To develop and validate an automated surveillance system for healthcare-associated Clostridioides difficile infections (HA-CDI).

Multicenter cohort study.

16 acute care hospitals.

Patients admitted to participating hospitals between 2013 and 2022.

An automated surveillance system was developed with retrospective extraction from admission/discharge/transfer and laboratory databases and compared with conventional surveillance based on clinical definitions collected prospectively by infection control professionals. Comparison of HA-CDI incidence rates calculated by automated vs conventional surveillances were performed with χ2, incidence rate ratios, and linear regression. A subset of discordant cases was further investigated by reviewing medical records.

Overall, conventional surveillance reported 3,211 cases of HA-CDI for an incidence rate of 4.94 per 10,000 patient-days. Automated surveillance detected 4,708 cases, for an incidence rate of 7.24 per 10,000 patient-days (incidence rate ratio, 1.47; 95% CI, 1.40–1.53). Full concordance between both surveillance methods was observed in 62% of cases, while 34% of cases were detected only by automated surveillance, and 4% were detected by conventional surveillance only. Between 2013 and 2022, an identical declining trend in HA-CDI incidence rates of –0.54 cases per 10,000 patient-days was observed with both surveillance methods. A subset of 49 cases detected only by automated surveillance were reviewed; the main reasons for discrepancy were delayed testing (39%), colonization (24%), misclassifications (14%), and interinstitutional transfers (12%).

HA-CDI incidence rates calculated by automated surveillance were higher than those of conventional surveillance, but the overestimation was consistent over time, suggesting that a correction factor could improve precision.

Antimicrobial resistance (AMR) is a growing global health crisis, with Klebsiella pneumoniae being a key pathogen due to its multidrug resistance (MDR). This study aimed to investigate the resistance profiles, demographic correlations, and molecular characteristics of MDR K. pneumoniae at UNIOSUN Teaching Hospital, Osogbo, Nigeria.

From January to April 2022, 99 clinical isolates (K. pneumoniae) were collected from various specimen types (blood, sputum, urine, wound, stool, and oral cavity). Antibiotic susceptibility was assessed using the Kirby-Bauer disk diffusion method, and virulence genes were analysed using multiplex polymerase chain reaction.

All isolates exhibited resistance to ceftriaxone, cefotaxime, and colistin, with high resistance observed for cefepime and carbapenems (meropenem, imipenem, and ertapenem). Molecular characterization revealed the presence of virulence genes K1, K2, and mrkD in 15 isolates, while other tested virulence genes (fimH, ramA, traT, K3, and K5) were not detected. Significant associations were identified between resistance patterns and demographic factors, including age and sex, highlighting potential vulnerabilities in specific populations.

This study underscores the alarming prevalence of MDR K. pneumoniae and aligns with global trends of rising AMR. Addressing these challenges requires targeted antimicrobial stewardship programs, infection control measures, public education, and enhanced surveillance systems. Incorporating molecular resistance testing and novel therapeutic agents in future research is crucial to developing effective containment strategies and preserving antibiotic efficacy.

Patients discharged from emergency departments (ED) with antibiotics for common infections often receive unnecessarily prolonged durations, representing a target for transition of care (TOC) antimicrobial stewardship intervention.

This study aimed to evaluate the effectiveness of TOC pharmacists’ review on decreasing the duration of discharge oral antibiotics in patients discharged from the ED at an academic medical center. Pharmacist interventions were guided by an antibiotic duration of therapy guidance focused on respiratory, urinary, and skin infections developed and implemented by the antimicrobial stewardship program. Pharmacist interventions from January 27, 2023, to December 29, 2023, were analyzed to quantify the total number of antibiotic days saved and the percentage of provider acceptance.

The ED TOC pharmacists reviewed a total of 157 oral antibiotic prescriptions. 86.6% percent of the reviews required pharmacist interventions. The most common indications for the discharge antibiotics were urinary tract infections (50.0%) and skin infections (23.4%). The total number of antibiotic days saved was 155 days with the provider acceptance rate of 76.5%. In 21% of cases, providers did not count the antibiotic doses administered in the ED, contributing to unnecessarily prolonged duration. 10.2% of patients re-presented to the ED while 6.4% of patients were hospitalized within 30 days of index ED discharge.

The transitions of care pharmacist-led intervention was successful in optimizing the duration of discharge oral antibiotics in the ED utilizing prospective audit and feedback based on institutional guidance. The ED represents a high-yield setting for TOC-directed antimicrobial stewardship.

Medication safety is critical for pediatric cardiac care, especially in low- and middle-income countries (LMICs), where limited resources contribute to high rates of medication errors. Studies in LMICs have shown that pharmacist interventions can reduce medication errors by up to 57% and proved that clinical pharmacists are essential for ensuring accurate and optimized medication use. This study aims to evaluate the role of clinical pharmacist interventions to rectify prescription errors in a pediatric cardiac care setting in Pakistan.

This single-center retrospective study was conducted from January to August 2022 in a pediatric cardiac ward at the National Institute of Cardiovascular Diseases. Pediatric patients of all age groups and genders diagnosed with acquired, inherited, or congenital heart diseases were included. We reviewed patient files for any prescription changes made by the clinical pharmacist, based on a comprehensive review of the patient profile, treatment regimens, and laboratory results, to ensure safe and effective pharmacotherapy.

260 pharmacist interventions were observed among 2754 patients over eight months, demonstrating a significant role in mitigating medication errors. The interventions addressed wrong doses (126), incorrect frequencies (101), redundant coverage (23), and therapy duration errors (8). Antibiotics were the most frequent source of prescription errors, accounting for 81% of the interventions.

Clinical pharmacists’ involvement in pediatric cardiac care significantly reduces medication errors in LMICs, as demonstrated by this study. These findings underscore the need to integrate clinical pharmacists into multidisciplinary teams to enhance medication safety and improve patient outcomes.