抗菌素耐药性和感染控制是一个全球论坛，面向所有致力于预防、诊断和治疗卫生保健相关感染以及所有卫生保健机构的抗菌素耐药性发展的人。该杂志涵盖了顶级干预和转化研究的广泛卓越实践和最佳可用数据，以及感染控制领域的创新发展。

Antimicrobial Resistance and Infection Control is a global forum aimed at all those dedicated to the prevention, diagnosis, and treatment of healthcare-associated infections, as well as the development of antimicrobial resistance in healthcare settings. The journal covers a wide range of excellence in top interventions and translational research, showcasing best practices and the best available data, along with innovative developments in the field of infection control.

《Antimicrobial Resistance and Infection Control》是一个全球性的论坛，旨在为所有致力于预防、诊断和治疗与卫生保健相关的感染，以及关注抗菌素耐药性发展的卫生保健机构提供交流平台。该杂志涵盖了顶尖的干预措施和转化研究，展示了感染控制领域的最佳实践和最新数据，以及创新的发展动态。

Antimicrobial Resistance and Infection Control

Abstract Background Antimicrobial resistance (AMR) is one of the leading global public health threats of the 21st Century. Antimicrobial stewardship (AMS) programmes have been shown to improve antibiotic use and clinical outcomes in high-income settings, but context-specific evidence is lacking on the value and effectiveness of current AMS programmes in low-resource settings. This study sought to explore context-specific underlying barriers to AMS implementation in Indonesian hospitals with a focus on governance practices and structural vulnerabilities. Methods We conducted semi-structured interviews with physicians, surgeons, clinical microbiologists, pharmacists, AMS team leaders, hospital managers, medical students, and national AMR stakeholders, and performed a thematic analysis. Results Based on 51 interviews conducted between January and October 2020, four main barriers to AMS implementation were evident in the participants' experiences: (1) Ineffective resourcing and institutional buy-in regarding mandatory AMS under hospital accreditation; (2) Entangled priorities to generate profits and interprofessional relationships between doctors and hospital managers or AMS leaders; (3) Cost-prohibitive bacterial culture testing and thresholds of national health insurance coverage; (4) Unreliable infrastructures , including microbiology laboratory and surgical facilities, ensuring high antibiotic usage to cover structural vulnerabilities. Conclusions Limited progress will be made with implementing AMS in Indonesian hospitals, and in settings with similar structural features, without addressing concerns around governance, competing interests, cost and structural vulnerabilities.

Ralalicia Limato

Alex Broom

Erni J. Nelwan

Raph L. Hamers

A qualitative study of barriers to antimicrobial stewardship in Indonesian hospitals: governance, competing interests, cost, and structural vulnerability

印度尼西亚医院抗菌药物管理障碍的定性研究：治理、利益冲突、成本和结构性脆弱性

Abstract Background Qualitative work has described the differences in prescribing practice across medical and surgical specialties. This study aimed to understand if specialty impacts quantitative measures of prescribing practice. Methods We prospectively analysed the antibiotic prescribing across general medical and surgical teams for acutely admitted patients. Over a 12-month period (June 2016 – May 2017) 659 patients (362 medical, 297 surgical) were followed for the duration of their hospital stay. Antibiotic prescribing across these cohorts was assessed using Chi-squared or Wilcoxon rank-sum, depending on normality of data. The t-test was used to compare age and length of stay. A logistic regression model was used to predict escalation of antibiotic therapy. Results Surgical patients were younger ( p &lt; 0.001) with lower Charlson Comorbidity Index scores ( p &lt; 0.001). Antibiotics were prescribed for 45% (162/362) medical and 55% (164/297) surgical patients. Microbiological results were available for 26% (42/164) medical and 29% (48/162) surgical patients, of which 55% (23/42) and 48% (23/48) were positive respectively. There was no difference in the spectrum of antibiotics prescribed between surgery and medicine ( p = 0.507). In surgery antibiotics were 1) prescribed more frequently ( p = 0.001); 2) for longer ( p = 0.016); 3) more likely to be escalated ( p = 0.004); 4) less likely to be compliant with local policy ( p &lt; 0.001) than medicine. Conclusions Across both specialties, microbiology investigation results are not adequately used to diagnose infections and optimise their management. There is significant variation in antibiotic decision-making (including escalation patterns) between general surgical and medical teams. Antibiotic stewardship interventions targeting surgical specialties need to go beyond surgical prophylaxis. It is critical to focus on of review the patients initiated on therapeutic antibiotics in surgical specialties to ensure that escalation and continuation of therapy is justified.

E. Charani

E. de Barra

T. M. Rawson

D. Gill

M. Gilchrist

N. R. Naylor

A. H. Holmes

Antibiotic prescribing in general medical and surgical specialties: a prospective cohort study

普通内外科抗生素处方情况：一项前瞻性队列研究

Recognition of carbapenem-resistant gram-negative bacteria (CR-GNB) carriage is frequently delayed, which increases the risk of subsequent infection and transmission. Previously, we developed a scoring system to identify CR-GNB carriage upon intensive care unit (ICU) admission. Although the ICU-CARB score showed satisfactory performance, it has not been externally validated. In this study, therefore, we externally validated the ICU-CARB score. In the previous article, we introduced a risk-scoring system that incorporated seven key variables: neurological disease, high-risk department history, length of stay ≥ 14 days, ICU history, invasive mechanical ventilation, gastrointestinal tube placement, and carbapenem usage. To externally validate the ICU-CARB score, we conducted a study involving patients admitted to the ICUs of four tertiary hospitals between January 2021 and December 2023. Patients from three hospitals were grouped into Cohort I (n = 815) and those from the fourth hospital into Cohort II (n = 1602). Model calibration, discrimination, and performance were then assessed. A total of 2417 patients were included, among which 289 (12%) carried CR-GNB upon ICU admission. Neurological disease, high-risk department history and length of stay ≥ 14 days were still 3 most important contributing factors in the scoring system. The ICU-CARB score exhibited high calibration, with an area under the receiver operating characteristic curve of 0.825 (95% confidence interval [CI], 0.778–0.873) for Cohort I and 0.823 (95% CI, 0.791–0.855) for Cohort II. The ICU-CARB score showed a highly positive association with CR-GNB carriage in both cohort I (C = 0.315; P < 0.001) and Cohort II (C = 0.381; P < 0.001). Despite differences in patient population characteristics, the ICU-CARB score for CR-GNB carriage upon ICU admission exhibited good discrimination in external validation, supporting its potential generalizability to other ICU settings.

Tong Wu

Xiaoli Wang

Ziyun Shen

Zhongwei Zhang

Yuhao Liu

Rong Fang

Qian Wang

Sheng Wang

Quanhong Zhou

Hongping Qu

Yunqi Dai

Ruoming Tan

External validation of the ICU-CARB score to predict carbapenem-resistant gram-negative bacteria carriage in critically ill patients upon ICU admission: a multicenter analysis

ICU-CARB评分预测重症监护病房入院时耐碳青霉烯类革兰氏阴性菌携带的外部验证：一项多中心分析

The necessity of post procedural prophylactic antibiotics following clean surgeries is controversial. While most evidence suggests that there is no benefit from these additional antibiotics and guidelines do not support their use, there is a paucity of evidence as to how often they are still being used and their impact on infection outcomes. The current study assessed the use of prophylactic antibiotics following cardiac implantable electronic device (CIED) implantations in the province of Alberta, and their impact on infection and mortality. We conducted a population-based cohort study in the province of Alberta. Administrative data was used to link all patients ≥ 18 who underwent outpatient CIED implantation from January 1, 2011 through December 31, 2019 to antibiotics commonly used for surgical prophylaxis which were prescribed within 48 h of implantation. The primary outcome, explored with an adjusted Poisson model, was incidence of complex surgical site infection within one year of device implantation. All-cause mortality was a secondary outcome. Post implantation prophylactic antibiotics were used 41% of the time overall, though the rate has been decreasing over time. The most commonly used prophylactic antibiotic was cefalexin (52%). When adjusted analyses were completed, there was no difference in the outcome of infection between those who did and did not receive post implantation prophylactic antibiotics (Relative Risk 0.74, 95% CI 0.46–1.17) and there was no difference in mortality (Relative Risk 0.8, 95% CI 0.63–1.02). The use of prophylactic antibiotics following CIED implantation does not correlate to a reduced rate of complex surgical site infection or reduced mortality. The widespread use of these antibiotics, which is not guideline concordant, suggests the need for targeted antimicrobial stewardship interventions for surgical prophylaxis to ensure that antibiotic use is being optimized. Further work should explore other adverse outcomes associated with this antibiotic usage and stewardship programs should explore interventions to educate and reduce antibiotic use for this indication.

Elissa Rennert-May

Jenine Leal

Zuying Zhang

Irina Rajakumar

Stephanie Smith

John M Conly

Derek Exner

Vikas Kuriachan

Derek Chew

Rates of post procedural prophylactic antibiotic use following cardiac implantable electronic device insertion and the impact on surgical site infections in Alberta, Canada

加拿大阿尔伯塔省心脏植入电子设备术后预防性抗生素使用率及其对手术部位感染的影响

Abstract Background The emergence and spread of Extended-Spectrum Beta-Lactamase (ESBL)-producing Escherichia coli pose significant challenges for treatment of infections globally. This challenge is exacerbated in sub-Saharan African countries, where the prevalence of ESBL-producing E. coli is high. This, combined with the lack of a strong and supportive healthcare system, leads to increased morbidity and mortality due to treatment failures. Notably, studies in Ethiopia have primarily focused on hospital settings, leaving a gap in understanding ESBL prevalence in rural communities, where human-animal proximity may facilitate microbial exchange. Methods We conducted a community-based study in the rural Somali region of Ethiopia, simultaneously examining the fecal carriage of ESBL-producing E. coli in children aged 2–5 years and their livestock (cattle, camel, goat). Fecal samples from 366 children and 243 animals underwent phenotypic screening for ESBL-producing E. coli . Following phenotypic confirmation, ESBL resistance genes were identified via conventional PCR. Whole-genome sequencing (WGS) was performed on a subset of isolates from human feces. Results We found that 43% (159/366) of children and 3.7% (9/244) of livestock harbored ESBL-producing E. coli . The ESBL gene bla CTX-M-15 was predominant in human (82.7%, 120/145) and livestock (100%) isolates. In the 48 human E. coli isolates subjected to WGS, a high diversity resulting in 40 sequence types (STs) was observed. Among these, ST-2353 was the most prevalent (5/48), followed by ST-10 and ST-48 (3/48) and ST-38, ST-450, and ST-4750 (2/48). These STs were associated with multiple resistance genes, such as bla CTX-M-15 , bla TEM-1B , bla OXA-1 , bla CTX-M-14 and bla TEM-35 . Conclusion We report a high prevalence of ESBL E. coli in rural children, which outnumbers its prevalence in livestock. These isolates displayed a high diversity of sequence types (STs) with ST-2353 being the dominant ST. Our study is the first to report the association of ST-2353 with multi-drug resistance genes in Ethiopia. Further research using an integrated approach including other domains such as water and food products is needed to truly understand and combat AMR transmission and acquisition in this region.

Abdifatah Muhummed

Ashenafi Alemu

Salome Hosch

Yahya Osman

Rea Tschopp

Simon Yersin

Tobias Schindler

Jan Hattendorf

Jakob Zinsstag

Guéladio Cissé

Pascale Vonaesch

Fecal carriage of ESBL-producing E. coli and genetic characterization in rural children and livestock in the Somali region, Ethiopia: a one health approach

索马里地区农村儿童和家畜中产ESBL大肠杆菌的粪便携带及遗传特征研究：基于“同一健康”方法

Infection prevention and control (IPC) programs form the basis of minimizing spread of pathogens in the healthcare setting and beyond. The COVID-19 pandemic amplified the demand for IPC. However, the environmental impact of IPC practices has yet to be addressed and attempts to quantify its climate implications have been sparse. We performed a scoping review to identify current evidence regarding the environmental footprint of IPC measures and to highlight existing gaps in the literature. We included 30 articles, with 23 quantifying the environmental impact by mass of waste generated, six via carbon emissions, and one reporting on the concentration of volatile organic compounds. The mass of infectious waste ranged from 0.16 to 3.95 kg/bed/day, with large variability between countries. In general, higher-income countries produced more waste than lower-income countries. Significant carbon emission savings resulted from substituting reusable gowns and sharps containers, compared to single use items. The most significant gaps are the overall lack of standardisation in quantifying the environmental footprint of IPC-related practices, and a lack of studies on carbon emissions stemming from low and lower-middle income countries. We quantify the environmental impact of IPC practices, suggest areas of infection control that warrant further evaluation, and an approach to standardising environmental metrics in an attempt to better map out the climate implications of adopted IPC measures.

Oliver Lim

Wei Yu Chua

Andrew Wong

Ryan Ruiyang Ling

Hwang Ching Chan

Swee Chye Quek

Sean Wu

Jyoti Somani

The environmental impact and sustainability of infection control practices: a systematic scoping review

感染控制实践的环境影响与可持续性：一项系统性范围综述

Abstract Background This work aims at providing practical recommendations for implementing automated surveillance (AS) of surgical site infections (SSI) in hospitals and surveillance networks. It also provides an overview of the steps, choices, and obstacles that need to be taken into consideration when implementing such surveillance. Hands-on experience with existing automated surveillance systems of SSI (AS SSI systems) in Denmark, France, the Netherlands and Spain is described regarding trend monitoring, benchmarking, quality control, and research for surveillance purposes. Methods Between April and October 2023, specific aspects/options of various surveillance purposes for AS SSI were identified during regular meetings of the SSI working group in the PRAISE (Providing a Roadmap for Automated Infection Surveillance in Europe) network. Expert discussions provided the basis for this perspective article. Results Decisions for implementation of AS SSI systems highly depend on the purpose of the surveillance. AS SSI systems presented here differ according to study population, setting, central or local implementation; the level of automation, design, and the data sources used. However, similarities were found for the rationales of automation, design principles and obstacles that were identified. There was consensus among all the experts that shortcomings in interoperability of databases, limited time, a want of commitment on the part of stakeholders, and a shortage of resources for information technology (IT) specialists represent the main obstacles for implementing AS SSI. To overcome obstacles, various solutions were reported, including training in the development of AS systems and the interpretation of AS SSI results, early consultation of end-users, and regular exchanges between management levels, IT departments, infection prevention and control (IPC) teams, and clinicians. Conclusion Clarity on the intended application (e.g. purpose of surveillance) and information on the availability of electronic and structured data are crucial first steps necessary for guiding decisions on the design of AS systems. Adequate resources for IT specialists and regular communication between management, IT departments, IPC teams, and clinicians were identified as essential for successful implementation. This perspective article may be helpful for a wider implementation of more homogeneous AS SSI systems in Europe.

Luisa A. Denkel

Isabelle Arnaud

Manon Brekelmans

Mireia Puig-Asensio

Hoger Amin

Sophie Gubbels

Pernille Iversen

Mohamed Abbas

Elisabeth Presterl

Pascal Astagneau

Stephanie van Rooden

Seven Aghdassi

Heike Düsseldorf

Karl Mertens

Maaike S. M. van Mourik

Suzanne D. van der Werff

Automated surveillance for surgical site infections (SSI) in hospitals and surveillance networks–expert perspectives for implementation

医院及监测网络中手术部位感染（SSI）的自动化监测——专家视角下的实施策略

Hand hygiene is a critical component of infection prevention in healthcare settings. Innovative strategies are required to enhance hand hygiene practices among patients and healthcare workers (HCWs).

Shuk-Ching Wong

Stephen Chun-Yat Ip

Monica Oi-Tung Kwok

Crystal Yuen-Ki Siu

Jonathan Hon-Kwan Chen

Simon Yung-Chun So

Kelvin Hei-Yeung Chiu

Kwok-Keung Yuen

Vincent Chi-Chung Cheng

Antimicrob Resist Infect Control

Promoting hand hygiene in a chemotherapy day center: the role of a robot

在化疗日间中心推广手部卫生：机器人的作用

As part of the containment of the COVID-19 pandemic, mobile handwashing stations (mHWS) were deployed in healthcare facilities in low-resource settings. We assessed mHWS in hospitals in the Democratic Republic of the Congo for contamination with Gram-negative bacteria.

Jocelyne Kalema

Anne-Sophie Heroes

Immaculée Kahindo

Peter Hyland

Jacques Muzinga

Octavie Lunguya

Jan Jacobs

Bacterial contamination of mobile handwashing stations in hospital settings in the Democratic Republic of the Congo

刚果民主共和国医院环境中移动洗手站的细菌污染

Active screening programs and early detection of asymptomatic carriers are effective in preventing carbapenem-resistant Acinetobacter baumannii (CRAB) dissemination in healthcare facilities. This study aims to identify risk factors associated with CRAB carriage among patients upon admission to an acute care hospital. A case-case-control study was conducted at an acute care hospital. Starting in June 2020, new admissions to medical wards underwent rectal and buccal screening. Patients with CRAB or carbapenem-susceptible A. baumannii (CSAB) carriage were compared to controls, randomly selected from patients with negative cultures, at a one-to-one ratio. Multinomial logistic regression using a backward stepwise method was employed to identify factors associated with CRAB and CSAB carriage. A Chi-square Automatic Interaction Detector analysis was also conducted to further elucidate risk factors. The study included 115 CRAB carriers, 117 CSAB carriers and 121 controls. Increasing age was associated with a reduced risk of CSAB (OR: 0.96, p < 0.001) and CRAB carriage (OR: 0.97, p = 0.02), while higher Charlson Comorbidity Index scores increased the risk for both. CRAB carriage was significantly associated with admission from long-term acute care hospitals (OR: 7.68, p < 0.001) and presence of pressure ulcers (OR: 89.98, p < 0.001). Decision tree analysis identified pressure ulcers, prior location, and Charlson score as key predictors, with CRAB carriage reaching 77.3% in patients admitted from long-term acute care hospitals with pressure ulcers. Pressure ulcers were strongly associated with the carriage of both susceptible and resistant strains of A. baumannii. CRAB carriage was predominantly observed in patients transferred from long-term acute care hospitals, highlighting the need for targeted screening in this high-risk population.

Debby Ben-David

Bar Roshansky

Yael Cohen

Niv Sylvie

Lili Raviv

Ariel Zimerman

Orna Schwartz

Identifying risk factors for carbapenem-resistant Acinetobacter baumannii carriage upon admission: a case-case control study

入院时耐碳青霉烯类鲍曼不动杆菌携带风险因素的识别：一项病例-病例对照研究

Abbreviation	Antimicrob Resist Infect Control
Journal Impact	4.68
Quartiles(Global)	PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH(Q1)

ISSN	2047-2994
h-index	66

Publication Information	Publisher: BioMed Central Ltd，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2012，Proportion of original research papers: 87.90%，Self Citation Rate:4.20%， Gold OA Rate: 99.34%
Journal Fees	$3090Details
Average review cycle	网友分享经验：13 Weeks

Antimicrobial Resistance and Infection Control

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