Infection Control Strategies Research Articles

Source-tracking Klebsiella outbreaks in premature infants using a novel amplicon fingerprinting method

BackgroundEven with state-of-the-art infection control practices, premature infants can develop life-threatening infections in the neonatal intensive care unit (NICU). The precise sources of most NICU-associated infections frequently remain unknown and, therefore, are difficult to address. In this study, we used a novel microbiome sequencing approach to source-track lethal sepsis-causing Klebsiella, opportunistic pathogens, and commensal bacterial strains colonizing the gut of hospitalized premature infants.MethodsAn exploratory-methods, case series was at performed Connecticut Children’s Medical Center NICU in 2021. Long-read 16–23 S rRNA gene sequencing was used to analyze fecal samples, mother’s milk, and clinical bacterial isolates derived from a cluster of Klebsiella-infected, and concurrently hospitalized non-infected, premature infants who were simultaneously enrolled in a neonatal microbiome study. Distinct groups of amplicons comprising a unique fingerprint pattern for a given strain were compared among the samples to ascertain relatedness.ResultsWe confirmed 100% amplicon identity between lethal Klebsiella quasipneumoniae from milk, gut, blood and trachea during sepsis in twins, while differentiating other infecting and colonizing Klebsiella strains in concurrently hospitalized premature infants. The method also successfully discriminated between multiple Klebsiella strains within the gut microbiota of a non-infected infant. Additionally, we showed that human milk is the source of many early intestinal colonizers, including Klebsiella, Enterococcus, Veillonella, and Bifidobacterium strains.ConclusionsAmplicon fingerprinting can be utilized as a high-throughput high-resolution test to assist in the investigation of nosocomial outbreaks. Additional applications such as routine monitoring of various reservoirs for potential pathogens could inform infection prevention and control strategies in the NICU.

Beyond the Incision: Pediatric Postoperative Sepsis Risk Patterns and Related Adverse Events in U.S. Inpatient Care

Background: Postoperative sepsis (POS) is a serious pediatric safety event tracked by the Agency for Healthcare Research and Quality’s Pediatric Quality Indicator 10 (PDI 10). Purpose: This study examined POS in United States inpatient care. Methods: Using the 2019 Kids’ Inpatient Database (KID), a nationally representative sample of U.S. pediatric discharges, we performed multivariable logistic regression to examine patient- and hospital-level predictors of POS. Results: Among approximately 5.24 million weighted discharges, 577,625 (12.65%) were flagged with POS. Key independent risk factors included undergoing major surgery, being treated in large urban teaching hospitals, and admission for surgical or injury-related care. Hospital characteristics such as Western region location, for-profit ownership, and large bed size were associated with increased POS odds, while rural and small hospitals showed protective effects. Race/ethnicity showed mixed findings; Native American and “Other” race patients had elevated POS risk, while Hispanic children had slightly reduced odds compared to White peers. Conclusions: Contrary to prior assumptions, neither age nor sex was a significant independent predictor. This study expands upon prior pediatric adverse event research by delineating the distinct risk profile of POS. The findings underscore the need for targeted infection control strategies in high-risk environments and support ongoing quality improvement efforts to reduce the surgical sepsis burden in children.

The Nosocomial Transmission of Carbapenem-Resistant Gram-Negative Bacteria in a Hospital in Baoding City, China

Background: The global rise of multidrug-resistant Gram-negative bacteria, particularly non-fermenting species and carbapenemase-producing Enterobacteriaceae, poses a significant challenge to hospital infection control. Methods: In this study, a total of 89 Acinetobacter spp. isolates, 14 Pseudomonas aeruginosa, and 14 carbapenem-resistant Enterobacteriaceae isolates were collected from patients in a tertiary hospital. Whole-genome sequencing and antimicrobial susceptibility testing were conducted. Resistance mechanisms and evolutionary relationships were analyzed using phylogenetic analysis and genetic context mapping. Results: Among the non-fermenting isolates, A. baumannii exhibited high resistance to carbapenems, clustering into distinct clonal groups enriched with genes associated with biofilm formation and virulence genes. P. aeruginosa isolates harbored fewer resistance genes but carried notable mutations in the efflux pump systems and the oprD gene. In Enterobacteriaceae, four blaNDM alleles were identified within a conservative structural sequence, while blaKPC-2 was located in a non-Tn4401 structure flanked by IS481- and IS1182-like insertion sequences. Phylogenetic analysis revealed that blaNDM-positive E. coli strains were closely related to susceptible lineages, indicating horizontal gene transfer. Conversely, K. pneumoniae isolates harboring blaKPC-2 formed a tight clonal cluster, suggesting clonal expansion. Conclusions: The study reveals distinct transmission patterns between resistance genes: horizontal dissemination of blaNDM and clonal expansion of blaKPC-2 in K. pneumoniae. These findings emphasize the need for resistance-gene-specific genomic surveillance and infection control strategies to prevent further nosocomial dissemination.

Bacteriological Profile of Pus Samples and Their Antibiotic Susceptibility Pattern at A Tertiary Care Hospital, Jamnagar, Gujarat, India'

Background: Pyogenic infections are a significant clinical concern, often caused by a variety of multidrugresistant organisms, particularly in hospitalized patients.The increasing trend of resistance in P. aeruginosa and other Gram-negative organisms highlights the need for updated local susceptibility data to guide empirical therapy. Methods: This retrospective observational study was conducted from September 2024 to February 2025 at M.P. Shah Government Medical College, Jamnagar. A total of 1000 pus samples were analyzed, of which 322 (32.2%) showed positive bacterial growth. The isolates were identified by standard microbiological methods and antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method, interpreted according to CLSI guidelines. Results: Out of 322 culture-positive isolates, Gram-negative bacteria were predominant (52.5%), with P. aeruginosa being the most frequently isolated organism (35.4%), followed by E. coli (16.1%) and Proteus spp. (12.7%). Among Gram-positive organisms, Staphylococcus aureus was most common (12.7%), with nearly half (48.1%) identified as MRSA. Carbapenems (meropenem, imipenem) showed high sensitivity against Gramnegative isolates, while vancomycin and linezolid were most effective against Gram-positive isolates. ESBL production was observed in 61.2% of Gram-negative isolates. Conclusion: The study emphasizes a high burden of multidrug-resistant pathogens in wound infections, particularly among Gram-negative organisms. Continued surveillance and strict antimicrobial stewardship are crucial to mitigate resistance. Carbapenems and beta-lactam/beta-lactamase inhibitor combinations remain the most effective empirical options. The findings support the need for hospital-specific antibiotic policies and infection control strategies

Prevalence of carbapenemase genes in Klebsiella pneumoniae and Escherichia coli isolated from intensive care unit patients in Iran: a systematic review (2014-2025).

This systematic review aimed to analyze the prevalence of the most common globally occurring carbapenemase genes (blaOXA, blaNDM, blaKPC, blaIMP, blaVIM, and blaGES) in Klebsiella pneumoniae and Escherichia coli isolated from Iranian ICUs between 2014 and 2025. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was conducted in Embase, PubMed/MEDLINE, and Scopus databases to find relevant studies. The search resulted in 931 records; after removing articles according to the inclusion/exclusion criteria, only 10 articles were included in this study. According to the results of this review, carbapenemase-encoding blaOXA (47%) and blaNDM (33.6%) were most prevalent in K. pneumoniae, while blaOXA was the sole gene detected in E. coli isolates, with a prevalence of 12.1%. The comparison revealed that K. pneumoniae had an OR of 6.4 (95% CI: 2.9-14.5; p-value < 0.001) for blaOXA prevalence compared to E. coli, indicating a significantly higher pooled prevalence of blaOXA in K. pneumoniae. Moreover, antibiotic resistance rates to carbapenems, aminoglycosides, fluoroquinolones, and cephalosporins were significantly higher in K. pneumoniae compared to E. coli isolates. The findings emphasize the importance of finding new inhibitors to cover OXA and NDM carbapenemases and infection control strategies in the ICU setting to address the significantly high prevalence of carbapenemases in Iranian ICUs.

Dynamic Profiling of Penicillin-Binding Protein 2a (PBP2a)-Positive Extracellular Vesicles: Implications for Early Diagnosis and Treatment Monitoring of Methicillin-Resistant Staphylococcus Aureus Infections.

Infections caused by methicillin-resistant staphylococci (MRS), such as methicillin-resistant Staphylococcus aureus (MRSA), pose significant challenges to public health. The early detection of MRS infections and monitoring of antibiotic resistance profiles are critical for patient management and infection control strategies. Extracellular vesicles (EVs) have emerged as promising biomarkers in infectious disease. By combining single-particle nano-flow cytometry and immunoelectron microscopy (immuno-TEM), we discovered that PBP2a is present on the surface of EVs extracted from MRS. However, whether PBP2a can serve as an EVs-associated protein marker for diagnosing bacterial infections remains unexplored. Using MRSA as a model strain, mouse models of localized and systemic infections were established, alongside a clinical cohort study, to investigate the dynamics of PBP2a-positive (PBP2a+) EVs in plasma following bacterial infection, infection progression, and in response to antimicrobial therapy. In mouse infection models, PBP2a+ EVs were detected in plasma, with variable detection rates observed across different infection models. The study found a progressive correlation between increasing plasma PBP2a+ EVs levels and non-specific inflammation markers (CRP, IL-6) during infection progression. Antimicrobial therapies, however, inversely affected the ratio of PBP2a+ EVs. Furthermore, a clinical cohort study confirmed a direct association between the magnitude of PBP2a+ EVs in the plasma of patients with MRSA infection and the severity of infection. The investigation highlights the potential of PBP2a+ EVs as plasma biomarkers of MRSA antibiotic resistance, particularly during the early stages of resistant infections. Their persistence in plasma throughout the infectious episode makes them valuable indicators for monitoring disease progression and evaluating the efficacy of antibiotic treatments.

Emergence of ST11-KL64 carbapenem-resistant hypervirulent Klebsiella Pneumoniae isolates harboring blaKPC−2 and iucA from a tertiary teaching hospital in Western China

BackgroundCarbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-HvKP) poses a critical global health threat. However, molecular epidemiological data on CR-HvKP in Western China remain scarce. This study aimed to characterize the clinical profiles, molecular features, and risk factors of CR-HvKP isolates in Western China.MethodsSixty-eight carbapenem-resistant Klebsiella pneumoniae (CRKP) clinical isolates were collected from January to December in 2024. Clinical characterization included antimicrobial susceptibility profiling and hypermucoviscosity assessment via string test. Detection of carbapenemases using inhibitor enhancement test. Molecular characteristics of CRKP included serotype, carbapenemases, virulence-associated factors, and multilocus sequence typing (MLST) performed by using the PCR method. CR-HvKP was defined as the presence of any one of rmpA, rmpA2, iroB, iucA, and peg-344. Risk factors were initially evaluated using univariate logistic regression analysis, with significant variables subsequently incorporated into a multivariate regression model. A p-value < 0.05 was considered statistically significant.ResultsAmong 68 CRKP isolates, 36 were identified as CR-HvKP, all harboring the iucA gene (100%, 36/36). However, only 22.2% (8/36) of string test results correlated with virulence gene presence. All CRKP strains exhibited high resistance to most antibiotics, with comparatively lower resistance rates observed for tigecycline (0%) and polymyxin B (14.7%). Carbapenemase production was the predominant resistance mechanism, with 61.8% (42/68) carrying blaKPC−2. Serotyping and MLST revealed that ST11-KL64 CR-HvKP being predominant. A novel wzi752 allele was identified, encoding amino acid sequences homologous to serotype KL47. Univariate analysis demonstrated significantly higher ICU admission rates (p = 0.018) and carbapenem exposure (p = 0.023) in CR-HvKP patients with infections. Multivariate analysis highlighted borderline significance for ICU admission (OR = 2.939, p = 0.056) as a potential risk factor.ConclusionsThe ST11-KL64 CR-HvKP clone harboring blaKPC−2 and iucA has emerged as a dominant pathogen of hospital infections in Western China, posing dual threats of resistance and virulence. Enhanced molecular surveillance and infection control strategies are urgently needed to mitigate its spread.

Australian infection prevention and control governance, strategy and structure: Design for success.

Governance, strategy and organisational structure for Infection Prevention and Control (IPC) programs across Australia remain variable. The standardisation and integration of these functions across jurisdictions are critical for effective advancement of IPC across health systems. Across the Australian Federal, State and Territory jurisdictions, the study examined a twofold research question: first, what are the governance, strategy and organisational structures of IPC programs?; and second, what are the essential elements for a standardised, consistent IPC governance framework? Comprising four integrated steps: preconference document analysis of key jurisdictional program information; a survey of conference participants; open discussion - an expert panel of jurisdictional leads and conference participants; and expert panel review, incorporating mixed methods and a modified Delphi approach for consensus and validated guidance. IPC representatives across Australia participated in this study with 44 % (226/513) responses. Structures reported included: patient safety, public health, or infectious diseases. Reported key elements for effective IPC governance included IPC leadership expertise (42 %), a consistent and transparent structure (30 %), and adequate resourcing and funding for IPC (18 %). IPC governance structures across Australia remain substantially variable. The Australian Centre for Disease Control (AusCDC) is considered the pre-eminent IPC governance agency, that could enhance IPC governance, structure and strategic direction. Clear governance, strategy, and organisational structures have a critical role in the effectiveness of IPC programs and healthcare associated infection reduction strategies. The developed framework provides additional insight towards a comprehensive, standardised national IPC governance framework, offering opportunity for improvement and informing future priorities.

Genomic characterisation of carbapenem-resistant Pseudomonas aeruginosa from ICU admission screening in Hanoi, Vietnam, 2023.

Genomic characterisation of carbapenem-resistant Pseudomonas aeruginosa from ICU admission screening in Hanoi, Vietnam, 2023.

Winning the Global Surgery War: A Conceptual Framework.

Global surgery (GS), which comprises surgery, obstetrics, and anesthesia, is a complex multidisciplinary enterprise that focuses on the provision of timely, safe, and equitable surgical care to the global population. As with any war, understating the burden of surgical disease risks failure in any crafted strategy, as the measures would be substantially inadequate. Using strategies from successful large-scale interventions, the author proposes a conceptual framework for sustainable GS scale-up. The author collated GS scale-up strategies from the literature and aligned them with the 6 core indicator metrics as the primary outcome measures. The proposed conceptual framework hangs on the successes of the Marshall Plan for Europe and the World Health Organization multimodal strategy for infection control and prevention to provide funding and intervention models, successively, for GS scale-up. Smile Train and Operation Smile strategies for strengthening surgical systems provide potential learning points for GS scalability. Collaborating with these and other surgical nongovernmental organizations and harnessing their experiences and networks promises potential for success in GS scale-up. The proposed conceptual framework provides potential sustainable GS scale-up, using a nonprescriptive "bundled" intervention approach, permitting individual countries to progress at their own pace, while allowing for transparent sharing of learned experiences.

Respiratory infectious disease transmission of dental healthcare workers.

Respiratory infectious disease transmission of dental healthcare workers.

Mpox Resurgence of New Clade and Infection Control Strategies

Mpox Resurgence of New Clade and Infection Control Strategies

The growing concern of MDR/XDR bacteria in patients undergoing dialysis: a cross-sectional study

Background. Dialysis patients are at heightened risk for multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacterial infections due to their vulnerability to infections and frequent exposure to healthcare environments. This study aims to determine the prevalence, risk factors, and antimicrobial resistance patterns of these pathogens to enhance patient care and infection control strategies. Materials and methods. This cross-sectional study was conducted at the Al-Hussein Teaching Hospital Dialysis Unit in Thi-Qar, Nasiriyah, Iraq, from September to December 2024, involving 121 dialysis patients. Data collected from participants included demographic information, comorbidities, and dialysis-related parameters. Microbiological analysis involved urine sample processing through bacterial culture, with bacterial identification and antimicrobial susceptibility testing performed using the VITEK 2 Compact system. Results. The mean age of the study population was 55.0 ± 16.6 years, with a higher proportion of males (52.9 %). Diabetes mellitus was the most common comorbidity, affecting 70 % of patients either alone or in combination with hypertension and cardiovascular disease. The culture positivity rate was 19.0 %, with E.coli being the most frequently isolated pathogen (65.2 %), followed by K.pneumoniae (21.7 %) and E.cloacae (13.1 %). Antimicrobial resistance testing revealed that 60 % of E.coli and all K.pneumoniae isolates were MDR, while 40 % of E.coli and 33.3 % of E.cloacae were XDR. A significant negative correlation was observed between dialysis duration and infection frequency (r = –0.2285, p = 0.0117), indicating a higher likelihood of infections during the initial year of dialysis therapy. Conclusions. The findings underscore the high prevalence of MDR/XDR bacterial infections among dialysis patients, particularly during the early stages of treatment. This highlights the urgent need for enhanced infection control measures, robust antimicrobial stewardship programs, and regular surveillance within dialysis facilities. Targeted interventions are essential to reduce infection-related morbidity and mortality among this vulnerable patient population.

PREVALENCE OF HEPATITIS B AND C AMONG THALASSEMIC PATIENTS UNDER 12 YEARS CHILDRENS IN DISTRICT SWAT

Background: Thalassemia is a group of inherited hemoglobinopathies characterized by defective synthesis of alpha or beta globin chains, leading to microcytic hypochromic anemia. Patients with beta thalassemia major require lifelong blood transfusions to maintain adequate hemoglobin levels, increasing their risk of transfusion-transmitted infections (TTIs) such as hepatitis B virus (HBV) and hepatitis C virus (HCV). In regions with limited blood screening infrastructure, such as parts of Pakistan, this risk becomes a critical public health concern. Objective: To determine the prevalence of HBV and HCV among transfusion-dependent thalassemic patients under 12 years of age in District Swat, Pakistan. Methods: A descriptive cross-sectional study was conducted at the Pathology Department of Saidu Teaching Hospital, Swat, from August 2023 to March 2024. A total of 214 blood samples were collected from pediatric thalassemia patients (&lt;12 years) using standardized phlebotomy procedures. Samples were centrifuged and screened for HBV (HBsAg) and HCV (anti-HCV antibodies) using Immunochromatographic Test (ICT) kits manufactured by Healgen Biotechnologies. Data were recorded using a pre-designed proforma and analyzed with SPSS v17.0. Results: Out of 214 patients, 11 (5.1%) tested positive for HBV and 17 (7.9%) for HCV. Gender-wise, among 118 males, 11 (5.1%) were HCV positive and 6 (2.8%) HBV positive. Among 96 females, 5 (2.3%) were HCV positive and 6 (2.8%) HBV positive. Age-wise, in the 1–4 years group (n=89), 9 (4.2%) were HCV positive and 7 (3.3%) HBV positive; in 5–8 years (n=67), 5 (2.3%) HCV and 3 (1.4%) HBV; and in 9–12 years (n=58), 3 (1.4%) HCV and 1 (0.5%) HBV. Conclusion: The study revealed a higher prevalence of HCV compared to HBV among transfusion-dependent thalassemia patients, particularly among males and younger age groups. These findings highlight the need for enhanced screening, immunization, and infection control strategies in pediatric thalassemia care.

Consensus of experts on healthcare-associated infection prevention and control of Candida auris

Candida auris is an emerging multidrug-resistant fungal pathogen, its infections have been reported in over 50 countries and regions to date. It has gradually become a global public health concern. Characterized by challenges in identification, high drug resistance, treatment difficulties, and rapid transmission, Candida auri is prone to causing hospital infection outbreaks. Given the varying recommendations in domestic and international guidelines for preventing and controlling Candida auris healthcare-associated infection, the National Medical Institution Infection Surveillance System of China, the Healthcare-associated Infection Control Branch of Chinese Preventive Medicine Association, and the National Training Center of Hospital Infection in China jointly organized a panel of national experts. Through reviewing global literature, evidence-based medical research, and experiences in curbing outbreaks and adopting the Oxford Centre for Evidence-Based Medicine's levels of evidence classification criteria and grading of recommendation strength, and after discussion and voting by the expert panel, 14 recommendation statements consensus on the prevention and control of Candida auris healthcare-associated infection were ultimately formulated. Key contents include an overview of Candida auris outbreaks, microbiological characteristics, laboratory identification, epidemiology, healthcare facility infection prevention and control strategies and specific measures, outbreak investigation and control protocols, and clinical management. The consensus aims to recommend practical and effective prevention and control measures, standardizing and enhancing the capacity to combat Candida auris healthcare-associated infection.

Regulatory mechanism for host-cell contact-dependent T3SS gene expression in Vibrio parahaemolyticus.

Many pathogenic bacteria regulate gene expression in response to the surrounding environment to establish infection. One such mechanism is the regulation of gene expression in response to contact with host cells. Here, we show that Vibrio parahaemolyticus, a causative agent of foodborne gastroenteritis, has a host-cell contact-dependent regulatory mechanism for virulence gene expression. Type III secretion system 2 (T3SS2), an essential virulence determinant for acute gastroenteritis encoded by V. parahaemolyticus pathogenicity island (Vp-PAI), recognizes host-cell contact by sensing high intracellular K+ levels and switching its secretory substrates. The switching of secretory substrates is regulated by proteins called gatekeepers. Mutants deficient in the gatekeeper genes lose the ability to switch secretory substrates and lock their secretory state into a host-cell contact-dependent manner. Transcriptomic analysis of these mutants revealed the upregulation of Vp-PAI genes, which was dependent on T3SS2 secretory activity, suggesting the presence of a negative regulator secreted by T3SS2. Comparative proteomic analyses identified a previously unrecognized T3SS2 secretory substrate, VPA1369 (VtrN), that negatively regulates Vp-PAI gene transcription. Secretion of VtrN was promoted under conditions that mimic host-cell contact. vtrN gene deletion specifically upregulated Vp-PAI gene expression, independent of T3SS2 secretory activity, indicating its role as a repressor. VtrN interacts with VtrB, a key transcription factor for Vp-PAI genes, suppressing its transcriptional activity. This mechanism illustrates how V. parahaemolyticus enhances virulence gene expression upon host-cell contact through the T3SS2 recognition system, highlighting an adaptive strategy for establishing infection.IMPORTANCEThe type III secretion system (T3SS) is a crucial virulence factor tightly regulated for optimal host manipulation and virulence. This study revealed that the expression of T3SS2, a key virulence factor in Vibrio parahaemolyticus that causes acute gastroenteritis, is strictly regulated by host-cell contact. VtrN, a negative regulator exported from the bacterium through T3SS2, plays a key role in this host-cell contact-dependent gene transcriptional process. VtrN binds directly to the master regulator of Vp-PAI, the region encoding T3SS2, and represses its transcriptional activity. Upon host-cell contact, VtrN export is promoted, leading to the derepression of Vp-PAI gene expression. Thus, V. parahaemolyticus can effectively upregulate the expression of virulence factors when interacting with the host cells. Understanding these regulatory mechanisms could lead to innovative infection control strategies, opening new avenues for research and discovery.

2,4-difluorophenyl(piperidin-4-yl) methanoneoxime derivatives as potent contenders to combat antibacterial resistance of MRSA: In-silico approach

Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat as a primary contributor to bacterial infections in healthcare and community environments. Its resistance to various antibiotics poses challenges for treatment. Consequently, combating MRSA has become a central objective in infection control strategies worldwide. In this study, a series of 44 compounds was designed to identify potential inhibitors against MRSA proteins. Ligand-based pharmacophore modeling was employed using the PHASE module within Schrödinger’s Drug Design Suite, resulting in a five-featured model (DHHRR) comprising three hydrogen bond donors, a pair of hydrophobic entities, and two aromatic rings. The drug-likeness properties of the compounds were assessed using Lipinski's Rule of 5 and Veber's Rule, confirming their pharmacological attributes. Absorption, Distribution, Metabolism, Excretion and Toxicity (ADMET) predictions evaluated the compounds' potential as viable drug candidates, and molecular docking studies against MRSA proteins like Staphylococcus aureus Gyrase protein (PDB ID: 2XCT), and Escherichia coli Penicillin Binding Protein 1b (PBP1b) (PDB ID: 5HL9) were performed. The top-ranked compound, 5k: (Z)-(2,4-difluorophenyl)(1-((4-hydroxyphenyl)sulfonyl)piperidin-4-yl)methanone oxime, exhibited strong interactions with both proteins, showcasing favorable binding energies of − 8.3 and − 8.0 kcal/mol for 2XCT and 5HL9. Molecular dynamics simulations were employed to study the stability of the protein–ligand complexes, and Molecular Mechanics-Generalized Born Surface Area (MM-GBSA) analysis confirmed the strong binding free energy of 5k with the target proteins − 31.87 ± 2.67, and − 33.39 ± 7.84 kcal/mol for 2XCT and 5HL9. Lastly, Density Functional Theory (DFT) calculations provided insights into the electronic and molecular characteristics of 5k, revealing promising reactivity and chemical properties. Overall, compound 5k stands out as a promising candidate for MRSA inhibition based on Computational findings. However, further investigations are necessary to validate and confirm its potential as a novel MRSA inhibitor.Graphical

Beyond patient contact: combined short- and long read sequencing reveals continuous occurrence of genomically related carbapenemase-producing Enterobacterales and plasmid mobility in a hospital, Germany, 2018 to 2021

BACKGROUNDCarbapenemase-producing Enterobacterales (CPE) frequently cause nosocomial outbreaks. To investigate these, tracing focused on patients with related CPE strains and spatiotemporal contact (e.g. contact with each other in a room or on a ward during overlapping periods) has limitations. Moreover, as widely available molecular typing methods cannot detect plasmid-related transmissions, carbapenemase gene transfer across enteric bacteria through plasmids in hospitals remains poorly understood.AIMBecause whole-genome sequencing (WGS), particularly long-read sequencing, can offer insights into bacterial relationships both at core-genome and plasmid levels, we tested its utility, using VIM-CPE as example, to investigate plasmid and CPE spread in a hospital beyond outbreaks.METHODSWe included inpatient episodes from 2018 to 2021 involving blaVIM-bearing CPE isolates. Short- and long-read WGS data were combined with patient movement information to identify genomically related hospital-acquired VIM-CPE and putative transmission routes.RESULTSAmong 43 included inpatient episodes, 27 isolates were hospital-acquired, with 23 genomically related based on core-genome or plasmid analyses. For 14 of these 23 isolates, patient movement data supported suspected transmission events. Plasmid and core-genome level analyses revealed that most transmission events did not temporally concur, occurring over up to 33 months. Thus, conventional infection tracing methods focusing on concurrent spatiotemporal contact missed a substantial proportion of transmission events.CONCLUSIONWith our findings, we advocate for broader epidemiological investigations of temporal connections if genomic data suggest relatedness. We emphasise considering plasmid transfer alongside analyses of core-genome relatedness of bacteria beyond patient contact events to study CPE and resistance spread, and guide infection control strategies.

Effectiveness of Nursing Interventions on Preventing the Risk of Infection in Adult Inpatients: Protocol for a Systematic Review

Background/Objectives: Healthcare-associated infections (HAIs) are a major global public health concern, significantly impacting patient safety and healthcare quality. These infections are associated with high morbidity and mortality rates, prolonged hospital stays, and increased healthcare costs. Nurses play a critical role in infection prevention, implementing evidence-based interventions to reduce infection risks. This systematic review aims to identify and synthesize the most effective nursing interventions to prevent HAIs in hospitalized adults, analyzing their variability across different clinical settings and populations. Methods: This systematic review follows the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness and is reported according to PRISMA guidelines. The protocol is registered in the PROSPERO database (CRD42024582820). This review includes randomized controlled trials, quasi-experimental studies, and observational studies (cohort, case-control, and cross-sectional) assessing the effectiveness of nursing interventions in reducing HAIs. A comprehensive search is conducted in the PubMed, CINAHL, Scopus, Web of Science, and Cochrane databases. Study selection, data extraction, and quality assessment are performed by two independent reviewers, with disagreements resolved by a third reviewer. Results: The primary outcomes include reductions in HAI incidence rate, increased adherence to preventive interventions, decreased hospital length of stay, reduced readmission rates due to infections, and overall patient safety improvements. A meta-analysis is conducted when feasible; otherwise, results are synthesized narratively. Conclusions: The findings of this review contribute to the standardization of evidence-based nursing practices for HAI prevention, promoting safer healthcare environments. By identifying the most effective interventions, this study aims to support healthcare professionals and policymakers in implementing targeted infection control strategies.

Infection Control Strategies for Preventing Methicillin-Resistant Staphylococcus aureus-Related Surgical Site Infections in Pakistan: A Mixed-Methods Analysis

Background: Methicillin-resistant Staphylococcus aureus (MRSA) significantly contributes to surgical site infections (SSIs) in Pakistan, with high prevalence rates among S. aureus isolates, leading to increased morbidity and healthcare costs.Objective: This study assessed the effectiveness of infection control strategies in reducing MRSA-related SSIs in Pakistani healthcare facilities, identified implementation barriers, and proposed context-specific recommendations.Methods: A mixed-methods study, conducted from January to March 2025, surveyed 100 healthcare professionals (32% surgeons, 28% nurses, and 18% infection control specialists) across public, private, and rural hospitals in all Pakistani provinces. Quantitative data from a structured questionnaire were analyzed using chi-square tests and logistic regression, while qualitative responses were thematically analyzed using Braun and Clarke’s framework.Results: Quantitatively, only 8% of facilities screened all surgical patients for MRSA, with 46% performing no screening, and 38% achieved 51-70% hand hygiene compliance, correlating with higher MRSA-SSI rates (odds ratio = 3.42, p < 0.001). Qualitatively, key themes included resource scarcity (e.g., “We often share a single dispenser”), staff resistance, and systemic inefficiencies.Conclusion: Strengthening hand hygiene, selective MRSA screening, and surgical bundles, alongside improved training and resource allocation, can reduce MRSA-SSIs in Pakistan. Tailoring global guidelines to local constraints is essential for effective implementation. These findings guide strategies to enhance surgical safety in resource-limited settings.