This study examines gaps in mask-related behaviors, beliefs, and perceptions among healthcare personnel (HCP), investigates the influence of vaccination status on masking practices, and identifies opportunities to enhance adherence in clinical settings.

A survey was conducted among HCP providing direct patient care at State University of New York Upstate Medical University from November 2024 to January 2025.

A total of 655 HCP responded to the survey. Of these, 335 (51.1%) reported being up to date on coronavirus (COVID-19) vaccination, and 501 (76.5%) intended to receive the 2024 – 2025 influenza vaccine. Majority believed masking protects them (n = 381, 61%) and others (n = 400, 64.6%), perceived the workplace as carrying a high respiratory risk (n = 366, 58.6%), and believed patient masking offers protective benefits (n = 359, 57.4%). Self-reported masking rates were highest when participants were sick or symptomatic (n = 477, 72.8%) and lowest during respiratory specimen collection (n = 233, 35.6%). High adherence was observed when participants were symptomatic, among those who were up to date on their COVID-19 vaccination (n = 276, 82.4%) and who intended to receive the 2024 – 2025 influenza vaccine (n = 407, 81.2%).

These findings suggest self-reported masking adherence remains suboptimal, reflecting low perceived risk of COVID-19 infection in the postpandemic period. Targeted interventions highlighting masking as an important component of broader measures including vaccination, hand hygiene, and ventilation are needed to enhance hospital infection prevention and control.

There is limited research investigating advanced practice provider (APP) knowledge and perspectives on education in antimicrobial stewardship (AS).

Large academic children’s hospital.

APPs in Division of Pediatrics, Antimicrobial Stewardship Program (ASP) stakeholders.

We conducted four focus groups with APPs and one focus group with ASP stakeholders. APPs were asked eleven open questions about training, influences on prescribing practices, knowledge gaps and desired topics for education in AS as well as general barriers to learning. ASP stakeholders were asked five open-ended questions about teaching initiatives, knowledge gaps and high yield teaching topics for APPs.

20 APPs and 6 ASP stakeholders (1 medical director, 3 pharmacists and 2 pediatric infectious diseases fellows) participated in focus groups. Four domains and eight themes were generated. (1) Barriers to AS in Practice: lack of critical thinking and conflict between the ASP and APPs within the cultural context of the institution. (2) Approach to Education: logistical challenges to curriculum development and adopting APP centered approaches to teaching. (3) Education for New to Practice APPs: learning basics of microbiology, infectious diseases and utilizing resources to encourage AS in practice. (4) Education for Experienced APPs: learning approaches to common clinical scenarios and updates to improve AS in practice.

Curricular content should acknowledge the cultural influences of the institution, target knowledge gaps and areas of interest of learners, and be delivered via flexible and engaging learning modalities that encourage maximal participation.

Hospital-attributable central line-associated bloodstream infections (HA-CLABSI) are associated with severe patient outcomes. Published data on HA-CLABSI epidemiology in hospitals locally remains limited. This study aimed to determine the HA-CLABSI incidence and risk factors to inform targeted infection prevention practices.

Retrospective, nested case-control study was performed at Singapore General Hospital from January 2018 to December 2020, involving 127 cases and 252 controls. HA-CLABSI cases developed CLABSI ≥ 3 calendar days of hospitalization. Controls had central line inserted but did not develop CLABSI. Cases and controls were matched on 1:2 ratio for central line insertion date. Multivariable conditional logistic regression was performed to identify independent risk factors for HA-CLABSI, with adjusted odds ratio (aOR), 95% confidence intervals (CI) and p-values reported. Variables with p-value < 0.05 were statistically significant. HA-CLABSI incidence rate was calculated per 1,000 central line-days.

HA-CLABSI incidence rate during the study period was 8.4/1,000 central line-days. Independent risk factors for HA-CLABSI were transfer to high-risk areas (aOR: 2.03, 95% CI: 1.05–3.92), immunocompromised health status (aOR: 4.62, 95% CI: 2.20–9.69), antibiotic administration (aOR: 7.41, 95% CI: 3.24–16.92), and total parenteral nutrition (aOR: 3.61, 95% CI: 1.49–8.77) being included as indications for central line insertion, insertion of PICC (aOR: 13.61, 95% CI: 3.12–55.53), presence of non-tunneled central lines (aOR: 2.95, 95% CI: 1.48–5.87) and prior MRSA acquisition (aOR: 3.41, 95% CI: 1.83–6.35).

HA-CLABSI remains a significant concern despite on-going infection prevention efforts. Risk factors identified facilitate development of targeted, evidence-based interventions.

Mucocutaneous fungal infections, particularly oral and genital candidiasis, are the most common fungal diseases in neonatal populations. Although generally mild, non-invasive Candida infections can serve as sources of colonization increasing the risk of progression to invasive candidiasis, especially in preterm neonates.

This study aimed to describe the infection prevention and control (IPC) measures, including contact precautions, disinfection of environment and shared devices and the review of hand hygiene protocols implemented during an outbreak of neonatal Candida spp. infections in a newborn nursery and special care unit of a secondary hospital, and to analyze associated neonatal and maternal risk factors.

An observational cohort study was conducted following the identification of an outbreak between April and June 2024. A case was defined as a neonate with clinical signs of oral or genital candidiasis and/or microbiological confirmation from mucosal swabs.

125 neonates and mothers were included, 16 neonates (12.8%) met the case definition. Female sex, small-for-gestational-age status, Apgar score <7, and need for phototherapy were significantly associated with infection. Maternal primiparity also showed a significant association, whereas maternal vaginal Candida colonization and antibiotic exposure did not. After the implementation of IPC measures, decline of cases was observed. All affected neonates received antifungal therapy and recovered fully without progression to invasive disease.

This outbreak demonstrates that even full-term neonates can be at risk for mucocutaneous Candida infection. The application of IPC measures highlights the importance of surveillance, and environmental sanitation in controlling infection transmission.

Infectious disease (ID) care involves a diverse range of professionals, yet the shortage and geographical disparity of ID physicians, among other professionals, remain underexplored. This cross-sectional descriptive study aimed to elucidate the distribution of ID physicians, infection control (IC) pharmacists, and IC nurses in Japan, focusing on the interrelations among the ID workforce within medically relevant geographical units.

Publicly available data from 335 secondary medical areas (SMAs) in Japan, with a population of 125 million, were analyzed. Workforce distribution was assessed using the Gini index to quantify inequalities and spatial clustering across the SMAs per capita, per hospital bed, and per unit area. χ2 test was used to assess the association of hospital characteristics with the presence of each professional.

The research subjects were 1,729 ID physicians, 1,371 IC pharmacists, and 2,657 IC nurses, whose workplace data were available in Japan as of 2023. The Gini coefficients for the densities of ID physicians, IC pharmacists, and IC nurses per 100,000 people were 0.46, 0.34, and 0.28, respectively. The density of the ID workforce per unit area (1,000 km2) showed a positive correlation ( > 0.8) with any combination of ID physicians, IC pharmacists, and IC nurses. A total of 186 SMAs (56%) had at least one member from each professional group and 13 (3.9%) lacked staff from all three.

The substantial variation in ID workforce composition across SMAs suggests opportunities for both regional and national policy and identifies new avenues for improving access to ID care.

Evaluate whether a complex outpatient antimicrobial therapy (COpAT) program led by advanced practice providers (APPs) conducting transition-of-care (TOC) services improves post discharge patient follow-up and reduces hospital readmission.

Pre- and postimplementation cohort study comparing outcomes 6 months before and 5 months after COpAT launch.

706-bed tertiary university teaching hospital.

Adult patients admitted to the hospital with bone and joint infections, seen by our inpatient infectious disease consultation service and discharged with at least fourteen days of antimicrobial therapy, with follow-up at our specialized musculoskeletal infectious diseases clinic.

The APP led pilot COpAT program was launched on March 1st, 2024, with a multidisciplinary team including an infectious diseases physician, APP, nurse, medical assistant, and TOC pharmacists. Patients enrolled at hospital discharge and were scheduled for APP-led TOC visits within fourteen days, followed by a physician visit.

The pre- and post-intervention groups included 100 and 135 patients, respectively. Mean postdischarge follow-up time decreased from 20.1 to 9.1 days (P < .001), and patients seen within fourteen days increased from 42% to 83% (P < .001). Readmission rates and emergency room visits did not change significantly. TOC pharmacy engagement rose from 8% to 42% (P < .001), and both TOC pharmacy and APP interventions frequently addressed medication errors, side effects, and treatment modifications.

A structured, COpAT program with APP and TOC pharmacy involvement optimizes postdischarge follow-up, strengthens antimicrobial outpatient monitoring, and supports timely intervention for patients with complex infections.

To describe the revised APSIC Environmental Hygiene Guidelines for prevention of healthcare-associated infections inclusive of surface cleaning, air and water quality.

The revised guideline was developed by Infection Prevention and Control key opinion leaders from Asia Pacific.

This guideline emphasizes on practical implementation of environmental hygiene for prevention of healthcare-associated infections inclusive of surface cleaning, air and water quality relevant to Asia Pacific settings.

Any patients hospitalized in healthcare setting.

Literature search was done for recent international updates in environmental hygiene inclusive of surface cleaning, air and water quality. Recommendations were evaluated for practical and feasible recommendation in low-resourced settings in Asia Pacific.

The key recommendations are listed in the best practices for cleaning patient care areas. Additional measures are recommended to improve the air and water quality in healthcare settings.

Implementation of environmental hygiene in Asia Pacific should take into consideration of the air and water quality in addition of surface cleaning. Measures to assess the cleanliness should be performed using conventional visual assessment, environmental cleaning and disinfection checklist, auditing, and additional measures (e.g., environmental culture or fluorescence).

Effective antibiotic stewardship programing in clinical settings necessitates a good understanding of local prevalences of antimicrobial resistance and important patient and community risk factors. However, most studies are limited in sample size and geographic coverage.

This study utilized phenotypic resistance data of Escherichia coli from the Veteran’s Health Administration of the United States (U.S.), incorporating 126,777 unique cultures from veteran outpatients from seven Midwest states from 2010 to 2023, to examine the spatial pattern and important individual- and county-level risk factors for resistance to four important classes of antibiotics. We utilized Bayesian conditional autoregressive zero-inflated Poisson regression models to generate smoothed rates of resistance in each county and multilevel logistic regression models to detect risk factors for resistance.

High overall rates of resistance were seen for fluoroquinolone (29%) and TMP-SMX (22%). Geographic variation was seen among and between antibiotic classes. Certain urban regions in the southern parts of Illinois, Indiana, and Ohio had higher local resistance rates for fluoroquinolone and TMP-SMX. Being male, having diabetes, and previous exposure to antibiotics are significant risk factors for all classes of antibiotics while the significance of other risk factors varied across classes.

Diverse geographic patterns of resistance level may reflect differences in local prescribing practices, while the differential correlations with risk factors likely reflect their clinical indications and prescribing patterns in clinical settings. The local resistance rates and risk factors for different classes of antibiotics should provide important guidance in practicing empirical prescribing and antibiotic stewardship in clinical settings.

To describe the revised Asia Pacific Society of Infection Control (APSIC) Guidelines for Prevention of Central Line Associated Blood Stream Infections (CLABSI) 2024.

The revised guidelines was developed by infection prevention and control experts and key opinion leaders from Asia Pacific.

Emphasis on practical implementation of Central Line Insertion and Maintenance Bundles using quality improvement approach is recommended towards the goal of achieving zero CLABSI in any healthcare setting.

Any patients with a central line in a healthcare setting

Literature search was done for recent international updates in CLABSI prevention. Recommendations were evaluated for practical and feasible implementation in low resourced settings.

The key recommendations are listed in the APSIC CLABSI insertion and maintenance guidelines. Additional measures are recommended for use where CLABSI rates remain high despite implementation of all preventive strategies to achieve institutional goals.

A surveillance program is recommended to monitor outcomes and compliance with bundles. Ongoing review of the performance data with appropriate interventions made should facilitate efforts towards zero CLABSI rate.