The spread of Candida auris (C. auris), methicillin-resistant Staphylococcus aureus (MRSA) and various viruses in healthcare settings is of global concern. Far-UV-C222 reduces the concentration of microorganisms in laboratory settings and can be used directly in patient care rooms at doses safe for human eyes and skin. The effectiveness of UV-C222 inactivation of C. auris, MRSA and T1 bacteriophage (a viral surrogate) in a hospital setting was studied.

A partially blinded, cross-over study was conducted of two conditions: intervention, active UV and control, no UV. C. auris, MRSA and T1 bacteriophage were inoculated and dried onto stainless steel disc carriers at two soil levels, (0.03% BSA and 5.0% CBS), and placed at 24 locations in two unoccupied, two-bed patient rooms. UV-C222 luminaires were placed behind the head of each bed and one in the bathroom for both study rooms. Simultaneous 24-h exposures for both rooms were in random order. Pathogens were processed for cultures.

UV-C222 doses exposing the discs ranged from a low of 5 mJ/cm2 to high 637 mJ/cm2. Under treatment conditions, MRSA showed a 1.0 log reduction in 0.03% soil, C. auris showed a 2.6 log reduction in 0.03% soil and a 1.0 log reduction in 5.0% soil and T1 bacteriophage showed a 0.6 log reduction in 0.03% soil.

In patient rooms, continuous UV-C222 exposure showed decreased concentrations of C. auris (low and high soil), MRSA (low soil), and T1 (low soil). Studies are needed to determine benefits in occupied settings.

There is increasing evidence on the effectiveness of prevention bundles against non-ventilator hospital-acquired pneumonia (nvHAP), but detailed reports on their implementation are lacking. This study aims to describe and structure the implementation activities undertaken in a single-center multimodal intervention that achieved a 31% reduction in nvHAP incidence.

Longitudinal descriptive qualitative study.

Nine medical and surgical departments of a Swiss university hospital.

Healthcare professionals and implementation teams in study departments.

We collected longitudinal data on implementation activities using (1) implementation activity logs, (2) drop-in interviews and observations, (3) “action plan meetings,” (4) focus groups, and (5) unstructured recall sessions among the project team. Data were deductively coded using the “Expert Recommendations for Implementing Change” taxonomy, specified using Proctor et al.’s “Recommendations for specifying and reporting implementation strategies” and mapped to the “Exploration, Preparation, Implementation, Sustainment” framework phases.

A total of 174 activities were undertaken. Activities varied by implementation phase, most frequently involving “evaluative and iterative strategies,” “develop stakeholder interrelationship strategies” and “training and education of stakeholders” during Exploration, Preparation, and Implementation, respectively. During Implementation, 54% of activities were initiated by department nurses, and 27% were initiated by the institutional implementation team. Activities included interdisciplinary kick-off events, education in various formats, posters, informational stickers for patients, provision of new equipment (e.g., toothbrushes), and electronic medical records order sets.

This report offers valuable insights for future implementation efforts by providing a structured overview of the concrete implementation activities performed in a successful one-hospital multimodal nvHAP prevention project.

nvHAP (nonventilator hospital-acquired pneumonia) can affect all non-intubated patients, and semi-automated systems enable incidence surveillance. This feasibility study evaluated the performance and implementation of a semi-automated nvHAP surveillance in Swiss acute care hospitals.

Multicenter feasibility study

Seven Swiss acute care pilot hospitals representing different sizes and language regions

Inpatients of the participating hospitals.

Hospitals implemented an adaptable nvHAP selection algorithm including one to five indicators (radiology procedure, radiology report, leukocytes, body temperature, intubation). Five hospitals performed manual review on the preselected patients following standardized definitions. Performance characteristics of the algorithms (i.e., sensitivity and percentage records to manually review) and time investment to implement the semi-automated surveillance were evaluated. Barriers and facilitators for implementation were identified through interviews.

Hospitals implemented algorithms including one, two, four and five indicators. Sensitivity ranged from 98% to 100% in larger hospitals. Percentage of records to manually review ranged from 1% to 6% in hospitals that surveyed the total patient population and was 13% in one hospital that focused on two high-risk departments. Time for technical implementation varied from 55 to 437 hours. Mean time for manual review per preselected patient was 14 minutes and decreased with experience. Implementation facilitators included preprocessed data, team experience in similar projects, and external support.

Semi-automated nvHAP surveillance was feasible and sufficiently sensitive regardless of the algorithm. It required effort for setup and manual review. Algorithm adaptability enabled the implementation in hospitals with limited electronically available data or IT resources.

The COVID-19 pandemic caused unprecedented operational stress on hospital-based antimicrobial stewardship programs (ASP). We utilized a systems engineering framework to characterize multi-level systems challenges to and strategies for resilient, hospital-based antimicrobial stewardship (AMS) during the COVID-19 pandemic.

Using a national data set, we identified hospitals that had significant COVID-19 burden. We conducted semi-structured interviews with pharmacists, physicians and quality leaders involved in ASPs during the pandemic at those hospitals. Interview guides were developed using the Systems Engineering Initiative for Patient Safety (SEIPS) framework. Transcribed interviews were analyzed using deductive content analysis.

We interviewed 37 participants from 22 different healthcare systems across the country. Challenges to resilient ASP included physician employment model; limited AMS resources; staff shortages due to illness; shift in priorities; increased workload; remote work; and therapeutic momentum. Preexisting strategies to promote resilient AMS included system-wide AMS; decentralized AMS; excellent interprofessional relationships; strong culture of AMS and embracing incremental change. Real-time response strategies included ability to prioritize well; consistency with AMS work; being flexible and adopting change; intensifying infectious disease engagement; dedication to the profession; and reliance on automated tools and technology.

Using a systems engineering informed qualitative approach, participants identified many modifiable challenges to AMS resiliency. Given the unfortunate reality that infectious disease pandemics and periods of operational stress are likely to occur in the future, we recommend that healthcare system leadership utilize the preexisting and real-time response strategies identified in this manuscript as a roadmap to ASP preparedness and a more proactive future response.

To understand how the workflows and infection prevention and control (IPC) practices of certified nursing assistants (CNAs) during high-contact resident care activities contribute to multidrug-resistant organism (MDRO) transmission in nursing homes.

We conducted 10 high-fidelity simulations of two high-contact resident care activities, bed bathing and incontinence care, with CNAs from long-term or mixed-care units. Four genetic variants of λ phage were applied to select surfaces prior to simulations and subsequently sampled from the environment, residents, supplies, and CNAs. Simulations were video recorded and analyzed for patterns of hand-to-surface contact and performance of IPC practices, including hand hygiene, personal protective equipment use, and environmental surface cleaning or disinfection.

A median of 11.5 transmission events occurred per simulation. Most events (60%) occurred within residents’ immediate environments, reflecting how CNAs frequently transitioned between a resident, their surroundings, and care supplies, combined with infrequent hand hygiene and surface disinfection. Contamination of CNA scrubs and hands accounted for 24% of events, primarily from bed bathing, which involved frequent contact without a gown. Transmission to shared objects (e.g., linen bin, trash can, wheelchair) accounted for 16% of events and created additional opportunities for transmission between residents. Transmission between residents or their immediate environments was rare but typically associated with workflow disruptions from limited-supply availability.

In high-fidelity simulations of high-contact resident care activities, transmission of surrogate markers for MDROs closely followed the workflows of CNAs. This method identifies potential transmission pathways and interventions for mitigating MDRO spread in nursing homes.

Penicillin allergy reporting is common in U.S. healthcare systems, but true allergies and clinically significant reactions are inaccurately reported. Validated tools like PEN-FAST score allow for structured risk assessment; however, many clinicians remain unfamiliar with how to utilize the score to inform decision-making and prescribing. Integrating the PEN-FAST tool into the electronic health record (EHR) admission workflow may promote awareness and improve clinical utility.

We integrated the PEN-FAST tool into the admission navigator of our hospitals’ electronic health record to be completed by nursing staff. Over a seven-month period, completed PEN-FAST scores across our health system were analyzed to evaluate the overall opportunity for allergy assessment and delabeling. The study population consisted of patients with a documented penicillin class allergy and a completed PEN-FAST score. Patients with incomplete scores or responses marked as unknown for every item were excluded.

A total of 13,121 patients were included in the final evaluation. There were 10,309 (78.6%) patients with low-risk scores (PEN-FAST score of 0–2), indicating they were potential candidates for direct antibiotic challenges. The remaining 2,812 (21.4%) patients were categorized as high-risk (PEN-FAST score of 3+), who were likely not eligible for a challenge without prior skin testing.

A substantial opportunity remains to improve the assessment and documentation of penicillin allergies throughout the healthcare system. Utilizing the electronic health record to prompt frontline staff to use validated risk assessment tools may improve documentation of allergies and support better management of patients with penicillin allergy labels.

Vancomycin overuse in pneumonia should be a key target for antimicrobial stewardship according to Centers for Disease Control and Prevention. High negative predictive value of nasal Methicillin Resistant Staphylococcus aureus (MRSA) polymerase chain reaction (PCR) (nMP) screening for pneumonia has been shown. We implemented informatics-based ASP intervention to reduce vancomycin use in pneumonia by 20% in 6 months.

Quasi-experimental: Pre-intervention period (P1: 4/1/24–9/30/24) compared with post-intervention period (P2: 10/15/24–3/15/2025).

Quality improvement (QI) initiative in a tertiary-care center in Upper Midwest.

Hospitalized pneumonia patients.

Automated default nMP order was incorporated in pneumonia order-set in electronic medical record while ordering vancomycin for hospital acquired/ventilator associated pneumonia, severe community acquired pneumonia.

Outcome measures declined significantly: Average vancomycin use density as reported with days of therapy (DOT)/1,000 patient days decreased by 49.5% (from 72.2 DOT/1,000 patient days in P1 to 36.3 DOT/1,000 patient days in P2; p < .0001). Average vancomycin drug inventory cost decreased by 50% (from 1,089.5 U.S. Dollars (USD)/1,000 patient days in P1 to 546.3 USD/1,000 patient days in P2; p < .0001). All process measures showed significant changes: nMP ordering increased to 100% in P2 (p < .0001); proportion of pneumonia patients with negative PCR results with discontinuation of vancomycin within 48–72 hours increased to 71% (p < .0001) and time to vancomycin discontinuation declined by 46% (p < .001). Balancing measures (readmissions; nMP order-to-result time) remained unchanged.

Informatics-based ASP intervention was transformative leading to significant decline in vancomycin utilization, considerable healthcare-cost savings and significant increase in nMP screening among pneumonia patients.

To quantify antibiotic-related misinformation across major social networking platforms and examine its potential relevance to antimicrobial stewardship(AMS) and healthcare epidemiology.

A retrospective, Cross-platform infodemiology study (2015–2025).

Public data from Twitter/X, Reddit, and Facebook were analyzed, and a temporal association with global antimicrobial-resistance measures from the World Health Organization’s Global Antimicrobial Resistance(AMR) Surveillance System.

We extracted 1.8 million posts containing antibiotic-related key terms. Natural-language processing and transformer-based classification identified misinformation themes, sentiment polarity, and diffusion dynamics. Topic modeling and network analysis (Gephi) characterized echo-chamber structures. Temporal associations between misinformation intensity and antimicrobial-resistance indicators were examined using cross-correlation and Granger lead–lag analysis.

Misinformation comprised 19.3% of posts, spreading 2.4 times faster than factual content (p <.001). Four dominant themes were identified: self-medication advocacy, natural-remedy promotion, misinformation alleging hidden motives or suppressed evidence, and anti-medical discourse. Misinformation intensity correlated strongly with antibiotic search intent (ρ = .74; p <.001) and preceded resistance trends by 6–9 months for Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus.

Antibiotic misinformation may function as a measurable behavioral exposure with potential relevance to AMS and infection prevention goals. The inclusion of digital-behavioral surveillance in AMS reporting platforms would offer warning signs for potential risks associated with antibiotic resistance.

Although preterm infants are prone to healthcare-associated infections (HAI), HAI surveillance in neonates is still not widely practiced. In this paper, we present the HAI rates subsequent to nationwide implementation of NEO-KISS, the German national surveillance system for HAI in high-risk neonates. We also report on risk factors for the development of HAI in this population.

Observational study.

German National Reference Centre for Surveillance of Nosocomial Infections, responsible for the maintenance of NEO-KISS.

Infants with a birth weight of less than 1500 g.

NEO-KISS data from the years 2008–2022 was analyzed retrospectively and incidence densities were calculated (in five-year reference periods) for different types of healthcare-associated sepsis (HAS), healthcare-associated pneumonia (HAP), and necrotizing enterocolitis (NEC). Rates were analyzed with Cox-proportional hazard regression models.

A total of 118,214 infants with a birth weight of less than 1500 g from 251 neonatology departments were included. They comprised 15,254 HAS, 1,657 HAP, and 2,786 NEC. The incidence densities of HAS and HAP were 33.3% and 46.7% lower in the admission period 2018-2022 compared to 2008–2012 (2.98 vs. 4.47 HAS, 0.3 vs. 0.56 HAP, per 1,000 patient days). In the multivariable regression analysis, the period of admission remained significant after adjustment for independent risk factors for HAS, HAP, and NEC.

In Germany, the surveillance data for neonates in NEO-KISS between 2008 and 2022 showed a nationwide decrease in incidence densities of HAS, HAP, and NEC. The continuous engagement with NEO-KISS surveillance data may have contributed to this reduction.

Clostridioides difficile infection (CDI) requiring colectomy carries substantial mortality risk, with optimal timing of surgery remaining poorly defined. We examined temporal trends in colectomy among inpatients with CDI, identified predictors of surgical intervention and postoperative mortality, and evaluated the association between surgical timing and patient outcomes.

A retrospective cohort study was conducted using the National Inpatient Sample database from 2018 to 2022. We compared patients undergoing colectomy with those managed medically. To minimize confounding by hospital-onset cases, the analysis of surgical timing and mortality was restricted to patients undergoing colectomy within 8 days of admission. Predictors were identified using survey-weighted logistic regression and LASSO regression models.

Among 240,564 CDI hospitalizations (representing 1,207,995 weighted nationally), 717 patients underwent colectomy (3,585 weighted). CDI prevalence declined from 0.99% (2018) to 0.76% (2022), while colectomy rates increased from 0.28% to 0.34%. Peritonitis (OR 5.42; 95% CI, 4.46–6.59), coagulopathy (OR 4.96; 95% CI, 3.76–6.55), and sepsis/septic shock (OR 3.89; 95% CI, 3.39–4.47) were the strongest predictors of colectomy. Among patients undergoing colectomy within 8 days (2,830 weighted), in-hospital mortality was 26.5% overall, increasing from 21.0% (2018) to 30.7% (2022). Sepsis/septic shock (OR 8.20; 95% CI 2.92–23.07) and coagulopathy (OR 7.27; 95% CI 3.31–15.97) predicted mortality. Each additional day from admission to colectomy was associated with a 16% (OR 1.16; 95% CI 1.04–1.28) increased mortality risk.

In this nationally representative cohort, surgical timing was an independent and modifiable determinant of survival in patients with CDI requiring colectomy. Our findings underscore the importance of early surgical consultation for CDI patients with peritonitis, sepsis, and coagulopathy.