Vasilopoulos T, Smith CR, Frantz AM
… +4 more, LeMaster T, Martinez RA, Gunnett AM, Fahy BG
Am J Infect Control
· 2026 Jul · PMID 41544770
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BACKGROUND: The recent history of viral global epidemics highlights the importance of teaching the proper use of personal protective equipment (PPE) for personal safety and infection prevention. The present study evaluat...BACKGROUND: The recent history of viral global epidemics highlights the importance of teaching the proper use of personal protective equipment (PPE) for personal safety and infection prevention. The present study evaluated long-term retention of knowledge for proper donning and doffing of PPE following face-to-face and video instruction. METHODS: Three cohorts of residents were examined, with long-term retention assessment occurring in subsets of each cohort at least 7 months following initial training. Without instruction, the anesthesiology residents donned appropriate PPE and then sprayed with Glo Germ before doffing to identify areas of contamination. Following instruction, the process was repeated both immediately post-training and at long-term follow-up. RESULTS: Twenty-three participants completed long-term assessment. Overall donning compliance from post-training to long-term retention did not change significantly (mean difference = -4.5%; 95% CIs: -10.7%, 1.7%; P = .105); however, doffing compliance decreased significantly (mean difference = -20.7%; 95% CIs: -28.1%, -13.4%; P < .001). Contamination rates of multiple sites increased by 17.4% (P = .248), though did not reach statistical significance. CONCLUSIONS: At long-term follow-up, there was a higher retention of proper donning with a decay of knowledge with doffing. It is important to implement educational maintenance programs, not single courses, for healthcare workers to prevent contamination during these common, highly virulent epidemics.
Johnson C, Wood MG, Graham MB
… +6 more, Gorecki P, Shockey A, Mooney A, Bateman A, Simon N, Figueroa Castro CE
Am J Infect Control
· 2026 Jun · PMID 41544769
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BACKGROUND: To investigate and determine the cause of an increase of isolation of Mycobacterium mucogenicum in broncho-alveolar lavage samples in a tertiary hospital. METHODS: Outbreak investigation including 30 patients...BACKGROUND: To investigate and determine the cause of an increase of isolation of Mycobacterium mucogenicum in broncho-alveolar lavage samples in a tertiary hospital. METHODS: Outbreak investigation including 30 patients who underwent bronchoscopy procedures in a minor procedural area of a university-affiliated, tertiary-care medical center between January and October 2022. The investigation included epidemiological analysis and response, environmental sampling, and whole genome sequencing (WGS) of clinical and environmental isolates. RESULTS: Environmental sampling identified M mucogenicum group from procedure room sinks, sterile processing sinks, bronchoscopes, and ice machine water. WGS of 9 patient isolates and 5 environmental isolates revealed clonal relatedness (0-5 single nucleotide polymorphisms) between patient isolates and potable water isolates. No patients developed active infections requiring treatment. CONCLUSIONS: A pseudo-outbreak of M mucogenicum group was linked to ice used to cool saline used to vasoconstrict biopsy collection sites in bronchoscopy procedures. WGS provided high-resolution evidence of the transmission source, distinguishing between multiple strains present in the environment. Implementation of modified processes for saline handling, equipment reprocessing, and prevention of supply contamination from potable water sources successfully addressed the source of contamination.
Yogo A, Milner AL, Cadnum JL
… +2 more, Torres-Teran MM, Donskey CJ
Am J Infect Control
· 2026 Jun · PMID 41539391
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BACKGROUND: We hypothesized that an ultraviolet-C (UV-C) light wand would be as efficacious as a disinfectant wipe for disinfection of portable equipment with the potential for lower carbon and plastic footprints. METHOD...BACKGROUND: We hypothesized that an ultraviolet-C (UV-C) light wand would be as efficacious as a disinfectant wipe for disinfection of portable equipment with the potential for lower carbon and plastic footprints. METHODS: We tested the efficacy of a UV-C wand against methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile spores on steel disks and inoculated computer keyboards. The efficacy of the UV-C wand was compared to a quaternary ammonium-alcohol wipe for disinfection of portable equipment and keyboards. We calculated potential reductions in carbon and plastic footprints if this device replaced ready-to-use wipes. RESULTS: On disks, 20- and 40-second UV-C exposures reduced MRSA and C difficile spores by > 3 log. On inoculated computer keys, 20- and 40-second cycles distributed over the entire keyboard reduced MRSA, but not C difficile spores, by > 3 log. On real-world equipment, a 40-second UV-C exposure was as efficacious as the disinfectant wipe in reducing vegetative pathogens and total aerobic colony counts, but less efficacious in reducing aerobic colonies to undetectable levels. We estimated that use of the device could substantially reduce carbon and plastic footprints. CONCLUSIONS: Use of the UV-C device rather than ready-to-use disinfectant wipes for shared equipment could substantially reduce plastic and carbon footprints.
Stone A, Nolt D, Ali R
… +4 more, Kim Y, Caverly LJ, Gold JA, Qin X
Am J Infect Control
· 2026 Jun · PMID 41520924
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BACKGROUND: Burkholderia cepacia complex (BCC) is a cause of health care-associated infections in immunocompromised patients and people with cystic fibrosis (PwCF). This report summarizes a B contaminans pseudo-outbreak...BACKGROUND: Burkholderia cepacia complex (BCC) is a cause of health care-associated infections in immunocompromised patients and people with cystic fibrosis (PwCF). This report summarizes a B contaminans pseudo-outbreak related to improper laboratory processes affecting surgical specimens from immunocompetent individuals and respiratory cultures from PwCF. METHODS: In October 2024, an increase in BCC isolates involving surgical, respiratory, and urine specimens occurred at an academic tertiary hospital. An investigation was launched involving the electronic clinical surveillance system, environmental surveillance, and review of laboratory processes. Species identification and genotyping was performed with randomly amplified polymorphic DNA (RAPD) typing. Whole genome sequencing (WGS) was completed for clonality analysis. RESULTS: A total of 19 BCC isolates were included, 17 collected for clinical indications and 2 from reagents during the investigation. BCC was recovered from phosphate-buffered saline (PBS) used for rehydrating surgical samples and Sputolysin (dithiothreitol) diluted with PBS and used to liquify respiratory samples. Species analysis revealed B contaminans in surgical, respiratory, and reagent samples. RAPD typing and WGS confirmed clonality, suggesting that PBS was a source of extrinsic contamination. CONCLUSIONS: This investigation underscores the role of multidisciplinary collaboration, robust electronic health information systems, and microbial genomic tools in infection prevention and control, ensuring timely interventions and patient safety.
Am J Infect Control
· 2026 Apr · PMID 41519385
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Central line-associated bloodstream infection prevention remains challenging in clinical settings. This experience describes how barriers identified through a needs assessment in Brazilian hospitals were translated into...Central line-associated bloodstream infection prevention remains challenging in clinical settings. This experience describes how barriers identified through a needs assessment in Brazilian hospitals were translated into a tailored serious game to support catheter care practices. Using the Octalysis Framework, real-world challenges were converted into interactive missions simulating catheter care. This approach illustrates how context-specific barriers can be operationalized into an educational tool to support health care workers' adherence to central line-associated bloodstream infection prevention measures.
Zules-Oña R, Otero-Romero S, Rodrigo-Pendás JA
… +7 more, Minguell-Monyart J, Amat-Mateu C, Lung M, Martínez-Gómez X, Quintana-Alonso C, Limón E, Parés-Badell O
Am J Infect Control
· 2026 Jun · PMID 41490525
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BACKGROUND: In early 2018, we detected an increase in surgical site infections (SSI) after total knee arthroplasty in a tertiary hospital in Barcelona. We implemented an infection prevention and control (IPC) interventio...BACKGROUND: In early 2018, we detected an increase in surgical site infections (SSI) after total knee arthroplasty in a tertiary hospital in Barcelona. We implemented an infection prevention and control (IPC) intervention reinforcing preventive bundles and reorganizing surgical schedules for high-risk patients and senior surgeons. We aimed to identify SSI-associated factors and evaluate the IPC intervention's impact. METHODS: We conducted a retrospective cohort study in 2018 with 90-day follow-up. SSI rates were compared pre- and post-intervention. Preintervention risk factors were assessed using Cox models. Differences in associated factor distributions were estimated. Kaplan-Meier and log-rank tests evaluated incidence, and a sensitivity analysis was stratified by American Society of Anesthesiologists (ASA) and National Nosocomial Infection Surveillance (NNIS) risk. RESULTS: Among 463 patients, overall SSI incidence was 0.52 per 1,000 patient-days. Incidence significantly declined postintervention (pre: 0.75; post: 0.26; P = .030). Obesity (HR: 3.63; 95% CI: 1.02-12.86) and afternoon surgery (HR: 3.02; 95% CI: 1.02-8.92) were associated. High ASA, NNIS risk, and inadequate prophylaxis significantly decreased (P < .001). The intervention reduced SSI risk by 66% (HR: 0.34; 95% CI: 0.13-0.94; P = .037). A nonsignificant reduction was seen in high-risk strata. CONCLUSIONS: Our study showed the impact of an IPC intervention addressing associated factors and significantly reducing SSI incidence rates.
Am J Infect Control
· 2026 Jun · PMID 41482067
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BACKGROUND: Accurate surveillance for health care-associated infections (HAIs) is essential for infection prevention and regulatory compliance. Despite the availability of National Healthcare Safety Network (NHSN) defini...BACKGROUND: Accurate surveillance for health care-associated infections (HAIs) is essential for infection prevention and regulatory compliance. Despite the availability of National Healthcare Safety Network (NHSN) definitions, variation in application persists, and formal training is not universally required. This study evaluated whether structured surveillance training with annual competency testing improves infection preventionists' (IPs') accuracy in applying standardized HAI definitions over time. METHODS: This longitudinal observational study analyzed annual surveillance test scores from 69 IPs employed by a single consulting company between 2019 and 2024. All IPs completed standardized onboarding and annual competency tests using a validated 20-question case-scenario test bank. Linear mixed-effects models assessed the association between repeated testing and surveillance performance. RESULTS: Repeat testers achieved significantly higher mean scores (mean = 0.83, SD = 0.12) compared to first-time testers (mean = 0.66, SD = 0.18; P < .001). Years of experience significantly predicted higher scores (β = 0.15, P < .001), while certification, surveillance hours, and facility type did not. A nonsignificant upward trend in scores was observed among repeat testers over time. CONCLUSIONS: Structured, repeated surveillance training and testing were associated with improved HAI coding accuracy. These findings support the integration of ongoing competency assessments into infection prevention programs to strengthen data quality and standardization.
Am J Infect Control
· 2026 Jun · PMID 41456764
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BACKGROUND: Personal protective equipment (PPE) is crucial for healthcare personnel to protect against infections from exposure to body fluids containing bloodborne pathogens such as Ebola, HIV, Hepatitis B, and Hepatiti...BACKGROUND: Personal protective equipment (PPE) is crucial for healthcare personnel to protect against infections from exposure to body fluids containing bloodborne pathogens such as Ebola, HIV, Hepatitis B, and Hepatitis C. Despite advancements in PPE materials, interface regions, particularly the junction between gloves and protective clothing, remain vulnerable to fluid leakage. Although taping these interfaces is a common practice, its efficacy has not been thoroughly evaluated. This study examined the barrier performance of various tape models applied at the glove-protective clothing interface using a quantitative fluid leakage test. METHODS: Five tape models; Gorilla Crystal Clear, 3M Contractor Grade Multi-Use Duct tape, Kappler Chemtape, 3M Durapore Surgical tape, and 3M Nexcare tape were evaluated under controlled conditions using a robotic arm that simulated healthcare personnel movements. A 5-second soak exposure followed by motion sequences was conducted, and fluid penetration was quantified by measuring absorption by the inner cotton sleeve. One-way analysis of variance and post-hoc comparisons determined differences among tape models. RESULTS: Gorilla Crystal Clear Tape significantly reduced fluid leakage compared to all other models. 3M Durapore showed the highest leakage, while 3M Nexcare performed moderately. CONCLUSIONS: Taping significantly decreases fluid leakage at the glove-protective clothing interface, though performance depends on tape type. Some tapes may damage garments during removal, underscoring the need to balance barrier efficacy with ease of doffing in PPE use.
Am J Infect Control
· 2026 Jun · PMID 41423146
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BACKGROUND: Hand hygiene is vital to infection prevention, but sustaining high compliance remains an ongoing challenge. This project aimed to determine if a culturally focused hand hygiene program, leveraging existing re...BACKGROUND: Hand hygiene is vital to infection prevention, but sustaining high compliance remains an ongoing challenge. This project aimed to determine if a culturally focused hand hygiene program, leveraging existing resources and context-driven data, could sustain high compliance in an acute care hospital setting. METHODS: In June 2023, our tertiary acute care hospital implemented a hand hygiene program targeting roots of non-compliance. Light-duty nurses and patient care technicians observed compliance through security cameras, provided real-time feedback, and acted as cultural change agents. Context-specific data were leveraged to create targeted education and recognition programs. Results were analyzed using an interrupted time series analysis, logistic regression, and a decision tree algorithm to assess impact and predictors of compliance. RESULTS: 191,403 observations were collected across 11 inpatient units. Overall post-implementation compliance improved by 11.6% (effect size: 0.34). Improvements were observed across all units, roles, and shifts. Significant predictors of compliance were identified, including staff roles and shifts. Improvements were resilient to the hourly census and showed a 54% reduction in the variance of compliance. CONCLUSION: Our program sustainably improved and stabilized hand hygiene compliance. The approach offers a practical and scalable model for institutions seeking to overcome common challenges to achieve sustainable compliance.
Keating JA, Legenza L, McKinley L
… +4 more, Bendixsen C, Lepak AJ, Schweizer ML, Safdar N
Am J Infect Control
· 2026 Jun · PMID 41421794
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BACKGROUND: Clinical decision support tools (ie, electronic alerts) can improve outcomes for patients with Staphylococcus aureus bacteremia (SAB) in hospitals with on-site infectious disease (ID) specialists. However, ma...BACKGROUND: Clinical decision support tools (ie, electronic alerts) can improve outcomes for patients with Staphylococcus aureus bacteremia (SAB) in hospitals with on-site infectious disease (ID) specialists. However, many rural hospitals lack on-site ID consultants and/or electronic health record (EHR) interoperability, presenting challenges for SAB patient care. METHODS: We conducted qualitative interviews with rural hospital employees about SAB management processes and needs and elicited feedback on an EHR alert used at a large urban hospital with on-site ID specialists. We used a rapid qualitative inquiry process to identify interview themes. RESULTS: Rural hospitals had wide variation in existing availability of ID consultations and processes for seeking consultations. Participants provided suggestions for tailoring and implementing an electronic alert encouraging ID consultation within rural hospital work systems. DISCUSSION: Increasing ID consultations, including through EHR alerts in rural hospitals, has many barriers. An EHR alert providing first-line guidance on urgency, therapy, and communication may support guideline-concordant care for SAB within the unique workflows of smaller and more rural hospitals. CONCLUSIONS: Electronic alerts, while useful in hospitals with on-site ID specialists to encourage ID consultations, will need to be tailored and implemented in rural hospitals to achieve similar clinical decision support results.
Knighton S, Torres-Teran M, Cadnum J
… +2 more, Colosimo L, Donskey CJ
Am J Infect Control
· 2026 May · PMID 41421793
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BACKGROUND: Patients' hands can serve as reservoirs for health care-associated and transient pathogens, both of which can contribute to illness and transmission. Most hand hygiene programs target health care workers, eve...BACKGROUND: Patients' hands can serve as reservoirs for health care-associated and transient pathogens, both of which can contribute to illness and transmission. Most hand hygiene programs target health care workers, even though transient bacteria on patients' hands are removable with proper technique. While inpatient initiatives such as the Patients' 4 Moments for Hand Hygiene have reduced contamination, little is known about outpatient settings or the effect of just-in-time education. METHODS: We conducted a prospective before-after pilot study of 61 outpatients at a Veterans Affairs medical center. Each participant provided bilateral hand cultures before and after alcohol-based handrub (ABHR) use, accompanied by just-in-time education based on the Visitors' 4 Moments framework. RESULTS: Before ABHR, 52 of 61 patients (85.2%) had bacterial growth, commonly nonenteric gram-negative rods (27.9%), Enterococcus species (23.0%), and Staphylococcus aureus (16.4%). Health care-associated pathogens included methicillin-resistant S aureus (3.3%) and carbapenem-resistant Enterobacteriaceae (6.6%). After ABHR, 67.2% had no detectable growth (P < .001). Residual growth reflected low-density transient flora. CONCLUSIONS: Outpatients frequently carry transient and health care-associated bacteria capable of causing infection but largely removable with effective ABHR use. A brief, just-in-time education intervention significantly reduced hand contamination, supporting patient-centered hand hygiene as a feasible, low-cost strategy to interrupt transmission in ambulatory care settings.
Am J Infect Control
· 2026 Jun · PMID 41412379
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BACKGROUND: Health care workers' suboptimal influenza vaccination rates persist globally despite occupational risks. This study examines how vaccine literacy dimensions influence their vaccination and recommendation beha...BACKGROUND: Health care workers' suboptimal influenza vaccination rates persist globally despite occupational risks. This study examines how vaccine literacy dimensions influence their vaccination and recommendation behaviors. METHODS: A cross-sectional survey assessed vaccine literacy (fundamental knowledge, core belief, behavioral competency) among 1,725 Chinese health care workers. Multivariate logistic regression analyzed associations with influenza vaccination willingness and recommendation to others. RESULTS: Only 34.09% exhibited behavioral competency literacy, revealing a knowledge-belief-practice gap. Core belief literacy predicted vaccination willingness (odds ratio [OR] = 2.12, 95%CI: 1.70-2.64) and recommendation (OR = 3.43, 95%CI: 2.54-4.62). Behavioral competency literacy also increased vaccination willingness (OR = 2.30, 95%CI: 1.81-2.93). DISCUSSION: Core belief is the critical driver bridging knowledge and practice. Nurses showed significantly lower literacy than physicians (OR = 1.35, 95%CI: 1.08-1.70), warranting targeted interventions. CONCLUSIONS: Addressing the "knowledge-belief-practice dissociation" through belief-focused strategies---not merely knowledge dissemination---is essential to improve influenza vaccine uptake among health care workers.
Tavakoli S, Heidari H, Jambarsang S
… +1 more, Teimouri F
Am J Infect Control
· 2026 Jun · PMID 41407162
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BACKGROUND: This study was investigating bacterial contamination, particularly Legionella pneumophila and multidrug-resistant Pseudomonas aeruginosa, in outlet water of stationary and portable reverse osmosis (RO) system...BACKGROUND: This study was investigating bacterial contamination, particularly Legionella pneumophila and multidrug-resistant Pseudomonas aeruginosa, in outlet water of stationary and portable reverse osmosis (RO) systems used in hemodialysis. Antibiotic resistance, and biofilm-related risks were compared to assess their implications for infection control in clinical settings. METHODS: This study was performed across 3 leading hospital hemodialysis units in Yazd City. Water samples were analyzed for the presence of Staphylococcus aureus, P aeruginosa, L pneumophila, and heterotrophic plate count bacteria. RESULTS: The output water from 36.11% of RO systems tested positive for L pneumophila, while 15.28% contained P aeruginosa and 6.94% contained heterotrophic bacteria. Portable RO systems showed significantly higher contamination levels of Legionella and heterotrophic bacteria compared to stationary units (P-value = .002). Antibiotic susceptibility testing demonstrated concerning resistance patterns among P aeruginosa isolates: 72.73% were resistant to piperacillin, 63.64% to piperacillin-tazobactam, and 45.46% to imipenem. Notably, 52.2% of isolates exhibited multidrug-resistant profiles. CONCLUSIONS: Portable RO systems demonstrated significantly greater Legionella contamination than stationary units, likely due to biofilm formation. This poses serious infection risks for hemodialysis patients, potentially leading to extended hospitalizations and increased mortality. Mandatory quarterly microbiological monitoring and biofilm-targeted disinfection protocols are recommended for portable systems.
Baklouti AJ, Catanzaro AT, Elson N
… +11 more, Ankrah M, Rost J, Parsia S, Yates B, McDermott L, Agatep A, Morgan K, Singh S, Escareno P, Chen C, Frederick A
Am J Infect Control
· 2026 Jun · PMID 41391714
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BACKGROUND: Few studies describe quantitative thresholds for daily device review that attempt to drive a decrease in device utilization (DU) for central venous catheter devices. Increased DU in the period spanning March...BACKGROUND: Few studies describe quantitative thresholds for daily device review that attempt to drive a decrease in device utilization (DU) for central venous catheter devices. Increased DU in the period spanning March 2020 through December 2021 paralleled an increased incidence of central line-associated bloodstream infections (CLABSI) within a Medical Surgical Intensive Care Unit (ICU) of an acute care hospital. An intervention tool was developed to foster targeted discussions around DU to ultimately reduce the risk of CLABSI. METHODS: An evidence-based performance improvement initiative was implemented in March 2022 which included the deployment of an ICU Rounding Checklist tool to drive ICU intensivist signature sign-off of standardized device indications in collaboration with ICU nurses. RESULTS: Significantly fewer central venous catheters were present in ICU patients following implementation of the intervention, χ(1) = 7.06, P < .01. Concurrently, zero CLABSI events were encountered during the 32-month intervention evaluation period. CONCLUSIONS: In addition to evidence-based bundle compliance elements and leadership visibility of device de-escalation opportunities, hospitals should optimize methods to encourage collaborative discussions between nurses and physicians to impact central venous catheter utilization, reducing the risk of CLABSIs.
Rodrigues BF, Constantino PMR, De Menezes IRDSC
… +4 more, Iida LIS, Chiaratto VC, Padoveze MC, Gnatta JR
Am J Infect Control
· 2026 Jun · PMID 41391713
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BACKGROUND: Hospital-acquired pneumonia (HAP) remains a common health care-associated infection worldwide. Understanding risk factors for nonventilated HAP (NVHAP) in postoperative patients is crucial for targeted preven...BACKGROUND: Hospital-acquired pneumonia (HAP) remains a common health care-associated infection worldwide. Understanding risk factors for nonventilated HAP (NVHAP) in postoperative patients is crucial for targeted prevention strategies. METHODS: A retrospective case-control study was conducted from April 2022 to April 2023 in a surgical ward of a university hospital. Cases included patients aged ≥ 18 years diagnosed with NVHAP. Controls were selected based on the closest hospitalization date, matched by sex, age, and surgery type (2 controls per case). Data on patient demographics, surgical procedures, and clinical factors were collected and analyzed. RESULTS: Out of 1,739 hospitalized patients, 10 developed NVHAP, resulting in a sample of 30 individuals (mean age 63.27 years). Exploratory laparotomy was the most common surgery. Multivariate analysis identified vomiting as the only independent risk factor (P < .001), significantly associated with HAP occurrence. DISCUSSION: Vomiting was significantly linked to NVHAP, suggesting that management of nausea and vomiting could reduce the risk of bronchopulmonary aspiration and subsequent pneumonia in postoperative patients. CONCLUSIONS: Implementing protocols for early detection and control of nausea and vomiting in surgical patients may decrease NVHAP incidence, emphasizing the need for preventive strategies targeting aspiration risk.
Kwon S, Park Y, Sung M
… +3 more, Kim JY, Kim J, Jeong D
Am J Infect Control
· 2026 Jun · PMID 41391712
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BACKGROUND: During the COVID-19 pandemic, hospitals in South Korea operated various types of negative pressure isolation units (NPIUs), ranging from makeshift conversions to purpose-built wards. While vaccination and per...BACKGROUND: During the COVID-19 pandemic, hospitals in South Korea operated various types of negative pressure isolation units (NPIUs), ranging from makeshift conversions to purpose-built wards. While vaccination and personal protective equipment were essential in reducing occupational exposure, the impact of physical infrastructure on the safety of health care workers remains underexplored. This study examined whether nurses' infection risk varied by the level of isolation ward infrastructure. METHODS: Infection data were collected from a public hospital between February 2022 and June 2023. Four ward types were evaluated: general wards and 3 government-classified NPIUs, each differing in infection control infrastructure. Infection rates per 1,000 nurse-days were calculated. Differences across ward types were analyzed using negative binomial regression, post-hoc comparisons, and permutation tests accounting for temporal overlap. RESULTS: A facility-level gradient in infection risk was observed. The highest rate occurred in a minimally converted unit (21.62), followed by a partially remodeled unit (5.14). A purpose-built NPIU maintained a low infection rate (1.30), comparable to that of the general ward (0.97). CONCLUSIONS: The risk of nurse infection was associated with the level of integrated infection control infrastructure. Purpose-built systems substantially reduced occupational exposure.
Abbas S, Jamil F, Shaikh A
… +11 more, Ilyas S, Bin Masood A, Afzal MU, Touseef A, Noor A, Wasim-Ud-Din M, Akbar MT, Ali S, Nazir MA, Mukhtar A, Sultan F
Am J Infect Control
· 2026 Apr · PMID 41386299
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We conducted a retrospective study to evaluate the performance of 5 large language models in detecting surgical site infections (SSIs), compared with manual surveillance by an infection preventionist nurse. Forty abdomin...We conducted a retrospective study to evaluate the performance of 5 large language models in detecting surgical site infections (SSIs), compared with manual surveillance by an infection preventionist nurse. Forty abdominal surgery patients were included. Manual review achieved 100% diagnostic accuracy. All large language models demonstrated high accuracy (90%-95%) and strong agreement with manual review (κ = 0.80-0.90), with no statistically significant differences in performance (P > .05). AI-based tools may enhance the efficiency of surgical site infection surveillance.
Auld D, Broadley M, de Abreu A
… +6 more, Gomes MF, Jackson G, Leszczynski J, Martinez M, Parente S, Gibas KM
Am J Infect Control
· 2026 Jun · PMID 41371303
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BACKGROUND: Hand hygiene is the cornerstone of infection prevention; however, many health care institutions struggle to achieve consistently high health care personnel (HCP) compliance. Engaging patients/visitors in hand...BACKGROUND: Hand hygiene is the cornerstone of infection prevention; however, many health care institutions struggle to achieve consistently high health care personnel (HCP) compliance. Engaging patients/visitors in hand hygiene interventions is an important strategy to improve accountability and compliance. METHODS: We piloted a program enabling patients/visitors to audit HCP hand hygiene practices across 3 acute care hospitals and a pediatric/adolescent behavioral health hospital. An initial pilot ran from August 2024 to January 2025 in 1 outpatient clinic and 5 inpatient units across 4 hospitals before being expanded to all inpatient units and select on-site outpatient areas across these hospitals. Patient/visitor participants submitted anonymous audits via QR code or paper forms, documenting HCP hand hygiene and comfort prompting staff to perform hand hygiene. RESULTS: Participants completed 360 hand hygiene audits, with observed HCP compliance of 86% (286/326), aligning with staff-reported compliance of 88% (126,653/144,214). HCP compliance observed by patients/visitors varied by hospital (77%-97%). 78% (254/324) of participants reported feeling comfortable prompting HCP to perform hand hygiene. Discomfort was associated with lower observed compliance across all sites. CONCLUSIONS: Patient and visitor auditing of HCP hand hygiene is feasible, acceptable, and may enhance accountability, representing a scalable, patient-centered adjunct to traditional compliance programs.
Skuntaniyom S, Techasaensiri C, Muntajit T
… +1 more, Piebpien P
Am J Infect Control
· 2026 Jun · PMID 41371302
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BACKGROUND: While screening-automated surveillance systems (SASS) for surgical site infections (SSIs) are widely used in high-resource settings, adoption remains limited in low- and middle-income countries, including Tha...BACKGROUND: While screening-automated surveillance systems (SASS) for surgical site infections (SSIs) are widely used in high-resource settings, adoption remains limited in low- and middle-income countries, including Thailand. This study aimed to develop and validate an automated surveillance model tailored to the Thai health care context. Routine SSI surveillance following coronary artery bypass graft surgery in Thailand relies on direct method surveillance systems (DMSS), which are labor-intensive and require manual record review. METHODS: A retrospective validation study was conducted at a tertiary care hospital performing ∼120 coronary artery bypass graft procedures annually. Data from January 2020 to April 2022, when both DMSS and SASS were active, were analyzed to assess diagnostic performance and workload reduction. RESULTS: Among 4 algorithms tested, the "Possible SSI Surveillance Code" algorithm achieved 100% sensitivity (95% CI: 78.47-100), 91.69% specificity (95% CI: 88.18-94.23), a positive predictive value of 34.15% (95% CI: 21.56-49.45), and a negative predictive value of 100% (95% CI: 98.27-100). It also reduced manual workload by 87.91%. CONCLUSIONS: SASS demonstrated high diagnostic accuracy and substantial workload reduction compared to DMSS. The selected algorithm provides a scalable model for enhancing SSI surveillance in low- and middle-income country settings and advancing digital health transformation.
Am J Infect Control
· 2026 Jun · PMID 41371301
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BACKGROUND: To estimate the global prevalence of carbapenem-resistant Enterobacteriaceae (CRE) colonization and identify study-level factors associated with variation in reported rates. METHODS: We conducted a systematic...BACKGROUND: To estimate the global prevalence of carbapenem-resistant Enterobacteriaceae (CRE) colonization and identify study-level factors associated with variation in reported rates. METHODS: We conducted a systematic review and meta-analysis. Data were extracted on study characteristics, diagnostic methods, CRE species, carbapenemase genes, and risk factor analysis. Pooled prevalence was calculated using a random-effects model. Subgroup analyses and meta-regression were conducted to explore sources of heterogeneity. RESULTS: Across 89 studies (116,743 participants), pooled CRE colonization prevalence was 14% (95% CI: 11%-18%; I² = 99.96%), peaking at 33% in 2017 and declining to 8% in 2023. Vietnam had the highest (43%), US had the lowest (5%). Hospital-based (18%) and universal screening (20%) yielded higher prevalence than community-based (3%) and targeted/systematic sampling (3%-15%). Hospital setting was the only significant predictor of higher prevalence (coefficient = 0.14; P = .009). Klebsiella pneumoniae (52.8%) and Escherichia coli (44.9%) were the most common organisms; NDM (45.6%) and OXA-type (36.3%) were predominant carbapenemase genes. CONCLUSIONS: CRE colonization remains a global concern, particularly in health care settings with screening protocols. Geographic and methodological variability underscores the need for standardized surveillance and targeted control strategies. Molecular surveillance is essential to monitor resistance determinants evolution.