American Journal of Infection Control

BACKGROUND: Health care-associated infection (HAI) surveillance is vital for safety in health care settings. It helps identify infection risk factors, enhancing patient safety and quality improvement. However, HAI surveillance is complex, demanding specialized knowledge and resources. This study investigates the use of artificial intelligence (AI), particularly generative large language models, to improve HAI surveillance. METHODS: We assessed 2 AI agents, OpenAI's chatGPT plus (GPT-4) and a Mixtral 8×7b-based local model, for their ability to identify Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) from 6 National Health Care Safety Network training scenarios...

OBJECTIVES: Novel β-lactams have in vitro activity against Pseudomonas aeruginosa (PA), but their clinical performances and the selection criteria for practical use are still not clear. We aimed to evaluate the efficacy of novel β-lactams for PA infection in various sites and to compare the efficacy of each agent. METHODS: We searched PubMed, Embase, Cochrane Library and Web of Science for randomized controlled trials (RCTs) that using novel β-lactams to treat PA infection...

INTRODUCTION: Outbreaks linked to inadequate endoscope drying have infected numerous patients, and current standards and guidelines recommend at least 10 minutes of forced air for drying channels. This study evaluated a new forced-air drying system (FADS) for endoscopes. METHODS: Drying was assessed using droplet detection cards; visual inspection of air/water connectors, suction connectors, and distal ends; and borescope examinations of endoscope interiors. Assessments were performed after automated endoscope reprocessor (AER) alcohol flush and air purge cycles and after 10-minute FADS cycles...

BACKGROUND: Self-medication with antibiotics (SMA) is a common public health concern. This study aimed to assess the prevalence of SMA in the general public and health professionals during the COVID-19 pandemic and identify the associated factors. METHODS: A cross-sectional study was conducted from October 28, 2022, to November 6, 2022. Logistics regression analysis was used to examine the associated factors. RESULTS: The rate of SMA was 10...

BACKGROUND: Surgical site infections (SSI) are a common complication of hysterectomy. Surgical bundles have been shown to reduce SSIs. Here we describe a bundle that was used to combat an abnormal rise in SSI events that resulted in a greater than 75% reduction at our institution. METHODS: A hysterectomy-specific bundle was developed based on the prior success of SSI prevention bundles. Development involved longitudinal education and training to ensure accuracy and compliance...

BACKGROUND: Clostridioides difficile infection (CDI) is a significant cause of morbidity and mortality among hospitalized patients, particularly those who are immunosuppressed. We aim to assess the outcomes of CDI among kidney transplant (KT) recipients. METHODS: Nationwide Inpatient Sample from 2016 to 2020 was used to identify patients with KT and stratify based on the presence of CDI. Data were collected regarding demographics and comorbidities. Outcomes included in-hospital mortality, acute kidney injury, intensive care unit admission, transplant rejection, transplant failure, length of stay, and total hospitalization charges...

BACKGROUND: Many outbreaks of coronavirus disease 2019 (COVID-19) have occurred in Japanese nursing homes in which residents and staff are in close daily contact. This study evaluated longitudinal changes in antibody titers in nursing homes in which clusters occurred and examined the association between antibody titer and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or severity. METHODS: This cohort study included 171 participants who had provided at least one antibody titer test between June 2022 and March 2023...

BACKGROUND: Despite current guidelines for tuberculosis (TB) control in healthcare settings, which focused on smear-positive cases, prevention of nosocomial TB transmission continues to be a challenge. Here, we report results of the first hospital-wide prospective study applying interferon-gamma release assay to investigate the role of smear-negative, culture-positive index cases in nosocomial TB transmission. METHODS: We prospectively identified cases of culture-confirmed smear-negative pulmonary TB receiving aerosol-generating procedures (AGPs) and cases of culture-confirmed smear-positive pulmonary TB admitted at a medical center...

BACKGROUND: Although routine changing of central venous catheters (CVCs) is commonly performed in patients with severe burns, information on pathogen colonization of the CVC tip and associated bloodstream infections (BSIs) is limited in those patients. METHODS: The medical records of 214 patients with severe burns who underwent routine CVC changing at 7-day intervals and their results of 686 pairs of CVC tips and concurrent blood cultures were retrospectively reviewed to evaluate the CVC colonization rate and associated BSI pathogens...

BACKGROUND: Recommendations for different types of bathing to prevent central line-associated bloodstream infections (CLABSI) are still divergent. The objective of this study was to verify whether bed bathing with wipes impregnated with 2% chlorhexidine (CHG) compared to conventional bed bathing is more effective in preventing CLABSI. METHODS: Systematic review of the literature by consulting the electronic databases PubMed/Medline, Embase, CINAHL, Scopus, and Web of Science from the date of inception until July 1, 2023, with no language or time restrictions...

OBJECTIVE: to evaluate the evidence related to maintaining the integrity and filtration efficiency of N95 and/or PFF2 respirators after decontamination in healthcare professionals' protection against COVID-19. METHODS: Systematic review, developed based on the guidelines from Joanna Briggs Institute (JBI) for syntheses focusing on effectiveness evidence. The protocol was registered on the International Prospective Register of Ongoing. Systematic Reviews (PROSPERO) platform, under the number CRD42022354256...

BACKGROUND: Central line-associated bloodstream infections (CLABSIs) pose a significant risk to critically ill patients, particularly in intensive care units (ICU) and are a significant cause of hospital-acquired infections. We investigated whether implementation of a multifaceted intervention was associated with reduced incidence of CLABSIs. METHODOLOGY: This was a prospective cohort study over 9 years. We implemented a bundled intervention approach to prevent CLABSIs, consisting of a comprehensive unit-based safety program (CUSP)...

An increase in hospital-onset Clostridioides difficile (HO-CDI) prompted an interprofessional team to implement enhanced environmental service cleaning practices and adopt a routine cleaning program undertaken by clinical staff. These interventions resulted in a reduction of HO-CDI from 7.27 cases per 10 000 patient days to 1.54 cases per 10 000 patient days.

BACKGROUND: There is increasing interest in improving routine HIV screening in emergency departments (EDs) and increasing HIV co-testing rates among patients tested for sexually transmitted infections (STIs), who are considered at elevated risk of acquiring HIV. METHODS: This is a retrospective review of all ED encounters at a large, urban ED with an existing HIV screening program for seven months before (November 1, 2018, to May 30, 2019) and after (June 1 to December 31, 2019) the implementation of a best practice advisory (BPA) prompting universal HIV and syphilis screening...

BACKGROUND: This prospective study aimed to explore the effectiveness of an oral care intervention with TegadermTM on the oral mucosal health of intubated patients. METHODS: A total of 70 intubated patients were included and randomly assigned to one of three groups, clean water brushing teeth (BT) (n = 23), brushing teeth combined with mouthwash (BTM) (n = 23), and brushing teeth combined with mouthwash and TegadermTM (BTMT) (n = 24). The Oral Mucositis Assessment Scale (OMAS) was applied to evaluate the patient's oral mucosal health before and after oral care intervention...

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BACKGROUND: There is poor self-reported (SR) execution of infection prevention and control (IPC) among physicians and nurses. Self-leadership is considered an important factor to enhance IPC SR-execution. This study aims to explore the associations between self-leadership and IPC SR-execution among physicians and nurses. METHODS: A cross-sectional study of 26,252 physicians and nurses was conducted in all secondary and tertiary hospitals in Hubei province, China...