The role of initial specimen diversion devices (ISDDs) in preventing contamination of central venous catheter (CVC) blood cultures is undefined. A model to simulate CVC colonization and contamination compared standard cultures with ISDD technique. ISDD detected 100% of colonized CVCs while decreasing false-positive cultures from 36% to 16%.

We evaluated one of the first secure large language models approved for protected health information, for identifying central line-associated bloodstream infections (CLABSIs) using real clinical notes. Despite no pretraining, the model demonstrated rapid assessment and high sensitivity for CLABSI identification. Performance would improve with access to more patient data.

We assessed the hospital environment as a reservoir of vancomycin-resistant E. faecium (VRE) and compared environmental VRE isolates to bloodstream infection E. faecium isolates. We identified distinct environmental and patient reservoirs, with the environment dominated by vanB VRE. Environment-clinical reservoir spillover accounted for 292/895 (33%) of putative transmission links.

Contaminated surfaces in clinics pose a pathogen transmission risk. Far ultraviolet-C light (UVC), with a favorable safety profile for human exposure, has the potential for continuous pathogen inactivation in occupied clinical areas. This study demonstrated real-world bioburden reduction on surfaces, despite frequent contamination from routine use by staff and patients in clinics.

Using the Statistical Analysis System (SAS) program shared here, all US hospitals can calculate hospital-specific hospital-acquired infection threshold counts for achieving a pre-specified benchmarked Standardized Infection Ratio performance percentile.

The use of extended reality (XR) for education of healthcare personnel (HCP) is increasing. XR equipment is reusable and often shared between HCP in clinical areas; however, it may not include manufacturer’s instructions for use (MIFU) in healthcare settings. Considerations for the selection of equipment and development of cleaning and disinfection protocols are described.

Serious superficial incisional surgical site infections (SSISSIs) are a critical subset of SSIs that require surgical intervention or lead to hospital readmission. Analyzing 11,617 SSIs from 47 community hospitals, the inclusion of SSISSIs changed 30/47 hospital rankings (p = 0.02), highlighting the need for inclusion in standardized infection surveillance models.

Ventilator-associated pneumonia (VAP) is a well-established cause of morbidity in critically ill patients. Current VAP criteria exclude patients on extracorporeal membrane oxygenation (ECMO). This retrospective analysis tests the validity of VAP in this population, as well as a new proposed diagnostic criterion for ECMO-associated pneumonia.

We investigated the accuracy and completeness of four large language model (LLM) artificial intelligence tools. Most LLMs provided acceptable answers to commonly asked infection prevention questions (accuracy 98.9%, completeness 94.6%). The use of LLMs to supplement infection prevention consults should be further explored.

In the United States, New Delhi metallo-beta-lactamase (NDM)-producing carbapenem-resistant Enterobacterales (CRE) are frequently associated with healthcare encounters. From September 2021 to September 2022, 21 patients with NDM-CRE identified from urine and without healthcare exposure were reported to the Centers for Disease Control and Prevention. Isolates were genetically similar to healthcare-associated strains.

Stewardship processes were compared across 123 hospitals that differed on a risk-adjusted post-discharge antibiotic use metric. Low-performing hospitals were less likely than high-performing hospitals to report routine interactions between their stewardship physician and pharmacist(s) (OR 0.12, 95% CI 0.03–0.55) and to have local antibiotic-prescribing guidelines (OR 0.21, 95% CI 0.05–0.93)

International Classification of Diseases, Tenth Revision (ICD-10) billing data used in outpatient stewardship metrics is under-described for acute and chronic sinusitis. We found that different sinusitis ICD-10 definitions impacted antibiotic prescribing rates (APRs). Chronic sinusitis ICD-10s dilute overall sinusitis APR, particularly in primary care settings and should be examined separately.

Whole genome sequencing (WGS) and clinical review were used to characterize 14 cases of central line-associated bloodstream infection (CLABSI) due to Staphylococcus epidermidis. WGS, which demonstrated disparate strains, suggested that 42.9% of S. epidermidis CLABSI cases were due to contamination, while clinical review suggested that 57.1% were contamination events.

CDSS-guided stewardship in six EDs during national culture bottles shortage was associated with significant reduction in median daily blood culture utilization per 1,000 ED visits from 141.5 (IQR:127.6–155.3) to 77.9 (IQR:68.3–86.3) and increased diagnostic yield from 6.2%(IQR:4.7%–7.6%) to 8.8%(IQR:6.1%–11.5%), without impacting length of stay or mortality.

We evaluated the viral load of varicella-zoster virus (VZV) in ambient air, vesicle, and pharyngeal swabs in VZV-infected patients. Of 46 cases, 6 had VZV detected in indoor air samples from patient rooms. Results suggest an association between viral load in the pharyngeal swab and indoor air.

Reducing antimicrobial exposure by limiting the duration of therapy is an effective antimicrobial stewardship strategy. In this article, we describe the impact of modification of the electronic health record to remove default durations of therapy on ambulatory antibiotic prescriptions issued from emergency departments in a large, multicenter health system.