件的住院部，研究时间为 2020 年 4 月 1 日至 2021 年 9 月 16 日。研究结果为 HCA CDI 或 MRSA 的平均感染率。协变量包括但不限于感染控制因素（如手部卫生率）、基础设施因素（如病房年龄）和组织因素（如走廊床位利用率）。进行多变量回归以确定具有统计学意义的风险因素：结果：较老的病房与较高的 HCA CDI 感染率相关（调整后相对风险 (aRR) 为 0.012; 95%ci) ：0.012；95%CI [0.004，0.020]）。较高的 HCA MRSA 感染率与手部卫生率下降（aRR：-0.035；95%CI [-0.063，-0.008]）、较高的 MRSA 生物负荷（aRR：9.008；95%CI [5.586，12.429]）、走廊病床使用率增加（aRR：0.680；95%CI [0.094，1.267]）、护理加班率增加（aRR：5.018；95%CI [1.210，8.826]）以及清洁供应室门未保持关闭（aRR：-0.283；95%CI [-0.536，-0.03]）：该研究证实了预防感染的多面性，并强调了跨部门合作对改善患者安全的重要性。

{"title":"Organizational and infrastructural risk factors for health care–associated Clostridioides difficile infections or methicillin-resistant Staphylococcus aureus in hospitals","authors":"Xuetao Wang MPH, Matthew Garrod MPH, Tamara Duncombe MSc, CIC, Eunsun Lee BSc, Joyce Ng BTech, Katy Short MPH","doi":"10.1016/j.ajic.2024.08.013","DOIUrl":"10.1016/j.ajic.2024.08.013","url":null,"abstract":"<div><h3>Background</h3><div>This study explores the infrastructural and organizational risk factors for health care–associated (HCA) <em>Clostridioides difficile</em> infections (CDIs) and methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) in hospitals.</div></div><div><h3>Methods</h3><div>This is a retrospective observational study involving all eligible inpatient units from 12 hospitals in British Columbia, Canada, from April 1, 2020 to September 16, 2021. The outcomes were the average HCA CDI or MRSA rates. Covariates included, but were not limited to, infection control factors (eg, hand hygiene rate), infrastructural factors (eg, unit age), and organizational factors (eg, hallway bed utilization). Multivariable regression was performed to identify statistically significant risk factors.</div></div><div><h3>Results</h3><div>Older units were associated with higher HCA CDI rates (adjusted relative risk [aRR]: 0.012; 95% confidence interval (CI) [0.004, 0.020]). Higher HCA MRSA rates were associated with decreased hand hygiene rate (aRR: −0.035; 95% CI [−0.063, −0.008]), higher MRSA bioburden (aRR: 9.008; 95% CI [5.586, 12.429]), increased utilization of hallway beds (aRR: 0.680; 95% CI [0.094, 1.267]), increased nursing overtime rate (aRR: 5.018; 95% CI [1.210, 8.826]), and not keeping the clean supply room door closed (aRR: −0.283; 95% CI [−0.536, −0.03]).</div></div><div><h3>Conclusions</h3><div>The study confirmed the multifaceted nature of infection prevention and emphasized the importance of interdepartmental collaboration to improve patient safety.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":"53 1","pages":"Pages 93-97"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the editor in response to Ganesh et al 致编辑回应Ganesh等人的信。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.09.001

Marco Del Riccio MD

引用次数: 0

Letter to the editor regarding the article: The efficacy of an alcohol-based nasal antiseptic versus mupirocin or iodophor for preventing surgical site infections: A meta-analysis 致编辑关于文章的信：酒精类鼻消毒剂与莫匹罗星或碘伏预防手术部位感染的疗效：一项荟萃分析。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.09.009

Joan N. Hebden MS, RN, CIC, FAPIC, FSHEA , Edward Septimus MD, FIDSA, FACP, FSHEA

引用次数: 0