Publications by authors named "Andreas Widmer"

Background: The environment of healthcare institutions plays a major role in the transmission of multidrug resistant organisms (MDRO) and likely in subsequent healthcare-associated infections (HAIs). Probiotic cleaning products are a novel option for environmental cleaning. They represent a sustainable and biodegradable alternative to conventional chemical disinfectants for controlling microbial bioburden, and preventing pathogen transmission in hospital environments.

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The implementation of isolation precautions for patients with suspected Coronavirus Disease 2019 (COVID-19) and pending test results is resource intensive. Due to the limited availability of single-bed rooms at our institution, we isolated patients with suspected COVID-19 together with patients without suspected COVID-19 on-site in multiple-bed rooms until SARS-CoV-2-test results were available. We evaluated the likelihood of SARS-CoV-2 transmission to individuals sharing the room with patients isolated on-site.

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Article Synopsis
  • The study aimed to investigate how patient-dependent factors affect the microbial composition of surgical-site infections (SSIs), analyzing data from over half a million patients in Switzerland.
  • Researchers identified key predictors, with age, body mass index (BMI), and duration of surgery being significant factors influencing the types of bacteria found in SSIs, particularly noting a shift from Staphylococcus spp. to Enterobacterales and Enterococcus spp. in older patients and those with longer surgeries.
  • The findings suggest that understanding patient characteristics can help in predicting and managing SSIs, and the research includes an online tool for applying the machine learning model in other healthcare contexts.
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Importance: Preoperative skin antisepsis is an established procedure to prevent surgical site infections (SSIs). The choice of antiseptic agent, povidone iodine or chlorhexidine gluconate, remains debated.

Objective: To determine whether povidone iodine in alcohol is noninferior to chlorhexidine gluconate in alcohol to prevent SSIs after cardiac or abdominal surgery.

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  • This study aimed to determine if administering surgical antimicrobial prophylaxis (SAP) reduces the risk of surgical site infections (SSI) following low-risk cholecystectomies (LR-CCE).
  • It analyzed data from 44,682 patients who underwent elective LR-CCE at Swiss hospitals, finding that 74% received SAP and experienced a significantly lower SSI rate of 1.1% compared to those who did not receive SAP.
  • The results suggest that routine use of SAP before LR-CCE could decrease SSI rates by 50%, indicating potential benefits for patients undergoing this type of surgery.
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Aims: This study evaluated an approach to establishing a comprehensive nationwide surveillance system for Clostridioides difficile infection in Switzerland. We report the results of patient-related surveillance and calculate the incidence rate of C. difficile infection in Switzerland in 2022.

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  • A study analyzed 451 historic MRSA isolates from Switzerland, collected between 1965 and 1987, to uncover evolutionary patterns and resistance factors compared to modern MRSA samples and international genomes.
  • The researchers found 17 unique sequence types (STs), including five new STs, indicating a mix of both previously known and novel genetic variations.
  • The dominant type identified among early isolates was ST247-MRSA-I, showing early MRSA strains were primarily from clonal complex 8, while other complexes began appearing from 1980 onwards, highlighting changes in MRSA diversity over time.
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Objectives: The aim of this study was to evaluate antibiotic prescribing of medium-to-high prescribing primary care physicians being followed up after the completion of a Swiss national intervention trial of antibiotic prescription audit and feedback in the first SARS-CoV-2 pandemic year.

Methods: We used health insurer based claims data to calculate monthly antibiotic prescription rates per 100 consultations (primary endpoint) and applying interrupted time series (ITS) analysis methods, we estimated the immediate (step change) and sustained effects (slope) of the SARS-CoV-2 epidemic in 2020 on antibiotic prescribing compared to the pre-pandemic trial period from 2017-2019.

Results: We analysed data of 2945 of 3426 physicians (86.

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Article Synopsis
  • - The study in Switzerland assessed the effectiveness of a targeted intervention program aimed at reducing surgical site infection (SSI) rates in eight hospitals, alongside existing SSI surveillance, from 2013 to 2020.
  • - Researchers included over 10,000 patients undergoing cardiac, colon, or hip/knee surgeries and focused on optimizing hair removal, skin disinfection, and antimicrobial prophylaxis as preoperative measures.
  • - Results showed a decrease in overall SSI rates post-intervention, with a significant reduction for cardiac surgeries, demonstrating the program's effectiveness in lowering infection rates.
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Aims Of The Study: Remdesivir has shown benefits against COVID-19. However, it remains unclear whether, to what extent, and among whom remdesivir can reduce COVID-19-related mortality. We explored whether the treatment response to remdesivir differed by patient characteristics.

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The silent pandemic of bacterial antimicrobial resistance is a leading cause of death worldwide, prolonging hospital stays and raising health-care costs. Poor incentives to develop novel pharmacological compounds and the misuse of antibiotics contribute to the bacterial antimicrobial resistance crisis. Therapeutic drug monitoring (TDM) based on blood analysis can help alleviate the emergence of bacterial antimicrobial resistance and effectively decreases the risk of toxic drug concentrations in patients' blood.

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Importance: World Health Organization guidelines recommend administering surgical antimicrobial prophylaxis (SAP), including cefuroxime, within 120 minutes prior to incision. However, data from clinical settings supporting this long interval is limited.

Objective: To assess whether earlier vs later timing of administration of cefuroxime SAP is associated with the occurrence of surgical site infections (SSI).

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The SARS-CoV-2 pandemic has highlighted the importance of viable infection surveillance and the relevant infrastructure. From a German perspective, an integral part of this infrastructure, genomic pathogen sequencing, was at best fragmentary and stretched to its limits due to the lack or inefficient use of equipment, human resources, data management and coordination. The experience in other countries has shown that the rate of sequenced positive samples and linkage of genomic and epidemiological data (person, place, time) represent important factors for a successful application of genomic pathogen surveillance.

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The SARS-CoV‑2 pandemic has shown a deficit of essential epidemiological infrastructure, especially with regard to genomic pathogen surveillance in Germany. In order to prepare for future pandemics, the authors consider it urgently necessary to remedy this existing deficit by establishing an efficient infrastructure for genomic pathogen surveillance. Such a network can build on structures, processes, and interactions that have already been initiated regionally and further optimize them.

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Importance: With the ongoing COVID-19 pandemic, it is crucial to assess the current burden of disease of community-acquired SARS-CoV-2 Omicron variant in hospitalized patients to tailor appropriate public health policies. Comparisons with better-known seasonal influenza infections may facilitate such decisions.

Objective: To compare the in-hospital outcomes of patients hospitalized with the SARS-CoV-2 Omicron variant with patients with influenza.

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Importance: Antibiotics are commonly prescribed in primary care, increasing the risk of antimicrobial resistance in the population.

Objective: To investigate the effect of quarterly audit and feedback on antibiotic prescribing among primary care physicians in Switzerland with medium to high antibiotic prescription rates.

Design, Setting, And Participants: This pragmatic randomized clinical trial was conducted from January 1, 2018, to December 31, 2019, among 3426 registered primary care physicians and pediatricians in single or small practices in Switzerland who were among the top 75% prescribers of antibiotics.

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Article Synopsis
  • Over 100,000 observations in Swiss hospitals showed that hand hygiene adherence rose significantly during the first wave of COVID-19.* -
  • Despite ongoing COVID-19 cases, adherence to hand hygiene fell back to pre-pandemic levels after two years.* -
  • The findings suggest that maintaining high hand hygiene standards through training and support is difficult even during a pandemic.*
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Article Synopsis
  • The -group includes both common, typically non-harmful species often seen as contaminants and some highly virulent strains.
  • This study examined 16 isolates from 15 patients identified using MALDI-TOF MS, finding varied species classifications through whole genome sequencing, with some lacking known virulence plasmids.
  • The research underscores the challenges in accurately identifying avirulent species in the -group with standard diagnostic methods, suggesting that advanced techniques like WGS and specialized databases could improve species identification.
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Objective: The aim was to assess the impact of operating room (OR) ventilation quality on surgical site infections (SSIs) using a novel ventilation index.

Background: Previous studies compared laminar air flow with conventional ventilation, thereby ignoring many parameters that influence air flow properties.

Methods: In this cohort study, we surveyed hospitals participating in the Swiss SSI surveillance and calculated a ventilation index for their ORs, with higher values reflecting less turbulent air displacement.

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Background: The optimal extent of screening of contact patients (CoPat) after exposure to patients infected or colonized with vancomycin-resistant enterococci (VRE) remains controversial.

Methods: We retrospectively developed a new risk stratification for screening patients exposed to VRE, based on data from three outbreaks-two with Enterococcus faecium vanB and one with Enterococcus faecium vanA involving 1096 CoPat-in a low endemic setting. We classified them into four risk groups: three on environmental exposure, one by healthcare exposure: high (sharing the same room/bathroom with a VRE-colonized patient), medium (hospitalization in the same room after a VRE-colonized patient's discharge until terminal disinfection including ultraviolet C (UVc)-disinfection), low (hospitalized in the same room within three weeks before the VRE-colonized patient), and "staff" (screening of patients having the same medical care team).

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Objectives: Isolation precautions (IP) are applied to prevent transmission of pathogens in healthcare settings. Potential negative health outcomes experienced by patients have been previously described but results remain conflicting. We aimed at evaluating the psychological impact of IP in adult patients in isolation using a novel psychological assessment tool.

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Article Synopsis
  • Vancomycin resistant enterococci (VRE) outbreaks have been increasing in European hospitals, with a significant outbreak occurring in Switzerland in 2018, leading to new guidelines for infection prevention.
  • A survey conducted in March 2020 showed that 88% of responding Swiss acute care hospitals adopted the new guidelines, with those having VRE cases more likely to change their infection control strategies.
  • The implementation of target strategies such as admission screening and contact precautions contributed to a reduction in VRE cases in the following years, indicating that the guidelines were effective in controlling the spread of VRE in these hospitals.
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Synopsis of recent research by authors named "Andreas Widmer"

  • - Andreas Widmer’s recent research primarily focuses on infection control in healthcare settings, addressing crucial issues such as the transmission of multidrug-resistant organisms (MDRO) and surgical site infections (SSIs) through innovative approaches like probiotic cleaning products and targeted intervention programs.
  • - His studies reveal that specific patient characteristics can significantly influence microbial composition in SSIs, highlighting the importance of personalized approaches in infection management, as well as the ongoing debate between different antiseptic agents effectiveness for preoperative skin antisepsis.
  • - Furthermore, Widmer investigates the impact of the COVID-19 pandemic on antibiotic prescribing patterns and aims to establish comprehensive surveillance systems for infections like Clostridioides difficile, reinforcing the need for continual evaluation of infection prevention strategies in healthcare environments.