We examined five common targets for diagnostic stewardship that have been associated with improved patient outcomes. For each, we estimated the financial and reputational impact of each intervention on a typical 200 bed community hospital. These estimates can be adjusted for individual hospital estimates.

We found consistent savings and potential improvements in hospital metrics associated with these different diagnostic stewardship interventions. Clostridioides difficile (CDI) diagnostic stewardship showed ＄125,617 expected savings plus a likely additional 75% reduction in the hospital-acquired condition (HAC) CDI metric. Urine culture stewardship showed ＄34,111–＄92,361 in savings with an additional 30% reduction in the HAC catheter-associated urinary tract infection metric. Procalcitonin de-implementation showed ＄78,938 expected savings from test discontinuation. Expanded respiratory pathogen panel stewardship showed ＄383,650–＄668,000 in savings, depending on degree of reduction and replacement with focused viral testing. Blood culture stewardship showed ＄1,860,800 in savings with an additional 33%–80% reduction in HAC central line associated bloodstream infection and MRSA bacteremia metrics.

In total, a 200-bed hospital implementing all five interventions could expect an approximate ＄2,482,616–2,825,216 in laboratory and clinical savings. These interventions would also improve many HAC metrics, providing an additional ＄200,000–＄600,000 in savings, depending on baseline performance. Finally, reputation metrics, such as Leapfrog grades, would also improve.

Piperacillin–tazobactam is a beta-lactam antibiotic with a distinct R1 side chain compared to other penicillins, therefore the risk of cross-reactivity should be theoretically low. Despite this difference, antimicrobial guidelines recommend against using piperacillin–tazobactam in patients with penicillin allergies. There is limited data available regarding piperacillin–tazobactam use in patients with a penicillin allergy, or rates of cross-reactivity. Therefore, the objective of this study was to assess the incidence of cross-reactivity to piperacillin–tazobactam in patients with a labeled penicillin allergy.

This was a retrospective study of patients admitted to Surrey Memorial Hospital (SMH) between November 1st, 2021 to January 31st, 2024 assessing tolerance to piperacillin–tazobactam in patients with prior labeled penicillin allergies. Baseline characteristics and outcomes were collected from electronic medical records (EMR).

Of the 191 patients included, 98% were found to tolerate one or more doses of piperacillin–tazobactam. This included 95 patients with “low risk delayed reactions,” 90 patients with “high risk anaphylactic reactions,” and 2 patients with “well-documented delayed reactions,” to penicillins. Only four patients out of 191 had documented intolerance to piperacillin-tazobactam post-exposure.

This study suggests that piperacillin–tazobactam has a low risk of intolerability (2%) in patients with labeled penicillin allergies, and that it is reasonable to consider piperacillin–tazobactam as an alternative to carbapenems and other broad-spectrum antibiotics for most patients with a previous penicillin allergy.

Candida auris (also referred to as Candidozyma auris) is an emerging multidrug-resistant fungal pathogen associated with high morbidity and mortality. Existing infection prevention and control (IPC) guidance has largely focused on adult populations, with limited recommendations for pediatric healthcare and non-healthcare settings.

The Society for Healthcare Epidemiology of America (SHEA) convened a multidisciplinary expert panel to develop IPC recommendations for C. auris. The panel developed recommendations using a structured, iterative Delphi consensus process with rounds of discussion, refinement, and anonymous electronic voting with predefined consensus thresholds. Panelists reviewed relevant peer-reviewed and gray literature integrated with expert judgment and practical considerations. Preambles and remarks provide additional context and guidance.

This consensus statement provides recommendations for prevention of C. auris in pediatric acute care settings, non-acute healthcare settings, and non-healthcare congregate settings. Recommendations incorporate pediatric risk factors and care and address screening practices, isolation precautions, caregiver–infant/child dyad considerations, room placement and rooming in, breastfeeding and skin-to-skin practices, visitation, use of shared spaces, environmental cleaning and disinfection, and management of medical and non-medical equipment, including toys. Recommendations emphasize coordination with local infection prevention and public health partners.

This SHEA consensus statement addresses gaps in pediatric-specific IPC guidance for C. auris. The recommendations provide a practical framework to support prevention of transmission within the context of pediatric clinical, developmental, and family-centered care.

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.

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).