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Population and hospital-level COVID-19 measures are associated with increased risk of hospital-onset COVID-19 Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-03-18 Emily Schmitz, Laura Anderson, Gabrielle Hatas, Linda Stevens, Fauzia Osman, Marin Schweizer, Nasia Safdar, Daniel Shirley
A review of hospital-onset COVID-19 cases revealed 8 definite, 106 probable, and 46 possible cases. Correlations between hospital-onset cases and both HCW and inpatient cases were noted in 2021. Rises in community measures were associated with rises in hospital-onset cases. Measures of community COVID-19 activity might predict hospital-onset cases.
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Use of whole genomic sequencing to detect New Delhi metallo-B-lactamase (NDM)-producing Escherichia coli outbreak associated with endoscopic procedures Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-03-18 Geehan Suleyman, Anita Shallal, Abigail Ruby, Eman Chami, Jenny Gubler, Sara McNamara, Arianna Miles-Jay, Robert Tibbetts, George Alangaden
Background: Whole-genome sequencing (WGS) has emerged as an alternative genotyping tool for outbreak investigations in the healthcare setting. We describe the investigation and control of a New Delhi metallo-B-lactamase (NDM)-producing Escherichia coli cluster in Southeast Michigan.Methods: Michigan Bureau of Laboratories identified several closely related NDM-producing E. coli isolates with WGS. An
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Comparing multiple infection control measures in a nursing home setting: a simulation study Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-03-15 Haomin Li, Daniel K. Sewell, Ted Herman, Sriram V. Pemmeraju, Alberto M. Segre, Aaron C. Miller, Philip M. Polgreen, for the CDC MInD-Healthcare Group
Objective: Compare the effectiveness of multiple mitigation measures designed to protect nursing home residents from infectious disease outbreaks.Design: Agent-based simulation study.Setting: Simulation environment of a small nursing home.Methods: We collected temporally detailed and spatially fine-grained location information from nursing home healthcare workers (HCWs) using sensor motes. We used
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Mortality associated with carbapenem resistance in Klebsiella pneumoniae bloodstream infection: A propensity score–matched study Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-03-15 Ling Wang, Chaoying Zeng, Xue Li, Yuqing Li, Zhihua Liu, Jing Hu
Objective: Klebsiella pneumoniae are common pathogens causing bloodstream infection (BSI) that increasingly express carbapenem resistance worldwide. To date, no study has precisely investigated the impact of carbapenem resistance in K. pneumoniae (CRKP) BSI on mortality. Methods: This retrospective study included 87 patients with CRKP BSI and 321 patients with carbapenem-susceptible K. pneumoniae (CSKP)
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Differences in the incidence of nosocomial-onset COVID-19 among hospitalized patients with exposure to SARS-CoV-2 Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-03-14 Masataka Nakagawa, Yumiko Fujishiro, Yohei Doi, Junichi Yamakami, Hitoshi Honda
We evaluated the secondary COVID-19 incidence among uninfected hospitalized patients after nosocomial COVID-19 exposure. An exposure source of SARS-CoV-2 was hospitalized patients or healthcare personnel (HCP) newly diagnosed as having COVID-19. Patients exposed to a COVID-19-infected patient in a shared room more frequently developed COVID-19 than those exposed to an infected HCP.
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Environmental cleaning and disinfection in the operating room: a systematic scoping review through a human factors and systems engineering lens Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-03-13 Anping Xie, Hugo Sax, Oluseyi Daodu, Lamia Alam, Marium Sultan, Clare Rock, C. Matthew Stewart, Shawna J. Perry, Ayse P. Gurses
Objective: To synthesize evidence and identify gaps in the literature on environmental cleaning and disinfection in the operating room based on a human factors and systems engineering approach guided by the Systems Engineering Initiative for Patient Safety (SEIPS) model. Design: A systematic scoping review. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
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Candida auris screening practices at healthcare facilities in the United States: An Emerging Infections Network survey Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-03-07 Ian P. Hennessee, Kaitlin Forsberg, Susan E. Beekmann, Philip M. Polgreen, Jeremy A.W. Gold, Meghan Lyman
We surveyed members of the Emerging Infections Network about Candida auris screening practices at US healthcare facilities. Only 37% of respondents reported conducting screening; among these, 75% reported detection of at least 1 C. auris case in the last year. Increased screening could improve C. auris detection and prevent spread.
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Impact of universal chlorhexidine bathing with or without COVID-19 intensive training on staff and resident COVID-19 case rates in nursing homes Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-03-05 Gabrielle M. Gussin, Raveena D. Singh, Shruti K. Gohil, Raheeb Saavedra, Thomas T. Tjoa, Kristine P. Nguyen, Robert Pedroza, Joshua B. Hsi, Kevin O’Brien, Chase Berman, Jessica Park, Emily A. Hsi, Kimia Ghasemian, Avy Osalvo, Stephanie Chun, Emily Fonda, Susan S. Huang
We evaluated whether universal chlorhexidine bathing (decolonization) with or without COVID-19 intensive training impacted COVID-19 rates in 63 nursing homes (NHs) during the 2020–2021 Fall/Winter surge. Decolonization was associated with a 43% lesser rise in staff case-rates (P < .001) and a 52% lesser rise in resident case-rates (P < .001) versus control.
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Contact precautions as a barrier to hand hygiene: The Plan–Do–Study–Act (PDSA) framework to improve compliance with gloved hand hygiene Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-29 Pamela Bailey, Kaila Cooper, Michael P. Stevens, Gonzalo Bearman, Michelle Doll
In an identified quality improvement effort, nurses were observed regarding their workflow while in contact precaution rooms. Multiple opportunities for hand hygiene were missed while nurses were in gloves, predominantly while moving between “dirty” and “clean” tasks. An education initiative afterward did not show improvement in hand hygiene rates.
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Regional impact of multidrug-resistant organism prevention bundles implemented by facility type: A modeling study Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-28 Samuel E. Cincotta, Maroya S. Walters, D. Cal Ham, Rany Octaria, Jessica M. Healy, Rachel B. Slayton, Prabasaj Paul
Background: Emerging multidrug-resistant organisms (MDROs), such as carbapenem-resistant Enterobacterales (CRE), can spread rapidly in a region. Facilities that care for high-acuity patients with longer stays may have a disproportionate impact on this spread. Objective: We assessed the impact of implementing preventive interventions, directed at a subset of facilities, on regional prevalence. Methods:
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Modeling relaxed policies for discontinuation of methicillin-resistant Staphylococcus aureus contact precautions Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-26 Jiaming Cui, Jack Heavey, Leo Lin, Eili Y. Klein, Gregory R. Madden, Costi D. Sifri, Bryan Lewis, Anil K. Vullikanti, B. Aditya Prakash
Objective: To evaluate the economic costs of reducing the University of Virginia Hospital’s present “3-negative” policy, which continues methicillin-resistant Staphylococcus aureus (MRSA) contact precautions until patients receive 3 consecutive negative test results, to either 2 or 1 negative. Design: Cost-effective analysis. Settings: The University of Virginia Hospital. Patients: The study included
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Disinfection of central venous access device needleless connectors: A human factors analysis Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-23 Frank A. Drews, Richard A. Martinello, Joan N. Hebden, Keith H. St. John, David A. Pegues
Objective: Evidence-based central-line–associated bloodstream infection (CLABSI) prevention guidelines recommend the use of an antiseptic scrub to disinfect needleless connectors before device access. Guideline noncompliance may render disinfection ineffective. The goal of this study was to observe needleless-connector disinfection practices and to identify perceived facilitators and barriers to best
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The impact of an intervention to reduce dispersal from wastewater drain sites on carbapenem-resistant Pseudomonas aeruginosa colonization and bloodstream infection on a hematopoietic cell transplant and hematologic malignancy unit Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-22 Lauren Fontana, Morgan Hakki, Egon A. Ozer, Amy Laird, Lynne Strasfeld
Objective: To evaluate the impact of an intervention to limit dispersal from wastewater drain (WWD) sites on meropenem-nonsusceptible Pseudomonas aeruginosa patient and environmental colonization and bloodstream infection (BSI) on a hematopoietic cell transplant (HCT) and hematologic malignancy (HM) unit. Design: This quasi-experimental study included pre/postintervention point-prevalence surveys in
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Catheter-associated urinary tract infections (CAUTIs) and non-CAUTI hospital-onset urinary tract infections: Relative burden, cost, outcomes and related hospital-onset bacteremia and fungemia infections Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-20 Timothy Kelly, ChinEn Ai, Molly Jung, Kalvin Yu
Objective: To describe the relative burden of catheter-associated urinary tract infections (CAUTIs) and non-CAUTI hospital-onset urinary tract infections (HOUTIs). Methods: A retrospective observational study of patients from 43 acute-care hospitals was conducted. CAUTI cases were defined as those reported to the National Healthcare Safety Network. Non-CAUTI HOUTI was defined as a positive, non-contaminated
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High touch surface bioburden associated with the use of disinfectants with and without continuously active disinfection in ambulatory care settings Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-20 Heidi M. Torres, Jamie Marino, Matthew S. Simon, Harjot K. Singh, Lars F. Westblade, David P. Calfee
A quaternary ammonium and alcohol-based disinfectant with reported continuous activity demonstrated reduced microbial buildup on surfaces over time compared to routine disinfectants without continuous activity in in vitro and hospital studies. We compared these disinfectants in ambulatory settings and found no difference in bioburden on high-touch surfaces over time.
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Prevalence of unnecessary antibiotic prescriptions among dental visits, 2019 Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-20 Ashlee M. Murphy, Ursula C. Patel, Geneva M. Wilson, Katie J. Suda
Objective: The US National Action Plan for Combating Antibiotic-Resistant Bacteria established a goal to decrease unnecessary outpatient antibiotic use by 50%. However, data to inform this goal have been limited to medical settings and have not included dental prescribing. Thus, we sought to identify the proportion of antibiotics prescribed inappropriately by dentists to inform outpatient stewardship
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Susceptibility of healthcare personnel with severe acute respiratory coronavirus virus 2 (SARS-CoV-2) hybrid immunity to XBB lineage reinfection Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-20 Karissa A. Whiting, Rebecca Guest, Venkatraman E. Seshan, Mini Kamboj
Among 8,678 vaccinated healthcare personnel (HCP) with previous coronavirus disease 2019 (COVID-19), by August 28, 2023, 909 (10%) had an infection of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) omicron XBB variant. Reinfection risk was comparable irrespective of previous infection type except for the omicron BQ.1 variant. Bivalent vaccination had a protective effect. COVID-19 vaccines
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Antibiotic consumption in French nursing homes between 2018 and 2022: A multicenter survey Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-19 Ségolène Bouges, Amélie Jouzeau, Florence Lieutier-Colas, Muriel Péfau, Lory Dugravot, Anne-Marie Rogues, Loic Simon, Catherine Dumartin
Objectives: Monitoring antibiotic consumption is a key component to steer antimicrobial stewardship programs, including in nursing homes. We analyzed changes in antibiotic consumption in French nursing homes during 5 years, including the COVID-19 pandemic, to identify potential priorities for improvement. Design: A multicenter survey was conducted between 2018 and 2022. Setting: The study was conducted
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Cost-effectiveness of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) testing and isolation strategies in nursing homes Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-15 Sarah M. Bartsch, Colleen Weatherwax, Marie F. Martinez, Kevin L. Chin, Michael R. Wasserman, Raveena D. Singh, Jessie L. Heneghan, Gabrielle M. Gussin, Sheryl A. Scannell, Cameron White, Bruce Leff, Susan S. Huang, Bruce Y. Lee
Objective: Nursing home residents may be particularly vulnerable to coronavirus disease 2019 (COVID-19). Therefore, a question is when and how often nursing homes should test staff for COVID-19 and how this may change as severe acute respiratory coronavirus virus 2 (SARS-CoV-2) evolves. Design: We developed an agent-based model representing a typical nursing home, COVID-19 spread, and its health and
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Impact of infectious diseases consultation for hospitalized patients with Clostridioides difficile infection Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-15 Mara Cranis, Azza Elamin, Brianna Hatch-Vallier, Curtis D. Collins, Anurag N. Malani
Clostridioides difficile infection (CDI) is associated with substantial morbidity and mortality. This study described outcomes associated with mandatory infectious diseases (ID) consultation in hospitalized patients with CDI. ID consultation was associated with increased appropriate concomitant antibiotic use, however longer courses of concomitant antibiotics were administered.
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Differentiating patients admitted primarily due to coronavirus disease 2019 (COVID-19) from those admitted with incidentally detected severe acute respiratory syndrome corona-virus type 2 (SARS-CoV-2) at hospital admission: A cohort analysis of German hospital records Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-14 Ralf Strobl, Martin Misailovski, Sabine Blaschke, Milena Berens, Andreas Beste, Manuel Krone, Michael Eisenmann, Sina Ebert, Anna Hoehn, Juliane Mees, Martin Kaase, Dhia J. Chackalackal, Daniela Koller, Julia Chrampanis, Jana-Michelle Kosub, Nikita Srivastava, Fady Albashiti, Uwe Groß, Andreas Fischer, Eva Grill, Simone Scheithauer
Objective: The number of hospitalized patients with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) does not differentiate between patients admitted due to coronavirus disease 2019 (COVID-19) (ie, primary cases) and incidental SARS-CoV-2 infection (ie, incidental cases). We developed an adaptable method to distinguish primary cases from incidental cases upon hospital admission. Design:
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Implementation of contact precautions for multidrug-resistant organisms in the post–COVID-19 pandemic era: An updated national Emerging Infections Network (EIN) survey Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-14 Jessica R. Howard-Anderson, Lindsey B. Gottlieb, Susan E. Beekmann, Philip M. Polgreen, Jesse T. Jacob, Daniel Z. Uslan
Objective: To understand how healthcare facilities employ contact precautions for patients with multidrug-resistant organisms (MDROs) in the post–coronavirus disease 2019 (COVID-19) era and explore changes since 2014. Design: Cross-sectional survey. Participants: Emerging Infections Network (EIN) physicians involved in infection prevention or hospital epidemiology. Methods: In September 2022, we sent
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Incidence and transmission associated with respiratory viruses in an acute care facility: An observational study Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-14 Abby L. Valek, Vatsala Rangachar Srinivasa, Ashley M. Ayres, Steven Cheung, Lee H. Harrison, Graham M. Snyder
We estimated the extent of respiratory virus transmission over three pre-COVID-19 seasons. Of 16,273 assays, 22.9% (3,726) detected ≥1 respiratory virus. The frequency of putatively hospital-acquired infection ranged from 6.9% (influenza A/B) to 24.7% (adenovirus). The 176 clusters were most commonly associated with rhinovirus/enterovirus (70) and influenza A/B (62).
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Length of antibiotic therapy among adults hospitalized with uncomplicated community-acquired pneumonia, 2013–2020 Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-14 Natalie L. McCarthy, James Baggs, Hannah Wolford, Sophia V. Kazakova, Sarah Kabbani, Brandon K. Attell, Melinda M. Neuhauser, Lindsey Walker, Sarah H. Yi, Kelly M. Hatfield, Sujan Reddy, Lauri A. Hicks
Objective: The 2014 US National Strategy for Combating Antibiotic-Resistant Bacteria (CARB) aimed to reduce inappropriate inpatient antibiotic use by 20% for monitored conditions, such as community-acquired pneumonia (CAP), by 2020. We evaluated annual trends in length of therapy (LOT) in adults hospitalized with uncomplicated CAP from 2013 through 2020. Methods: We conducted a retrospective cohort
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The devil’s in the defaults: An interrupted time-series analysis of the impact of default duration elimination on exposure to fluoroquinolone therapy Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-13 Rebekah H. Wrenn, Cara N. Slaton, Tony Diez, Nicholas A. Turner, Michael E. Yarrington, Deverick J. Anderson, Rebekah W. Moehring
Objective: To determine whether removal of default duration, embedded in electronic prescription (e-script), influenced antibiotic days of therapy. Design: Interrupted time-series analysis. Setting: The study was conducted across 2 community hospitals, 1 academic hospital, 3 emergency departments, and 86 ambulatory clinics. Patients: Adults prescribed a fluoroquinolone with a duration <31 days. Interventions:
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Genomic investigation of multispecies and multivariant blaNDM outbreak reveals key role of horizontal plasmid transmission Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-12 Nenad Macesic, Adelaide Dennis, Jane Hawkey, Ben Vezina, Jessica A. Wisniewski, Hugh Cottingham, Luke V. Blakeway, Taylor Harshegyi, Katherine Pragastis, Gnei Zweena Badoordeen, Pauline Bass, Andrew J. Stewardson, Amanda Dennison, Denis W. Spelman, Adam W.J. Jenney, Anton Y. Peleg
Objectives: New Delhi metallo-β-lactamases (NDMs) are major contributors to the spread of carbapenem resistance globally. In Australia, NDMs were previously associated with international travel, but from 2019 we noted increasing incidence of NDM-positive clinical isolates. We investigated the clinical and genomic epidemiology of NDM carriage at a tertiary-care Australian hospital from 2016 to 2021
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Antibiotic prescribing for acute respiratory infections during the coronavirus disease 2019 (COVID-19) pandemic: Patterns in a nationwide telehealth service provider Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-08 Jeffrey A. Linder, Stephen D. Persell, Marcella A. Kelley, Mark Friedberg, Noah J. Goldstein, Tara K. Knight, Katrina M. Kaiser, Jason N. Doctor, Wendy J. Mack, Jason Tibbels, Bridget McCabe, Steve Haenchen, Daniella Meeker
We examined 3,046,538 acute respiratory infection (ARI) encounters with 6,103 national telehealth physicians from January 2019 to October 2021. The antibiotic prescribing rates were 44% for all ARIs; 46% were antibiotic appropriate; 65% were potentially appropriate; 19% resulted from inappropriate diagnoses; and 10% were related to coronavirus disease 2019 (COVID-19) diagnosis.
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The cardinal rules: Principles of personal protective equipment for high-consequence infectious disease events Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-02-08 Sara K. Donovan, Jocelyn J. Herstein, Aurora B. Le, Shawn G. Gibbs, Elizabeth L. Beam, Christopher K. Brown, Abigail E. Lowe, John J. Lowe, James V. Lawler
In recognition of an increasing number of high-consequence infectious disease events, a group of subject-matter experts identified core safety principles that can be applied across all donning and doffing protocols for personal protective equipment.
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Impact of oral vancomycin treatment duration on rate of Clostridioides difficile recurrence in patients requiring concurrent systemic antibiotics Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-30 Diana Kwiatkowski, Kassandra Marsh, Alyson Katz, John Papadopoulos, Jonathan So, Vincent J. Major, Philip M. Sommer, Sarah Hochman, Yanina Dubrovskaya, Serena Arnouk
Background: There is a paucity of data guiding treatment duration of oral vancomycin for Clostridiodes difficile infection (CDI) in patients requiring concomitant systemic antibiotics. Objectives: To evaluate prescribing practices of vancomycin for CDI in patients that required concurrent systemic antibiotics and to determine whether a prolonged duration of vancomycin (>14 days), compared to a standard
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A comparative analysis of infection and complication rates between single- and double-lumen ports Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-26 Konrad M. Kozlowski, Hamed Jalaeian, Levi M. Travis, Joseph F. Zikria
Objective: Port-a-caths are implanted intravascular chest ports that enable venous access. With more port placements performed by interventional radiologists, it is important to discern differences in infection and complication rates between double- and single-lumen ports. Methods: We retrospectively reviewed 1,385 port placements over 2 years at the University of Miami. Patients were grouped by single-
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Clostridioides difficile infection across the lifespan: Estimation using life tables Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-25 Derek S. Brown, Margaret A. Olsen, Matthew R. Keller, Dustin Stwalley, Andrew D. Tipping, Holly Yu, Erik R. Dubberke
Using a life tables approach with 2011–2017 claims data, we calculated lifetime risks of Clostridioides difficile infection (CDI) beginning at age 18 years. The lifetime CDI risk rates were 32% in female patients insured by Medicaid, 10% in commercially insured male patients, and almost 40% in females with end-stage renal disease.
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A five-year quasi-experimental study to evaluate the impact of empiric antibiotic order sets on antibiotic use metrics among hospitalized adult patients Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-25 Wesley D. Kufel, Jeffrey M. Steele, Rahul Mahapatra, Mitchell V. Brodey, Dongliang Wang, Kristopher M. Paolino, Paul Suits, Derek W. Empey, Stephen J. Thomas
Objective: Evaluation of adult antibiotic order sets (AOSs) on antibiotic stewardship metrics has been limited. The primary outcome was to evaluate the standardized antimicrobial administration ratio (SAAR). Secondary outcomes included antibiotic days of therapy (DOT) per 1,000 patient days (PD); selected antibiotic use; AOS utilization; Clostridioides difficile infection (CDI) cases; and clinicians’
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Implementing a continuous quality-improvement framework for tuberculosis infection prevention and control in healthcare facilities in China, 2017–2019 Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-25 Canyou Zhang, Stephanie O’Connor, Sarah E. Smith-Jeffcoat, Diana Forno Rodriguez, Hui Guo, Ling Hao, Hui Chen, Yanbo Sun, Yan Li, Jiying Xu, Liang Chen, Lan Xia, Xing Yang, Anand Date, Jun Cheng
Background: Tuberculosis (TB) infection prevention and control (IPC) in healthcare facilities is key to reducing transmission risk. A framework for systematically improving TB IPC through training and mentorship was implemented in 9 healthcare facilities in China from 2017 to 2019. Methods: Facilities conducted standardized TB IPC assessments at baseline and quarterly thereafter for 18 months. Facility-based
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Potential underreporting of treated patients using a Clostridioides difficile testing algorithm that screens with a nucleic acid amplification test Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-25 Alice Y. Guh, Scott Fridkin, Dana Goodenough, Lisa G. Winston, Helen Johnston, Elizabeth Basiliere, Danyel Olson, Christopher D. Wilson, Jasmine J. Watkins, Lauren Korhonen, Dale N. Gerding
Objective: Patients tested for Clostridioides difficile infection (CDI) using a 2-step algorithm with a nucleic acid amplification test (NAAT) followed by toxin assay are not reported to the National Healthcare Safety Network as a laboratory-identified CDI event if they are NAAT positive (+)/toxin negative (−). We compared NAAT+/toxin− and NAAT+/toxin+ patients and identified factors associated with
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Assessing clinicians’ and trainees’ knowledge and practice of the IDSA guidelines for asymptomatic bacteriuria in older adults Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-25 Eleanor E. A. Smith, Nagakrishnal Nachimuthu, John Flynn, Ashok Balasubramanyam, Jose A. Negrete, Barbara W. Trautner, Mayar Al Mohajer
A survey of advanced practice clinicians (APCs), physicians, residents, and medical students at an academic medical center and community practices in southeastern Texas revealed a gap in knowledge and practice related to testing and treatment for asymptomatic bacteriuria (ASB) in older adults.
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Bacterial contamination of air and surfaces during dental procedures—An experimental pilot study using Staphylococcus aureus Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-24 Jessica Franz, Thomas C. Scheier, Maja Aerni, Andrea Gubler, Peter W. Schreiber, Silvio D. Brugger, Patrick R. Schmidlin
Objective: The oral cavity contains numerous microorganisms, including antimicrobial-resistant bacteria. These microorganisms can be transmitted via respiratory particles from patients to healthcare providers and vice versa during dental care. We evaluated the spread of Staphylococcus aureus during standardized dental procedures using different scaling devices and rinsing solutions. Methods: During
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Identification of carbapenem-resistant organism (CRO) contamination of in-room sinks in intensive care units in a new hospital bed tower Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-19 Bobby G. Warren, Becky A. Smith, Aaron Barrett, Amanda M. Graves, Alicia Nelson, Erin Gettler, Sarah S. Lewis, Deverick J. Anderson
Background: The origins and timing of inpatient room sink contamination with carbapenem-resistant organisms (CROs) are poorly understood.Methods: We performed a prospective observational study to describe the timing, rate, and frequency of CRO contamination of in-room handwashing sinks in 2 intensive care units (ICU) in a newly constructed hospital bed tower. Study units, A and B, were opened to patient
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Cycle threshold dynamics of non–severe acute respiratory coronavirus virus 2 (SARS-CoV-2) respiratory viruses Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-18 Selina Ehrenzeller, Rebecca Zaffini, Nicole D. Pecora, Sanjat Kanjilal, Chanu Rhee, Michael Klompas
Objective: Many providers use severe acute respiratory coronavirus virus 2 (SARS-CoV-2) cycle thresholds (Ct values) as approximate measures of viral burden in association with other clinical data to inform decisions about treatment and isolation. We characterized temporal changes in Ct values for non–SARS-CoV-2 respiratory viruses as a first step to determine whether cycle thresholds could play a
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Factors associated with patient-to-healthcare personnel (HCP) and HCP-to-subsequent patient transmission of methicillin-resistant Staphylococcus aureus Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-18 Timileyin Y. Adediran, Gwen L. Robinson, J. Kristie Johnson, Yuanyuan Liang, Sarah Bejo, Surbhi Leekha, David A. Rasko, O. Colin Stine, Anthony D. Harris, Kerri A. Thom
Background: Transient acquisition of methicillin-resistant Staphylococcus aureus (MRSA) on healthcare personnel (HCP) gloves and gowns following patient care has been examined. However, the potential for transmission to the subsequent patient has not been studied. We explored the frequency of MRSA transmission from patient to HCP, and then in separate encounters from contaminated HCP gloves and gowns
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The next frontier of healthcare-associated infection (HAI) surveillance metrics: Beyond device-associated infections Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-15 Sonali D. Advani, Kelly Cawcutt, Michael Klompas, Jonas Marschall, Jennifer Meddings, Payal K. Patel
In recent years, it has become increasingly evident that surveillance metrics for invasive device-associated infections (ie, central-line–associated bloodstream infections, ventilator-associated pneumonias, and catheter-associated urinary tract infections) do not capture all harms; they capture only a subset of healthcare-associated infections (HAIs). Although prevention of device-associated infections
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In vitro assessment of isopropanol leakage from antiseptic barrier caps into commonly used needleless connectors Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-12 Camille Boissière, Astrid Bacle, Romain Pelletier, Diane Le Bouedec, Thomas Gicquel, Yves Lurton, Brendan Le Daré
Background: Needleless connectors (NCs) can be disinfected using antiseptic barrier caps (ABCs) to reduce the risk of catheter-related bloodstream infections. However, recent evidence suggests that isopropanol can leak from the ABC into the NC, posing concern about their safe use. We sought to determine in vitro which ABC and NC parameters influence the leakage of isopropanol through the infusion circuit
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Diagnostic stewardship to improve patient outcomes and healthcare-associated infection (HAI) metrics Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-11 Harjot K. Singh, Kimberly C. Claeys, Sonali D. Advani, Yolanda J. Ballam, Jessica Penney, Kirsten M. Schutte, Christopher Baliga, Aaron M. Milstone, Mary K. Hayden, Daniel J. Morgan, Daniel J. Diekema
Diagnostic stewardship seeks to improve ordering, collection, performance, and reporting of tests. Test results play an important role in reportable HAIs. The inclusion of HAIs in public reporting and pay for performance programs has highlighted the value of diagnostic stewardship as part of infection prevention initiatives. Inappropriate testing should be discouraged, and approaches that seek to alter
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Hospital-acquired infections surveillance: The machine-learning algorithm mirrors National Healthcare Safety Network definitions Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-11 Stephani Amanda Lukasewicz Ferreira, Arateus Crysham Franco Meneses, Tiago Andres Vaz, Otavio Luiz da Fontoura Carvalho, Camila Hubner Dalmora, Daiane Pressotto Vanni, Isabele Ribeiro Berti, Rodrigo Pires dos Santos
Background: Surveillance of hospital-acquired infections (HAIs) is the foundation of infection control. Machine learning (ML) has been demonstrated to be a valuable tool for HAI surveillance. We compared manual surveillance with a supervised, semiautomated, ML method, and we explored the types of infection and features of importance depicted by the model. Methods: From July 2021 to December 2021, a
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Concurrent transmission of multiple carbapenemases in a long-term acute-care hospital Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-10 Danielle A. Rankin, Maroya Spalding Walters, Luz Caicedo, Paige Gable, Heather A. Moulton-Meissner, Allison Chan, Albert Burks, Kendra Edwards, Gillian McAllister, Alyssa Kent, Alison Laufer Halpin, Christina Moore, Tracy McLemore, Linda Thomas, Nychie Q. Dotson, Alvina K. Chu
Objective: We investigated concurrent outbreaks of Pseudomonas aeruginosa carrying blaVIM (VIM-CRPA) and Enterobacterales carrying blaKPC (KPC-CRE) at a long-term acute-care hospital (LTACH A).Methods: We defined an incident case as the first detection of blaKPC or blaVIM from a patient’s clinical cultures or colonization screening test. We reviewed medical records and performed infection control assessments
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Diving deep for the needle in the haystack: An outbreak investigation of Burkholderia cenocepacia bacteremia Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-04 Abdul Ghafur, Praveen Balaguru, S. G. Ramanan, Rejiv Rajendranath, Revathi Raj, Mohammed Zehran, T. Raja, Jose M. Easow, Sankar Srinivasan, Dedeepiya Devaprasad, Thilakavathy Sukumar, Praveen Nilgar, K. Sakthivel, Rakkesh M. Nirumal, K. Chandra, Sree V. Lakshmi, Nandini Sethuraman, Yamuna Devi Bakthavatchalam, Balaji Veeraraghavan
In an Indian oncology setting, between August and December 2021, 56 patients, developed Burkholderia cenocepacia bacteremia. An investigation revealed a contaminated batch of the antiemetic drug palonosetron. The outbreak was terminated by withdrawing the culprit batch and the findings were reported promptly to regulatory authorities.
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Incidence and risk factors for catheter-associated urinary tract infection in 623 intensive care units throughout 37 Asian, African, Eastern European, Latin American, and Middle Eastern nations: A multinational prospective research of INICC Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-04 Victor Daniel Rosenthal, Ruijie Yin, Eric Christopher Brown, Brandon Hochahn Lee, Camilla Rodrigues, Sheila Nainan Myatra, Mohit Kharbanda, Prasad Rajhans, Yatin Mehta, Subhash Kumar Todi, Sushmita Basu, Suneeta Sahu, Shakti Bedanta Mishra, Rajesh Chawla, Pravin K. Nair, Rajalakshmi Arjun, Deepak Singla, Kavita Sandhu, Vijayanand Palaniswamy, Arpita Bhakta, Mohd-Basri Mat Nor, Tai Chian-Wern, Ider
Objective: To identify urinary catheter (UC)–associated urinary tract infection (CAUTI) incidence and risk factors. Design: A prospective cohort study. Setting: The study was conducted across 623 ICUs of 224 hospitals in 114 cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries. Participants: The study included 169,036 patients, hospitalized for 1,166,593 patient
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National survey of infectious disease fellowship program directors: A call for subspecialized training in infection prevention and control and healthcare epidemiology Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-04 Marisa L. Winkler, Molly L. Paras, Sharon B. Wright, Erica S. Shenoy
Objective: The importance of infection prevention and control and healthcare epidemiology (IPC/HE) in healthcare facilities was highlighted during the COVID-19 pandemic. Infectious disease (ID) clinicians often hold leadership positions in IPC/HE teams; however, there is no standard for training or certification of ID physicians specializing in IPC/HE. We evaluated the current state of IPC/HE training
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A severe acute respiratory coronavirus virus 2 (SARS-CoV-2) nosocomial cluster with inter-facility spread: Lessons learned Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-04 Aurora E. Pop-Vicas, Laura Anderson, Gabrielle Hatas, Linda Stevens, Ashley Buys, David O’Connor, Nancy Wilson, Kasen Riemersma, Luis A Haddock Soto, Abby Richardson, Christine Clemens, Jennylynde Packham, Daniel Shirley, Nasia Safdar
Background: Despite infection control guidance, sporadic nosocomial coronavirus disease 2019 (COVID-19) outbreaks occur. We describe a complex severe acute respiratory coronavirus virus 2 (SARS-CoV-2) cluster with interfacility spread during the SARS-CoV-2 δ (delta) pandemic surge in the Midwest. Setting: This study was conducted in (1) a hematology-oncology ward in a regional academic medical center
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The impact of minimally invasive surgical approaches on surgical-site infections Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-03 Stephanie F. Sweitzer, Emily E. Sickbert-Bennett, Jessica Seidelman, Deverick J. Anderson, Moe R. Lim, David J. Weber
We performed a literature review to describe the risk of surgical-site infection (SSI) in minimally invasive surgery (MIS) compared to standard open surgery. Most studies reported decreased SSI rates among patients undergoing MIS compared to open procedures. However, many were observational studies and may have been affected by selection bias. MIS is associated with reduced risk of surgical-site infection
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Using interprofessional collaboration to reduce reported rates of central-line–associated bloodstream infection in an intensive care setting Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2024-01-02 Hannah Musgrove, Abigail Ruby, Eman Chami, Edward Pollak, Geehan Suleyman, Arielle Gupta
Using a multicomponent approach that included blood-culture stewardship, evaluation for secondary sources of bloodstream infection, improved documentation, and prompt central-line removal, an interprofessional team improved patient care and reduced central-line–associated bloodstream infection rates in collaboration with the primary team on the surgical intensive care unit.
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Diagnostic testing and antibiotic utilization among inpatients evaluated for coronavirus disease 2019 (COVID-19) pneumonia Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2023-12-28 Megan R. Wimmer, Meggie Griffin, Alex Peterson-Weber, Lucas T. Schulz, Ashlee G. Hamel, Rebecca J. Schwei, Karen Fong, Donna R. Burgess, Meghan Brett, Cory M. Hale, Marisa Holubar, Rupali Jain, Rachel Larry, Emily S. Spivak, Helen Newland, Jessica Njoku, Michael Postelnick, Carla Walraven, Michael S. Pulia
We evaluated diagnostic test and antibiotic utilization among 252 patients from 11 US hospitals who were evaluated for coronavirus disease 2019 (COVID-19) pneumonia during the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) omicron variant pandemic wave. In our cohort, antibiotic use remained high (62%) among SARS-CoV-2–positive patients and even higher among those who underwent procalcitonin
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Quantifying racial disparities in risk of invasive Staphylococcus aureus infection in Metropolitan Atlanta, Georgia, during the 2020–2021 coronavirus disease 2019 (COVID-19) pandemic Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2023-12-27 Herveen Kaur Singh, Radhika Prakash-Asrani, Allison Pall, Susan M. Ray, Melissa Tobin-D’Angelo, Scott K. Fridkin
We estimated the racial disparity in rates of invasive S. aureus infections based on community coronavirus disease 2019 (COVID-19) rates at the county level. Our data suggest that COVID-19 infection burden (1) affects not only hospital-onset MRSA invasive infection risk but also community-onset S. aureus invasive infection risk and (2) affects Black residents ∼60% more than White residents.
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Sink-traps are a major source for carbapenemase-producing Enterobacteriaceae transmission Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2023-12-27 Gili Regev-Yochay, Ili Margalit, Gillian Smollan, Rotem Rapaport, Ilana Tal, William P. Hanage, Nani Pinas Zade, Hanaa Jaber, Bradford P. Taylor, You Che, Galia Rahav, Eyal Zimlichman, Nati Keller
Objective: We studied the extent of carbapenemase-producing Enterobacteriaceae (CPE) sink contamination and transmission to patients in a nonoutbreak setting.Methods: During 2017–2019, 592 patient-room sinks were sampled in 34 departments. Patient weekly rectal swab CPE surveillance was universally performed. Repeated sink sampling was conducted in 9 departments. Isolates from patients and sinks were
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The utility of whole-genome sequencing to inform epidemiologic investigations of SARS-CoV-2 clusters in acute-care hospitals Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2023-12-22 Theodore S. Rader, Vatsala R. Srinivasa, Marissa P. Griffith, Kady Waggle, Lora Pless, Ashley Chung, Suzanne Wagester, Lee H. Harrison, Graham M. Snyder
Objective: To evaluate the utility of selective reactive whole-genome sequencing (WGS) in aiding healthcare-associated cluster investigations.Design: Mixed-methods quality-improvement study.Setting: Thes study was conducted across 8 acute-care facilities in an integrated health system.Methods: We analyzed healthcare-associated coronavirus disease 2019 (COVID-19) clusters between May 2020 and July 2022
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A cluster of three extrapulmonary Mycobacterium abscessus infections linked to well-maintained water-based heater-cooler devices Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2023-12-21 Jessica L. Seidelman, Arthur W. Baker, Sarah S. Lewis, Bobby G. Warren, Aaron Barrett, Amanda Graves, Carly King, Bonnie Taylor, Jill Engel, Desiree Bonnadonna, Carmelo Milano, Richard J. Wallace, Matthew Stiegel, Deverick J. Anderson, Becky A. Smith
Background: Various water-based heater-cooler devices (HCDs) have been implicated in nontuberculous mycobacteria outbreaks. Ongoing rigorous surveillance for healthcare-associated M. abscessus (HA-Mab) put in place following a prior institutional outbreak of M. abscessus alerted investigators to a cluster of 3 extrapulmonary M. abscessus infections among patients who had undergone cardiothoracic surgery
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Bronchoscopy-related outbreaks and pseudo-outbreaks: A systematic review Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2023-12-15 Loukas Kakoullis, Sofia Economidou, Preeti Mehrotra, George Panos, Theodoros Karampitsakos, Grigorios Stratakos, Argyrios Tzouvelekis, Fotios Sampsonas
Objective: To identify and report the pathogens and sources of contamination associated with bronchoscopy-related outbreaks and pseudo-outbreaks. Design: Systematic review. Setting: Inpatient and outpatient outbreaks and pseudo-outbreaks after bronchoscopy. Methods: PubMed/Medline databases were searched according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines
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Staphylococcus epidermidis joint isolates: Whole-genome sequencing demonstrates evidence of hospital transmission and common antimicrobial resistance Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2023-12-15 Samantha J. Simon, Mohamad Sater, Ian Herriott, Miriam Huntley, Emma Briars, Brian L. Hollenbeck
Objective: We investigated genetic, epidemiologic, and environmental factors contributing to positive Staphylococcus epidermidis joint cultures.Design: Retrospective cohort study with whole-genome sequencing (WGS).Patients: We identified S. epidermidis isolates from hip or knee cultures in patients with 1 or more prior corresponding intra-articular procedure at our hospital.Methods: WGS and single-nucleotide
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Association of a coronavirus disease 2019 (COVID-19) vaccine booster with control of a COVID-19 outbreak in a long-term care facility in Switzerland, November to December 2021 Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2023-12-13 Thomas W. Leiblein, Annemarie Winistörfer, Kurt Seiler, Rudolf Hauri, Rami Sommerstein
Coronavirus disease 2019 (COVID-19) outbreaks in long-term care facilities are often correlated with high case fatality rates. We describe the association of administration of an mRNA booster with the control of an outbreak. Our findings highlight the possibility of vaccine booster early in an outbreak as a promising method to mitigate the spread of infection.
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Identifying individual and organizational predictors of accidental exposure to blood (AEB) among hospital healthcare workers: A longitudinal study Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2023-12-13 René Sosata Bun, Karim Aït Bouziad, Oumou Salama Daouda, Katiuska Miliani, Anastasia Eworo, Florence Espinasse, Delphine Seytre, Anne Casetta, Simone Nérome, Laura Temime, Mounia N. Hocine, Pascal Astagneau
Background: Accidental exposure to blood (AEB) poses a risk of bloodborne infections for healthcare workers (HCWs) during hospital activities. In this study, we identified individual behavioral and organizational predictors of AEB among HCWs. Methods: The study was a prospective, 1-year follow-up cohort study conducted in university hospitals in Paris, France. Data were collected from the Stress at
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The impact of a blood-culture diagnostic stewardship intervention on utilization rates and antimicrobial stewardship Infect. Control Hosp. Epidemiol. (IF 4.5) Pub Date : 2023-12-13 Melinda C. Wang, Kelvin J. Zhou, Sabra L. Shay, James P. Herlihy, Muhammad A. Siddique, Sergio Trevino Castillo, Todd M. Lasco, Miriam Barrett, Mayar Al Mohajer
Blood-culture overutilization is associated with increased cost and excessive antimicrobial use. We implemented an intervention in the adult intensive care unit (ICU), combining education based on the DISTRIBUTE algorithm and restriction to infectious diseases and ICU providers. Our intervention led to reduced blood-culture utilization without affecting safety metrics.