{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:50:05Z","timestamp":1791809405125,"version":"4.3.4"},"reference-count":25,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"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":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X26105248_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess the association between hand hygiene adherence, as measured by an automated hand hygiene monitoring system (AHHMS), and multidrug-resistant organisms and other pathogens of epidemiologic significance (MDRO+).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105248_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105248_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Acute care hospitals within an academic healthcare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105248_as4\">\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>Hand hygiene data was collected from all badged staff January 2021 through September 2022. Adult inpatients on non-maternity units during this period were eligible for inclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105248_as5\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      After implementing an AHHMS, we analyzed correlations between monthly unit-level hand hygiene adherence (proportion of room entry\u2013exit opportunities during which hand hygiene solution was dispensed) and hospital-onset MDRO+ rates from all clinical cultures and\n                      <jats:italic>Clostridioides difficile<\/jats:italic>\n                      stool tests. Mixed-effect negative binomial regression models evaluated associations between monthly unit-level hand hygiene adherence and MDRO+ rates while adjusting for the number of clinical tests ordered, unit type, and average number of inpatient COVID-19 cases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105248_as6\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>During the study period, there were 22,767,036 hand hygiene opportunities. Mean hand hygiene adherence improved from 41% (January 2021) to 57% (September 2022). 1,847 MDRO+ detections were observed in 752,341 patient days with a median composite MDRO+ rate of 1.7 per 1,000 patient days (IQR: 0\u20133.6). The mixed-effect negative binomial regression model found a null association between hand hygiene adherence and MDRO+ rates (rate ratio 1.01; 95% confidence interval: 1.00\u20131.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105248_as7\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Despite an improvement in hand hygiene adherence, we did not find a resultant impact on MDRO+ detection, likely owing to the complex interaction between the two variables and unmeasured confounders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10524","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:38:57Z","timestamp":1787801937000},"page":"1039-1045","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Impact of hand hygiene on the detection of multidrug-resistant organisms and other pathogens of epidemiologic significance after implementation of an automated hand hygiene monitoring system"],"prefix":"10.1017","volume":"47","author":[{"given":"Radhika","family":"Prakash-Asrani","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03czfpz43","id-type":"ROR","asserted-by":"publisher"}],"name":"Emory University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8057-8448","authenticated-orcid":false,"given":"Kayoko","family":"Shioda","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7826-7846","authenticated-orcid":false,"given":"Chris W.","family":"Bower","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03czfpz43","id-type":"ROR","asserted-by":"publisher"}],"name":"Emory University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3062-6410","authenticated-orcid":false,"given":"James P.","family":"Steinberg","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03czfpz43","id-type":"ROR","asserted-by":"publisher"}],"name":"Emory University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4892-693X","authenticated-orcid":false,"given":"Scott K.","family":"Fridkin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03czfpz43","id-type":"ROR","asserted-by":"publisher"}],"name":"Emory University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9811-6260","authenticated-orcid":false,"given":"Jesse T.","family":"Jacob","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03czfpz43","id-type":"ROR","asserted-by":"publisher"}],"name":"Emory University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7473-6964","authenticated-orcid":false,"given":"Lindsey B.","family":"Gottlieb","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03czfpz43","id-type":"ROR","asserted-by":"publisher"}],"name":"Emory University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"S0899823X26105248_ref19","unstructured":"19. WHO guidelines on hand hygiene in health care. https:\/\/www.who.int\/publications\/i\/item\/9789241597906. Accessed March 30, 2026."},{"key":"S0899823X26105248_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2023.02.017"},{"key":"S0899823X26105248_ref17","doi-asserted-by":"publisher","DOI":"10.1086\/662179"},{"key":"S0899823X26105248_ref8","doi-asserted-by":"publisher","DOI":"10.1086\/524333"},{"key":"S0899823X26105248_ref10","first-page":"462","article-title":"Effectiveness of a hospital-wide infection control programme on the incidence of healthcare-associated infections and associated severe sepsis and septic shock: a prospective interventional study","volume":"25","author":"Hagel","year":"2019","journal-title":"Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis"},{"key":"S0899823X26105248_ref9","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2014-003080"},{"key":"S0899823X26105248_ref24","unstructured":"24. Patient Safety Component (PSC) | NHSN | CDC. https:\/\/www.cdc.gov\/nhsn\/psc\/index.html. January 7, 2025. Accessed June 6, 2025."},{"key":"S0899823X26105248_ref22","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2026.10513"},{"key":"S0899823X26105248_ref3","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-026-71195-4"},{"key":"S0899823X26105248_ref12","doi-asserted-by":"publisher","DOI":"10.1086\/677629"},{"key":"S0899823X26105248_ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.62059"},{"key":"S0899823X26105248_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2016.11.029"},{"key":"S0899823X26105248_ref14","first-page":"101","article-title":"Approaches to hand hygiene monitoring: from low to high technology approaches","volume":"65","author":"Masroor","year":"2017","journal-title":"Int J Infect Dis IJID Off Publ Int Soc Infect Dis"},{"key":"S0899823X26105248_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2007.08.007"},{"key":"S0899823X26105248_ref15","first-page":"408","article-title":"Implementation and impact of an automated group monitoring and feedback system to promote hand hygiene among health care personnel","volume":"40","author":"Conway","year":"2014","journal-title":"Jt Comm J Qual Patient Saf"},{"key":"S0899823X26105248_ref1","unstructured":"1. CDC. HAIs: reports and data. Healthcare-associated infections (HAIs). 2024. https:\/\/www.cdc.gov\/healthcare-associated-infections\/php\/data\/index.html. September 23, 2024. Accessed October 11, 2024."},{"key":"S0899823X26105248_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2014.01.002"},{"key":"S0899823X26105248_ref25","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S62704"},{"key":"S0899823X26105248_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2016.08.014"},{"key":"S0899823X26105248_ref4","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.9763"},{"key":"S0899823X26105248_ref23","unstructured":"23. CDC. Antibiotic resistance threats in the United States. 2019. https:\/\/stacks.cdc.gov\/view\/cdc\/82532\/cdc_82532_DS1.pdf. January 1, 2019. 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Society for Healthcare Epidemiology of America\/Association for Professionals in Infection Control\/Infectious Diseases Society of America","volume":"51","author":"Boyce","year":"2002","journal-title":"MMWR Recomm Rep Morb Mortal Wkly Rep Recomm Rep"},{"key":"S0899823X26105248_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2021.03.009"},{"key":"S0899823X26105248_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2021.09.016"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X26105248","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:37:30Z","timestamp":1791808650000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X26105248\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":25,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["S0899823X26105248"],"URL":"https:\/\/doi.org\/10.1017\/ice.2026.10524","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. 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"}]}}