{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T13:11:22Z","timestamp":1772284282596,"version":"3.50.1"},"reference-count":31,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T00:00:00Z","timestamp":1731283200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X24001788_as1\"><jats:title>Objective:<\/jats:title><jats:p>To determine the regional impact of transmission of multidrug-resistant organisms (MRDOs) and <jats:italic>Clostridioides difficile<\/jats:italic> (<jats:italic>C. difficile<\/jats:italic>) among a tertiary care hospital and surrounding facilities including long-term care facilities (LTCFs).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24001788_as2\"><jats:title>Design:<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24001788_as3\"><jats:title>Methods:<\/jats:title><jats:p>Patients admitted to a tertiary care hospital from July 2019 to July 2021 were recruited if their clinically collected cultures grew the following pathogens: Methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA), Extended-Spectrum Beta-Lactamase (ESBL) producing Enterobacterales, <jats:italic>Pseudomonas aeruginosa<\/jats:italic> with difficult-to-treat resistance, Carbapenem-resistant Enterobaterales, Vancomycin-resistant Enterococci, and <jats:italic>C. difficile<\/jats:italic>. Patient characteristics including admission and discharge pathway were collected. For the isolates of MRSA, ESBL-producing <jats:italic>Escherichia coli<\/jats:italic> (<jats:italic>E. coli<\/jats:italic>), and <jats:italic>C. difficile<\/jats:italic>, a molecular epidemiological analysis was conducted, utilizing the PCR-based Open-Reading Frame Typing (POT) method.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24001788_as4\"><jats:title>Results:<\/jats:title><jats:p>Three hundred-five patients were identified with a total of 332 culture specimens of the target pathogens. The top three were 132 MRSA isolates (43.3%, out of 305), 97 ESBL <jats:italic>E. coli<\/jats:italic> (31.8%), and 32 ESBL Enterobacterales (non-<jats:italic>E. coli<\/jats:italic>) (10.5%). The target pathogens were more detectable within 3 days among patients admitted from LTCFs or other hospitals than those admitted from home (Odds Ratio 4.6, 95% confidence interval 2.8-7.6, p-value &lt; 0.001). The molecular epidemiological analysis suggested the transmissions of MRSA, ESBL <jats:italic>E. coli<\/jats:italic> and <jats:italic>C. difficile<\/jats:italic> occurred 52 out of 111 patients within the in-hospital environment, and 7 out of 128 within the prehospital environment, respectively.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24001788_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>MDROs\/<jats:italic>C. difficile<\/jats:italic> transmission is prevalent within a tertiary care hospital and further complicated by its inter-facility transmission across surrounding LTCFs and hospitals in Japan.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2024.178","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T08:45:48Z","timestamp":1731314748000},"page":"35-42","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Transmission of MRSA, ESBL <i>E. coli<\/i>, and <i>C. difficile<\/i> within a tertiary care hospital and across surrounding facilities in Japan: a molecular epidemiological study with the PCR-based Open-reading frame typing"],"prefix":"10.1017","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6477-8204","authenticated-orcid":false,"given":"Hiroki","family":"Saito","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9393-2661","authenticated-orcid":false,"given":"Satoshi","family":"Miike","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuya","family":"Ohno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Momoko","family":"Anzai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumimasa","family":"Kasai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akiko","family":"Hosoyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomomi","family":"Takakura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yosuke","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeki","family":"Fujitani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2024,11,11]]},"reference":[{"key":"S0899823X24001788_ref25","doi-asserted-by":"publisher","DOI":"10.1017\/ash.2022.279"},{"key":"S0899823X24001788_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2019.08.016"},{"key":"S0899823X24001788_ref9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2672.2006.02932.x"},{"key":"S0899823X24001788_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2015.07.005"},{"key":"S0899823X24001788_ref13","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00016-17"},{"key":"S0899823X24001788_ref17","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-30637-5"},{"key":"S0899823X24001788_ref19","unstructured":"19. World Health Organization. Infection prevention and control assessment framework at the facility level. https:\/\/www.who.int\/publications\/i\/item\/WHO-HIS-SDS-2018.9. Published 2018. Accessed September 9, 2024."},{"key":"S0899823X24001788_ref16","unstructured":"16. Centers for Disease Control and Prevention. Carbapenem-resistant Enterobacterales (CRE) Infection Control. https:\/\/www.cdc.gov\/cre\/hcp\/infection-control\/index.html. Published 2024. Accessed September 9, 2024."},{"key":"S0899823X24001788_ref1","first-page":"629","article-title":"Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis","volume":"39","year":"2022","journal-title":"Lancet"},{"key":"S0899823X24001788_ref29","unstructured":"29. National Institute of Infectious Diseases. Methicillin-resistant Staphylococcus aureus (MRSA) infections April 1999 to December 2022. https:\/\/www.niid.go.jp\/niid\/ja\/mrsa-m\/1450-idsc\/iasr-topic\/12573-529t.html. Published 2024. 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National action plan on antimicrobial resistance (AMR). https:\/\/www.mhlw.go.jp\/file\/06-Seisakujouhou-10900000-Kenkoukyoku\/0000138942.pdf. Published 2016. Accessed September 9, 2024."},{"key":"S0899823X24001788_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2020.08.020"},{"key":"S0899823X24001788_ref18","unstructured":"18. World Health Organization. Hand hygiene self-assessment framework 2010. https:\/\/www.who.int\/publications\/m\/item\/hand-hygiene-self-assessment-framework-2010. Published 2010. Accessed September 9, 2024."},{"key":"S0899823X24001788_ref14","unstructured":"14. World Health Organization. WHO guidelines on hand hygiene in health care. https:\/\/www.who.int\/publications\/i\/item\/9789241597906. Published 2009. Accessed September 9, 2024."},{"key":"S0899823X24001788_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2019.06.014"},{"key":"S0899823X24001788_ref3","unstructured":"3. The Government of Japan. National Action Plan on Antimicrobial Resistance (AMR). https:\/\/www.mhlw.go.jp\/content\/10900000\/001096228.pdf. Published 2023. 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Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}