Almaguer-Valadez ME, Martin-Onräet A, Soto-Cisneros YP
… +3 more, Patricia V, Galicia-Flores N, Vilar-Compte D
Am J Infect Control
· 2026 Jun · PMID 42276233
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BACKGROUND: Patients with cancer are at high risk of severe COVID-19 and nosocomial SARS-CoV-2 infection. This study aimed to describe the incidence, clinical characteristics, and outcomes of nosocomial COVID-19 among pa...BACKGROUND: Patients with cancer are at high risk of severe COVID-19 and nosocomial SARS-CoV-2 infection. This study aimed to describe the incidence, clinical characteristics, and outcomes of nosocomial COVID-19 among patients with solid tumors and hematologic malignancies. OBJECTIVE: To describe the incidence, clinical characteristics, and outcomes of nosocomial COVID-19 among patients with solid tumors and hematologic malignancies over 4 years. METHODS: We performed a retrospective study of patients with cancer and nosocomialCOVID-19 over four years. Incidence rates were calculated per1,000 patient-days. Clinical presentation, vaccination status, treatment, andoutcomes were described. Risk factors for 30-day mortality were evaluated usinglogistic regression. RESULTS: Of 1,807 COVID-19 cases, 79 (4.4%) were hospital-acquired; incidence of0.36 per 1,000 patient-days. The incidence varied over time and peaked during theOmicron BA.1/BA.2 period. Thirty-day mortality was 19%, down from37.5% (2020) to 10% during Omicron; no deaths attributable to nosocomial COVID-19occurred in 2023-2024. In multivariable analysis, female sex (aOR 13.02, 95% CI1.71-99.00), critical COVID-19 at diagnosis (aOR 9.00, 95% CI 1.18-68.80), and SpO2<90% (aOR 5.92, 95% CI 1.19-29.58) were associated with 30-day mortality. CONCLUSIONS: Nosocomial COVID-19 was low and generally tracked communitytransmission, except during the initial months of the pandemic. Mortality declined overtime; severe presentation and hypoxemia at diagnosis were associated with higherodds of death.
Toplu SA, Tanrıverdi ES, Memişoğlu F
… +3 more, Yakupoğulları Y, Çelik T, Özdemir R
Am J Infect Control
· 2026 Jun · PMID 42276232
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BACKGROUND: Environmental microorganisms detected in neonatal feeding preparation areas may raise concern for healthcare-associated outbreaks and warrant investigation to identify potential environmental sources of conta...BACKGROUND: Environmental microorganisms detected in neonatal feeding preparation areas may raise concern for healthcare-associated outbreaks and warrant investigation to identify potential environmental sources of contamination. METHODS: Between July 2025 and February 2026, repeated bacterial growth was detected during routine microbiological surveillance of formula prepared for neonates. An investigation was conducted, including sampling of powdered formula, prepared formula, and distilled water. Bacterial identification was performed using routine methods, and genetic relatedness among selected Herbaspirillum isolates was evaluated using arbitrarily primed polymerase chain reaction. RESULTS: Environmental microorganisms were isolated from prepared formula and distilled water, while powdered formula showed no growth. Repeated isolation of Herbaspirillum species demonstrated clonal relatedness, suggesting a common environmental source. No clinical infections associated with these microorganisms were identified among neonates during the study period. CONCLUSIONS: This study identified environmental bacterial contamination associated with distilled water used during formula preparation. Molecular typing was valuable in confirming a common environmental source and guiding corrective interventions. Monitoring water sources is critical in neonatal care.
Mousavizadeh SA, Mirrahimi B, Salamzadeh J
… +6 more, Kargar A, Fahimzad SA, Esfahanian N, Taherpour N, Jamali F, Sistanizad M
Am J Infect Control
· 2026 Jun · PMID 42276231
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BACKGROUND: Pediatric surgical antibiotic prophylaxis (SAP) is often inappropriate and contributes to avoidable antimicrobial exposure; we evaluated whether a clinical pathway-based antimicrobial stewardship program coul...BACKGROUND: Pediatric surgical antibiotic prophylaxis (SAP) is often inappropriate and contributes to avoidable antimicrobial exposure; we evaluated whether a clinical pathway-based antimicrobial stewardship program could improve SAP appropriateness in pediatric surgery. METHODS: We conducted a single-center uncontrolled pre-post quasi-experimental study in a tertiary pediatric hospital in Tehran, Iran. All clean or clean-contaminated procedures across pediatric surgical services were screened during the baseline and post-intervention periods. Overall appropriate SAP was evaluated among all eligible surgeries (714 pre-intervention; 658 post-intervention). The primary compliance analysis included procedures with SAP indicated and administered (n=447 per period). The intervention combined pathway-based education, dosing aids, stocking first-line agents, and pharmacist feedback. The primary outcome was composite compliance with six guideline-defined elements. RESULTS: Among all eligible surgeries, overall appropriate SAP increased from 58.7% (419/714) to 74.2% (488/658; +15.5 percentage points; 95% CI 10.6-20.4; p<0.001). Among indicated-and-administered cases, composite compliance increased from 74.9% to 85.0%, and complete compliance increased from 52.6% to 71.4% (both p<0.001). Cefazolin-based regimens increased, while median doses of broader-spectrum agents declined. DISCUSSION: Findings suggest improved SAP processes and reduced exposure, but inference is limited by the nonrandomized, single-center design and short follow-up. CONCLUSION: A pathway-based stewardship program was associated with better SAP performance and increased narrow-spectrum prophylaxis use; multicenter studies with longer follow-up are needed to assess sustainability and clinical outcomes.
Turner D, DeMaet MA, Bundage D
… +5 more, Lisan A, Amaya A, Shockley L, Lasco T, Al Mohajer M
Am J Infect Control
· 2026 Jun · PMID 42248522
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During an 87-week interrupted time series, we evaluated screening positivity after de-escalating dedicated cohort units for Candida auris and later implementing enhanced nursing engagement. Discontinuing cohort units did...During an 87-week interrupted time series, we evaluated screening positivity after de-escalating dedicated cohort units for Candida auris and later implementing enhanced nursing engagement. Discontinuing cohort units did not increase adjusted screening positivity, whereas enhanced engagement was associated with lower positivity. Findings support sustained frontline engagement and clear screening/isolation workflows when cohorting is de-escalated.
Falci DR, Monteiro A, Ferraz L
… +4 more, Ramos F, Baptista A, de Oliveira SD, Flôrès AS
Am J Infect Control
· 2026 Jun · PMID 42235891
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BACKGROUND: Hospital clothing harbors bacteria causing healthcare-associated infections (HAIs). This study evaluated the association between silver, copper, and zinc oxide nanoparticle-impregnated textiles and HAI rates...BACKGROUND: Hospital clothing harbors bacteria causing healthcare-associated infections (HAIs). This study evaluated the association between silver, copper, and zinc oxide nanoparticle-impregnated textiles and HAI rates in an intensive care unit (ICU) setting. METHODS: A quasi-experimental ecological study in a 25-bed tertiary ICU compared. HAI rates across a 15-month baseline and 15-month intervention period using Wilcoxon rank-sum tests, autoregressive integrated moving average (ARIMA) interrupted time-series analysis, and multivariable Poisson regression model adjusted for time trend, bundle compliance, hand hygiene and ventilator utilization ratio. Antimicrobial efficacy was assessed via standardized microbiological methods. RESULTS: Patient characteristics did not differ between phases (SAPS3 P = .148). Ventilator-associated pneumonia (VAP) rates decreased from 4.84 to 2.36 events/1,000 ventilation-days (17 vs 7 events; Wilcoxon, P = .045). Poisson regression estimated a 49% reduction in VAP incidence rate (IRR = 0.51; 95% CI: 0.08-3.40; non-significant). ARIMA analysis did not detect a significant intervention effect (P = .817). Other HAI rates were unchanged. In vitro, bacterial reductions were 76.1% for Staphylococcus aureus, 52.4% for Escherichia coli, and 47.1% for Pseudomonas aeruginosa. CONCLUSIONS: Nanoparticle-impregnated textiles were feasibly implemented in an ICU and associated with reduced VAP rates. These hypothesis-generating findings support nanotechnology as a potential adjunct for HAI prevention, warranting future large-scale trials.
Arias-Sánchez A, Casadiego-Payares S, Acosta-Parada C
… +1 more, Silva JB
Am J Infect Control
· 2026 May · PMID 42217737
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BACKGROUND: Pediatric data on hospital-acquired Clostridioides difficile infection (HA-CDI) outbreaks in Latin America are scarce. We compared age-related clinical, microbiological, therapeutic, and outcome differences d...BACKGROUND: Pediatric data on hospital-acquired Clostridioides difficile infection (HA-CDI) outbreaks in Latin America are scarce. We compared age-related clinical, microbiological, therapeutic, and outcome differences during a Colombian HA-CDI outbreak. METHODS: We conducted a retrospective observational study at a 610-bed tertiary-care hospital in Medellín, Colombia, during an epidemiologically characterized HA-CDI outbreak (September 2017-March 2018). Cases required compatible diarrhea and real-time PCR detection of C. difficile toxin genes. RESULTS: Twenty-five HA-CDI cases were identified; 15 (60%) occurred in children. Children developed symptoms earlier after admission than adults (median 6 vs 13 days) and more often presented with fever and tachycardia. Molecular characterization identified C. difficile ribotype 027, corresponding to the 027/NAP1/BI lineage, in one pediatric severe case. Ten-day treatment regimens were more frequent in children than adults (86.7% vs 40.0%; p=0.01), while diarrhea duration was similar. One pediatric recurrence occurred; no CDI-attributable mortality was observed. DISCUSSION: Pediatric predominance may reflect age-related host-microbiota dynamics, colonization patterns, antibiotic exposure, and diagnostic ascertainment. Treatment findings represent local practice, not comparative effectiveness. CONCLUSIONS: This outbreak supports age-stratified HA-CDI surveillance, diagnostic stewardship, molecular surveillance, pediatric-adapted antimicrobial stewardship, and locally adapted infection-prevention strategies.
Jones KM, Catherine Sunlin M, Hua H
… +1 more, Krein SL
Am J Infect Control
· 2026 May · PMID 42202937
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In nursing homes (NHs), infection prevention and control quality assurance and performance improvement activities using structured methodologies are poorly defined. Small tests of change (STOC) are small-scale projects d...In nursing homes (NHs), infection prevention and control quality assurance and performance improvement activities using structured methodologies are poorly defined. Small tests of change (STOC) are small-scale projects designed to test interventions quickly. This study describes STOCs implemented by 24 NHs participating in a 12-month long collaborative to reduce healthcare-associated infections. With limited external project team support, facilities developed targeted STOCs. Findings highlight how NHs can effectively initiate STOC projects to enhance infection prevention and control outcomes.
Pertsch EK, Almukhtar S, Orsi H
… +5 more, Lopez-Yanez N, Spencer H, Demirtas H, Dworkin MS, Hershow R
Am J Infect Control
· 2026 May · PMID 42177916
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BACKGROUND: While risk factors for COVID-19 outbreaks in nursing homes were well characterized during the pandemic, the factors influencing outbreak severity in the postpandemic period remain poorly understood. METHODS:...BACKGROUND: While risk factors for COVID-19 outbreaks in nursing homes were well characterized during the pandemic, the factors influencing outbreak severity in the postpandemic period remain poorly understood. METHODS: We analyzed COVID-19 outbreaks in Illinois nursing homes from July 1, 2023 to June 30, 2024. A facility's average COVID-19 prevalence was calculated as confirmed resident cases per occupied beds, with outbreak severity classified as mild (>0% to ≤10%), moderate (>10% to ≤20%), or severe (>20%). Multivariate ordinal logistic regression assessed associations among outbreak severity and facility characteristics, staffing measures, and vaccination rates. RESULTS: Among 649 facilities, 32% experienced mild, 36% moderate, and 32% severe outbreaks. Higher odds of severe outbreaks were observed in facilities located in rural counties (odds ratio [OR]: 2.59, P < .001), those with above-median registered nurse turnover (OR: 1.41, P = .04), higher nurse aide hours per resident per day (OR: 1.75, P = .01), and lower resident vaccination rates (OR: 1.60, P = .003). Staffing quality was significantly associated with outbreak severity when staff vaccination rates were low (OR: 2.67, P = .02). CONCLUSIONS: These findings emphasize ongoing drivers of COVID-19 outbreak severity in nursing homes and highlight the importance of interventions that target vaccination uptake, staff retention, and infection prevention and control education.
Shaban RZ, Curtis K, Fry M
… +19 more, McCormack B, Parker D, Macbeth D, Mitchell BG, Russo PL, Friedman ND, Bennett N, Thompson L, Dalton JA, Dempsey K, Henderson B, Considine J, Bowes R, Powell M, Battaglini E, Dodson N, El-Assad K, McKay K, Viengkham C
Am J Infect Control
· 2026 May · PMID 42176857
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BACKGROUND: Healthcare-associated infections are a major health issue for older adults in residential aged care homes (RACHs). Events like the COVID-19 pandemic have increased focus on the practice of infection preventio...BACKGROUND: Healthcare-associated infections are a major health issue for older adults in residential aged care homes (RACHs). Events like the COVID-19 pandemic have increased focus on the practice of infection prevention and control professionals (ICPs) in RACHs. AIM: To synthesise evidence on practice requirements and competency standards for ICPs in RACHs globally. METHODS: This scoping review examined literature from electronic bibliographic databases and gray literature via citation chaining and manual searching limited to English from 1980 to 2025. Studies were screened against eligibility criteria. Data were analyzed using descriptive statistics and framework analysis. RESULTS: Forty-nine articles were included. Key practice requirements in the white literature included surveillance, staff education, resident care, and employee health; and directing IPC activities, standard precautions, and resident care in the gray literature. Training and credentialing featured less frequently, identifying a need for specialized training. Only 2 formal competency certifications were noted as a requirement or expectation for ICPs. CONCLUSION: Several key elements of practice have been identified, but there is limited detail and consistency regarding qualifications, competency standards, and credentialing. IMPACT: This work reviewed the literature regarding ICP practice requirements, qualifications, and credentialing. Gaps in this literature indicate a need for formal, evidence-based guidelines for ICPs in RACHs.
Am J Infect Control
· 2026 May · PMID 42176856
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To assess the utility of umbilical surveillance cultures for methicillin-resistant Staphylococcus aureus colonization in neonates, we performed a retrospective cohort study in patients in a neonatal intensive care unit (...To assess the utility of umbilical surveillance cultures for methicillin-resistant Staphylococcus aureus colonization in neonates, we performed a retrospective cohort study in patients in a neonatal intensive care unit (NICU). Over 6 years, 6/1,908 (0.32%) umbilical cultures were positive, all from patients with a concomitant positive culture from either the nares or rectum. The cost of umbilical cultures was $184,535. The value of neonatal umbilical methicillin-resistant S. aureus screening appears limited.
Am J Infect Control
· 2026 May · PMID 42176855
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Microbiota composition influences methicillin-resistant S aureus (MRSA) colonization, yet the contribution of the oral microbiota and the impact of decolonization approaches remain insufficiently explored. In this study,...Microbiota composition influences methicillin-resistant S aureus (MRSA) colonization, yet the contribution of the oral microbiota and the impact of decolonization approaches remain insufficiently explored. In this study, we report microbiota shifts in 3 adults with oral MRSA colonization who underwent decolonization treatment, including povidone-iodine. Relative bacterial abundances fluctuated across oral sites and over time, indicating distinct ecological responses to treatment. These findings improve our understanding of how the oral microbiota may affect MRSA decolonization and highlight the importance of oral microbial dynamics to guide more personalized and effective strategies.
Pearpleum S, Siribumrungwong B, Chancharoenrat W
… +4 more, Jantarathaneewat K, Kaewnil H, Camins BC, Apisarnthanarak A
Am J Infect Control
· 2026 May · PMID 42176854
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BACKGROUND: Multidrug-resistant organisms complicate diabetic foot infections (MDR-DFI) and are associated with adverse clinical and economic outcomes. Effective prevention strategies remain limited. METHODS: A quasi-exp...BACKGROUND: Multidrug-resistant organisms complicate diabetic foot infections (MDR-DFI) and are associated with adverse clinical and economic outcomes. Effective prevention strategies remain limited. METHODS: A quasi-experimental study was conducted at a Thai tertiary care hospital (January 2024-January 2026). The multimodal strategy included early surgical debridement, a predictive nomogram for risk-based isolation, standardized wound cultures, personalized, patient-specific antibiotic therapy, and enhanced infection prevention and control monitoring. The primary outcome was the cumulative incidence of MDR-DFI acquisition. Secondary outcomes included length of stay, 28-day recurrence, and DFI treatment costs. RESULTS: Among 100 patients, the cumulative incidence of MDR-DFI acquisition significantly decreased post-intervention (6.0% vs 38.0%; P < .001). The strategy was associated with shorter length of stay (13.2 ± 9.7 vs 19.3 ± 16.2 days; P = .03), lower 28-day recurrence (2.0% vs 18.0%; P = .02), and reduced costs (USD 1,933 vs 2,664; P = .04). Amputation, mortality, and readmission rates showed no significant differences. DISCUSSION: Integration of surgical management, risk stratification, personalized antibiotic therapy, and infection prevention and control measures may help address modifiable risk factors contributing to MDR-DFI. CONCLUSIONS: A multimodal strategy effectively reduced MDR-DFI acquisition and supports quality improvement in DFI management.
Shukla B, Pronty D, Levy M
… +4 more, Rosello G, Ferreira TBD, Parekh DJ, Jimenez A
Am J Infect Control
· 2026 May · PMID 42142741
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Reports increasingly predict a shortage of infection preventionists. To foster interest in infection prevention, 2 infection prevention departments from different academic healthcare organizations partnered with 2 univer...Reports increasingly predict a shortage of infection preventionists. To foster interest in infection prevention, 2 infection prevention departments from different academic healthcare organizations partnered with 2 universities to design and host internships for Master of Public Health (MPH) students. Twenty-six students completed the program, and 8 of them (30.8%) secured infection prevention positions. Here, we describe the internship model and report on the students' career paths following completion of the internship.
Zhang Z, Yap ASL, Wong HM
… +13 more, Lai DCM, Ong SJM, Yang Y, Lee LC, Ji X, Jin P, Tan KY, How MKB, Sellamat NSB, Tay AJL, Venkatachalam I, Chlebicki MP, Ling ML
Am J Infect Control
· 2026 May · PMID 42140318
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BACKGROUND: Endoscope-associated infections (EAIs) are an underrecognized subset of healthcare-associated infections. Despite advances in reprocessing, routine microbiological surveillance continues to detect residual co...BACKGROUND: Endoscope-associated infections (EAIs) are an underrecognized subset of healthcare-associated infections. Despite advances in reprocessing, routine microbiological surveillance continues to detect residual contamination, but its clinical significance outside outbreak settings remains unclear. METHODS: We conducted a retrospective surveillance study at a 1,900-bed academic medical center from January 2018 to December 2024. Patients undergoing endoscopic procedures were monitored for bloodstream infections (BSIs) within 30 days. Endoscope microbiological surveillance followed Gastroenterological Society of Australia guidelines. Bloodstream isolates were compared with surveillance culture organisms, and device-level trace-back assessed epidemiological linkage. RESULTS: Among 316,533 procedures, 2,366 post-endoscopic BSIs occurred (7.5 per 1,000 procedures). Rates were highest after bronchoscopy (47.7 per 1,000) and endoscopic retrograde cholangiopancreatography (36.0 per 1,000), with lower rates after gastroscopy, cystoscopy, and colonoscopy. No epidemiological or microbiological linkage was identified between contaminated endoscopes and post-procedural BSIs. CONCLUSIONS: Post-endoscopic BSIs occurred at 7.5 per 1,000 procedures, with higher rates after bronchoscopy and ERCP likely reflecting procedural invasiveness and host susceptibility. No epidemiological signal suggested exogenous transmission from contaminated endoscopes, supporting a low likelihood of such transmission. Integrating microbiological surveillance with EHR-based outcome monitoring provides a scalable framework for endoscope safety assurance.
Shaban RZ, Curtis K, Fry M
… +18 more, McCormack B, Parker D, Macbeth D, Mitchell BG, Russo PL, Friedman ND, Bennett N, Thompson L, Dalton JA, Dempsey K, Henderson B, Considine J, Bowes R, Powell M, Battaglini E, Dodson N, McKay K, Viengkham C
Am J Infect Control
· 2026 May · PMID 42134706
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BACKGROUND: Infection prevention and control (IPC) programs are critical to the wellbeing of older people in residential aged care homes (RACHs). There is a need to collate global evidence on governance and IPC programs...BACKGROUND: Infection prevention and control (IPC) programs are critical to the wellbeing of older people in residential aged care homes (RACHs). There is a need to collate global evidence on governance and IPC programs in RACHs. AIM: To synthesise evidence characterizing the elements of IPC and governance of RACHs. METHODS: This scoping review examined literature from electronic bibliographic databases and gray literature using citation chaining and manual searching limited to English language and from 1980 to 2025. Studies were screened against eligibility criteria, and data were analyzed using descriptive statistics and content analysis. RESULTS: 75 articles were included. Key components of IPC included standard precautions, employee health, surveillance, staff education, resident care, and outbreak management. Key components of infection control governance were varied but included appointment of an infection control professional and committee. Narrative-style reviews and surveys were most common among peer-reviewed articles, while practical guides and manuals were most common in the gray literature. CONCLUSION: Evidence published over the last 45 years on governance and elements of IPC programs in RACHs is sparse and heterogenous in scope and quality. IMPACT: This synthesis of evidence on the elements and governance of IPC programs in RACHs demonstrates an evidence-practice gap for future research.