Russell D, McDonald MV, Chastain AM
… +9 more, Xu Z, Vergez SM, Onorato N, Brasch J, Ramos E, Wang J, Perera UGE, McGoldrick M, Shang J
Am J Infect Control
· 2026 May · PMID 41354274
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BACKGROUND: Home health care (HHC) patients face elevated infection risks, yet adherence to infection prevention and control (IPC) practices by patients and caregivers remains understudied. This study assessed IPC-relate...BACKGROUND: Home health care (HHC) patients face elevated infection risks, yet adherence to infection prevention and control (IPC) practices by patients and caregivers remains understudied. This study assessed IPC-related knowledge, attitudes and practices in this population. METHODS: Surveys were administered to HHC patients at high/very high infection risk or their family caregivers from two large Medicare-certified HHC agencies in New York State. RESULTS: Among 250 respondents (132 HHC patients, 118 caregivers), participants demonstrated adequate IPC knowledge (mean proportion = 0.77), attitudes (mean proportion = 0.88), and adherence (mean proportion = 0.79). However, handwashing knowledge needed improvement (mean proportion = 0.63). Regression analyses showed higher IPC knowledge and more favorable attitudes predicted better IPC practice adherence. DISCUSSION: Unlike prior research among HHC nurses where only attitudes predicted practices, both knowledge and attitudes were associated with adherence among patients and caregivers. CONCLUSIONS: Interventions should enhance IPC knowledge, particularly proper handwashing, and emphasizing infection prevention importance to improve adherence among HHC patients and caregivers, especially older populations.
Gómez-Sánchez N, Alcalde L, Sancho-Chust JN
… +7 more, Boira I, Gálvez B, Esteban V, Chiner E, Yubero E, Colom MF, Ferrer C
Am J Infect Control
· 2026 May · PMID 41352485
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BACKGROUND: Health care professionals face a heightened risk of occupational infections, with procedures such as bronchoscopy further increasing this risk by generating aerosols containing diverse microorganisms. This st...BACKGROUND: Health care professionals face a heightened risk of occupational infections, with procedures such as bronchoscopy further increasing this risk by generating aerosols containing diverse microorganisms. This study quantified bioaerosol concentrations during bronchoscopy to evaluate occupational exposure. METHODS: Aerosol samples were collected during routine bronchoscopies in 2 hospitals using personal samplers with quartz filters attached to health care professional's clothing. Samples were cultured on various media, with bacterial colonies identified by 16S rDNA sequencing and fungal colonies by ITS1-2 region sequencing. Respiratory viruses (SARS-CoV-2, influenza A/B, RSV) were detected via RT-PCR. RESULTS: A total of 44 aerosol samples were collected: 7 pre-procedure, 32 during bronchoscopy, and 5 between patients. From samples taken during bronchoscopies, 287 microbial colonies were isolated. The most abundant bacterial genera were Micrococcus, Staphylococcus, and Bacillus, while fungal genera included Aspergillus, Talaromyces and Cladosporium. Several potentially pathogenic species were identified, such as Staphylococcus aureus, Kocuria rosea, and Kroppenstedtia pulmonis, as well as some pathogenic fungi. A total of 8 previously unsuspected SARS-CoV-2 positive samples were also detected. Our estimates suggest that an interventionalist, without protective equipment, could be exposed to approximately 98.94 CFU/m during a typical procedure. CONCLUSIONS: Bronchoscopy generates aerosols containing microorganisms from the oral, nasal, and pulmonary microbiota, as well as potential pathogens. These aerosols can be inhaled by health care workers, representing a risk of occupational infection.
Madran B, Genç Z, Abdel-Rahman SM
… +3 more, Bayıcı BZ, Keske Ş, Ergönül Ö
Am J Infect Control
· 2026 May · PMID 41344614
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BACKGROUND: Pandemics pose extraordinary challenges to health care systems. Breakdowns in infection prevention and control measures during such crises can significantly compromise patient outcomes and facilitate the spre...BACKGROUND: Pandemics pose extraordinary challenges to health care systems. Breakdowns in infection prevention and control measures during such crises can significantly compromise patient outcomes and facilitate the spread of resistant pathogens. This study aimed to describe the characteristics and impact of bacterial and fungal hospital outbreaks during the COVID-19 pandemic. METHODS: This systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and were registered in PROSPERO (CRD42025648727). RESULTS: A total of 619 outbreak-related cases were identified (62.9% male; age range: 21-101) in 25 studies. Acinetobacter baumannii was the most frequently reported (n = 320) pathogen with the highest mortality rate (59%), followed by Candida auris (n = 188, 52% mortality). Two-thirds of outbreaks (66.66%) with reported resistance data had all strains multidrug-resistant. Health care worker-related factors, such as a lack of personnel, insufficient training, and increased workload, were mainly cited as contributors to secondary hospital outbreaks. The maintenance of environmental cleaning and disinfection was often prioritized over hand hygiene. CONCLUSIONS: To prevent secondary hospital outbreaks of multidrug-resistant in the future, infection prevention and control programs should be strengthened with increased staff awareness, sustainable environmental hygiene, and antimicrobial stewardship interventions. These findings should be incorporated into pandemic preparedness frameworks and implemented through multidisciplinary audits to ensure sustainability.
Umekage Y, Shigaki R, Kida R
… +4 more, Yoshida R, Minami Y, Ohsaki Y, Sasaki T
Am J Infect Control
· 2026 May · PMID 41319810
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BACKGROUND: Considering the isolation of infected patients and the proportion of critically ill individuals requiring single-room management is crucial when implementing public health measures during nosocomial outbreaks...BACKGROUND: Considering the isolation of infected patients and the proportion of critically ill individuals requiring single-room management is crucial when implementing public health measures during nosocomial outbreaks such as coronavirus disease-2019. Using a mathematical model, we aimed to assess the level of hospital occupancy restriction required for the adequate isolation of infected and exposed patients while providing for critically ill patients requiring single-room management. METHODS: Patients were categorized into four groups: susceptible, exposed, infected, and recovered. We modeled a hospital ward with mixed room types, incorporating critically ill patients and sporadic unidentified infections, to evaluate isolation feasibility through simulations. RESULTS: Simulation results showed that patient isolation became difficult under high-occupancy conditions. The feasibility was also affected by infection control strategies, such as discharging infected or exposed patients and isolating exposed individuals in single rooms. DISCUSSION: Higher occupancy increases the risk of failed isolation measures, potentially promoting in-hospital transmission. However, this model does not incorporate long-distance airborne transmission or the effects of ventilation, and coronavirus disease-2019 can spread via aerosols. CONCLUSIONS: This model could be a valuable reference for determining appropriate hospital occupancy rates to ensure effective infection control during nosocomial outbreaks.
Hwang M, Jinadatha C, Choi H
… +3 more, Cadnum JL, Kim A, Donskey CJ
Am J Infect Control
· 2026 Mar · PMID 41317997
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Infectious complications are rare after transperineal prostate biopsy, and antibiotic prophylaxis may not be needed for most procedures. We report a case of Staphylococcus epidermidis urinary tract infection and bacterem...Infectious complications are rare after transperineal prostate biopsy, and antibiotic prophylaxis may not be needed for most procedures. We report a case of Staphylococcus epidermidis urinary tract infection and bacteremia after transperineal prostate biopsy. This case highlights the importance of infection control interventions to ensure effective skin preparation prior to transperineal prostate biopsy procedures.
Desai AN, Kingsley A, Rilloraza M
… +5 more, Mcglynn C, Reilly M, Bays DJ, Thompson GR, Cohen SH
Am J Infect Control
· 2026 Mar · PMID 41317996
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OBJECTIVES: Candidozyma auris (C auris) is a multidrug-resistant fungal pathogen of increasing global concern. We describe the development and validation of an active surveillance program for patients at high risk of C a...OBJECTIVES: Candidozyma auris (C auris) is a multidrug-resistant fungal pathogen of increasing global concern. We describe the development and validation of an active surveillance program for patients at high risk of C auris colonization in the setting of regionally reported cases of invasive infection. METHODS: From 2021 to 2024, 1,146 surveillance tests were obtained using the BD ESwab collection system. Surveillance testing was performed on the BD MAX PCR platform. RESULTS: Of 1,146 specimens tested over a 3-year period, only four surveillance tests were positive. Individuals with positive surveillance tests were isolated, and contact tracing of potentially exposures revealed no secondary cases. CONCLUSIONS: This report demonstrates the importance of establishing hyperlocal epidemiology and robust infection prevention practices when determining the prevalence of and responding to emerging pathogens.
Am J Infect Control
· 2026 May · PMID 41314422
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BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) colonization pressure (CP) may drive transmission in pediatric intensive care units (PICUs). We evaluated the associations of MRSA colonization and CP with i...BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) colonization pressure (CP) may drive transmission in pediatric intensive care units (PICUs). We evaluated the associations of MRSA colonization and CP with invasive infection, acquisition, and the impact of universal chlorhexidine bathing. METHODS: We retrospectively analyzed patients admitted to 2 PICUs in a tertiary hospital in South Korea (2016-2020). MRSA colonization was identified using weekly nasal/endotracheal surveillance and classified as acquired (on or after day 3 of admission) or imported (at admission). CP was defined as the monthly percentage of MRSA-positive patient-days. RESULTS: MRSA colonization was identified in 8.4% of 5,789 patients and 3.1% of acquired cases. Invasive infections occurred in 3.3% of colonized versus 0.1% of non-colonized patients (relative risk [RR], 22.2; 95% confidence interval [CI], 9.0-54.8), with higher risk in acquired (RR, 40.8) than imported (RR, 12.8). A CP of > 21.3% doubled the acquisition risk (OR, 2.0; 95%CI, 1.3-3.1) and quadrupled the infection risk (RR, 4.4; 95% CI, 0.9-20.5). Chlorhexidine bathing had no significant effects. CONCLUSIONS: MRSA colonization-especially acquired-significantly increased the risk of invasive infection. Elevated CP levels were associated with increased acquisition and potential infections. These findings support comprehensive infection control strategies incorporating CP monitoring and colonization management in PICUs.
Am J Infect Control
· 2026 May · PMID 41297768
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BACKGROUND: Family caregivers often provide direct bedside care in hospitals but are typically excluded from infection prevention efforts. Despite their frequent contact with patients and the environment, little is known...BACKGROUND: Family caregivers often provide direct bedside care in hospitals but are typically excluded from infection prevention efforts. Despite their frequent contact with patients and the environment, little is known about cognitive and belief-based predictors of their hand hygiene performance. METHODS: This cross-sectional study included 134 family caregivers from 2 general hospitals in South Korea. A structured questionnaire based on the Health Belief Model assessed hand hygiene performance and its predictors, including perceived susceptibility, severity, benefits, barriers, cues to action, knowledge, and self-efficacy. Multiple linear regression identified significant predictors. RESULTS: Hand hygiene performance was significantly associated with perceived benefits (β = 0.29, P = .002), perceived barriers (β = 0.24, P = .001), knowledge (β = 0.16, P = .032), habitual use of hand sanitizer (β = 0.23, P = .003), and age (β = 0.32, P < .001). The model explained 36.0% of the variance (adjusted R² = 0.359). Self-efficacy and other constructs showed limited predictive value. CONCLUSIONS: This study highlights the role of cognitive and contextual factors in promoting hand hygiene among family caregivers. Interventions should emphasize perceived benefits and knowledge while addressing behavioral and environmental barriers. Findings support the inclusion of family caregivers as active participants in infection prevention strategies.
Doran B, Cook M, Geary L
… +7 more, Ellis D, Zabriskie K, Bell J, Levine A, Naik S, Gilman M, Reese SM
Am J Infect Control
· 2026 Feb · PMID 41297767
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BACKGROUND: Infection preventionists' (IPs) role can be jeopardized by imbalance between expanding responsibilities and limited resources. Challenges of stress and burnout among IPs can lead to turnover and struggles wit...BACKGROUND: Infection preventionists' (IPs) role can be jeopardized by imbalance between expanding responsibilities and limited resources. Challenges of stress and burnout among IPs can lead to turnover and struggles with staffing and workloads. The goal of this project was to measure burnout and evaluate the impact of a burnout assessment on a population of IPs. METHODS: IPs from Association for Professionals in Infection Control and Epidemiology were recruited to participate. Participants completed a pre-survey, the Maslach Burnout Inventory (MBI) assessment, and a post-survey. Results from the pre- and post-survey were compared to determine changes in burnout awareness and perception following completion of the MBI. Results from the MBI were compared with the general population and between chapters. RESULTS: There were 65 participants who completed all 3 phases of the project. The MBI scores revealed patterns in burnout indicators within respondents. Almost 75% (73.9%, n=48) of participants reported the MBI tool provided useful information and almost 70% (67.7%, n=44) believed the MBI tool increased self-awareness about burnout. CONCLUSIONS: Burnout is a significant challenge for this pilot IP population. This project highlights the need for continued burnout evaluation and resource provision. Organizations and IP leaders must proactively support IPs to prevent burnout.
Delvecchio G, Vimercati L, Danza PA
… +1 more, De Maria L
Am J Infect Control
· 2026 Mar · PMID 41290099
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The reapplication of an ad hoc prevention protocol during a scabies outbreak at a University Hospital in 2024 resulted in a substantial reduction in scabies cases and limited the spread, compared to the previous outbreak...The reapplication of an ad hoc prevention protocol during a scabies outbreak at a University Hospital in 2024 resulted in a substantial reduction in scabies cases and limited the spread, compared to the previous outbreak in 2022. The protocol's effectiveness, demonstrated by lower prevalence and confined transmission, confirms its potential as a replicable model for the management of nosocomial scabies in health care settings, especially in the absence of standardized international guidelines.
Ge T, Feng H, Ni L
… +8 more, Wang F, Zhan Q, Zhao N, Shangguan Y, Chen H, Shen P, Cai H, Qu T
Am J Infect Control
· 2026 May · PMID 41276087
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BACKGROUND: Carbapenem-resistant organisms (CROs) are among the most concerning antimicrobial resistance pathogens, especially in intensive care units (ICUs). The role of environmental contamination in the transmission o...BACKGROUND: Carbapenem-resistant organisms (CROs) are among the most concerning antimicrobial resistance pathogens, especially in intensive care units (ICUs). The role of environmental contamination in the transmission of CROs has been increasingly recognized. The aim of this study was to establish a replicable strategy on CROs' infection prevention and control (IPC) in ICUs. METHODS: This study was conducted in 4 phases. Environmental surveillance of CROs was conducted in ICUs every month to identify specific risks, and targeted IPC measures were implemented accordingly. Incidence rates of CRO-related healthcare-associated infections (HAIs) were calculated in each phase to assess the effectiveness of the IPC strategies. RESULTS: The detection of CROs in the ICU environment showed a downtrend during the study, with a significant decrease from 3.27% in baseline phase to 1.07% in phase III (P < .05). The detection of CROs in the open-bay ICU environment was significantly higher than that in the single-patient room ICU at baseline (3.97% vs 1.51%, P < .05) and became comparable in phase III after the implementation of our IPC strategies. The incidence of CRO-related HAIs per 1,000 ICU patient-days also decreased significantly from 2.333 in the baseline phase to 1.143 in phase III (P < .001). CONCLUSIONS: Our environmental surveillance-driven CRO IPC strategies were associated with reductions in environmental CRO contamination and CRO-related HAIs in ICUs; however, the results were limited by unmeasured confounders and the quasi-experimental design.
Am J Infect Control
· 2026 May · PMID 41270907
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BACKGROUND: Automatic disinfection technologies have been developed to improve the reliability and thoroughness of hospital disinfection. However, it is not clear whether automated systems can achieve similar disinfectio...BACKGROUND: Automatic disinfection technologies have been developed to improve the reliability and thoroughness of hospital disinfection. However, it is not clear whether automated systems can achieve similar disinfection results to those obtained by well-trained professionals using manual methods. We evaluated the disinfection efficacies of automatic and manual plasma-treated hydrogen peroxide mist (PTHPM) systems in various hospital environments. METHODS: Disinfection was performed in 23 rooms in a teaching hospital, covering various hospital wards, outpatient departments, and emergency rooms. Overall, 459 surfaces were swabbed before and after disinfection. Only gram-positive bacteria were analyzed statistically owing to the low prevalence of gram-negative bacteria and molds. RESULTS: Before disinfection, the viability of gram-positive bacteria, based on colony-forming units, was highest in outpatient departments, followed by emergency rooms and hospital wards using both automatic and manual disinfection. Automatic PTHPM disinfection reduced the colony-forming units of gram-positive bacteria significantly in various environments. There were no significant differences in the effectiveness of automated and manual PTHPM disinfection. CONCLUSIONS: Automated PTHPM disinfection can be as effective as manual PTHPM disinfection in eliminating microbial contamination in teaching hospital environments.
Gagnon J, Naïmi M, Bergeron F
… +11 more, Longtin Y, Villeneuve J, Boudaoud K, Jolicoeur-Ouellette D, Xu HH, Cormier É, Guertin JR, Marx T, Adadja J, Bluteau A, Berthelot S
Am J Infect Control
· 2026 Apr · PMID 41265491
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BACKGROUND: This systematic review aimed to assess the effectiveness of full personal protective equipment (PPE) in preventing COVID-19 transmission among health care workers. METHODS: Studies published from December 201...BACKGROUND: This systematic review aimed to assess the effectiveness of full personal protective equipment (PPE) in preventing COVID-19 transmission among health care workers. METHODS: Studies published from December 2019 to August 2024 were searched in MEDLINE, Embase, Cochrane Library, CINAHL, Epistemonikos, ClinicalTrials.gov, MedRxiv, and Web of Science. Full PPE was defined as the combination of respiratory protection (surgical mask, N95, or equivalents), eye protection (visor or goggles), gown, and gloves, as recommended by the World Health Organization (WHO). The comparator was partial PPE or no PPE. Two reviewers independently performed screening, data extraction, and risk of bias assessment. The review was registered on PROSPERO (CRD4202230259). RESULTS: Eight observational studies were included; 4 showed a significant reduction in transmission with full PPE. Seven studies compared full to partial PPE, and 1 compared full PPE to no protection. Among studies with significant results, odds ratios ranged from 0.03 to 0.6. Risk of bias was critical in 6 studies and serious in 2. No meta-analysis was performed due to study quality. CONCLUSION: Full PPE appears protective for health care workers. The small number and low quality of studies limit the certainty of this conclusion. Further analyses are required to establish clear guideline for its use.