Publications by authors named "Schwaber M"

Escherichia coli producing OXA-48-like carbapenemases (OXA-EC) is considered a high-risk pathogen spread primarily in the community in low- and middle-income countries and nosocomially in high-income countries. We investigated the emergence and spread of OXA-EC in Israel, a high-income country with strong carbapenemase-directed infection control in healthcare institutions, by conducting a population-based study using data and isolates from the national surveillance system. A total of 3,510 incident cases of OXA-EC occurred during 2007-2023.

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During a health emergency, there is an urgent need to rapidly develop guidelines that meet minimum quality standards, as exemplified by the development of WHO guidelines on mask use in health care and community settings during the COVID-19 pandemic. Between January 2020 and October 2023, WHO developed 21 guideline updates on the use of masks as part of infection prevention and control (IPC) practices. Guideline developers had to deal with an ever-growing volume of evidence of variable quality.

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Background: Creating and sustaining an institutional climate conducive to patient and health worker safety is a critical element of successful multimodal hand hygiene improvement strategies aimed at achieving best practices. Repeated WHO global surveys indicate that the institutional safety climate consistently ranks the lowest among various interventions.

Methods: To develop an international expert consensus on research agenda priorities related to the role of institutional safety climate within the context of a multimodal hand hygiene improvement strategy, we conducted a structured consensus process involving a purposive sample of international experts.

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Article Synopsis
  • The study investigates the risk of bloodstream infections (BSI) caused by carbapenemase-producing Enterobacterales (CPE) among carriers in various settings, revealing a cumulative incidence of 2.4% over one year.
  • The research found that the risk of BSI varies significantly depending on the bacterial species, with lower risk seen in Escherichia coli carriers compared to Klebsiella pneumoniae, while high-risk settings like intensive care units show increased BSI risk.
  • Interestingly, the type of carbapenemase present did not significantly affect the risk of BSI, suggesting that the clinical environment and specific bacterial species may play a more crucial role in infection risk.
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Article Synopsis
  • Rapid and efficient infection control is essential during outbreaks of carbapenem-resistant Enterobacterales, with FTIR spectroscopy emerging as a promising alternative to the costly and complex WGS.
  • A study investigated an outbreak of OXA-48-producing E. coli by using FTIR to determine the relatedness of isolates in real-time and confirmed findings with WGS.
  • Results showed that FTIR successfully identified the outbreak cluster's genetic similarities and differences among isolates, suggesting its value as a quick, reliable tool for real-time outbreak investigations.
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(Ab) bloodstream infections (BSIs) are a major public health concern and associated with high mortality. We describe the nationwide incidence, antimicrobial resistance, and mortality of Ab-BSI in Israel using laboratory-based BSI surveillance data from January 2018 to December 2019. During the study period, there were 971 Ab-BSI events (508 in 2018 and 463 in 2019), with an average annual incidence of 8.

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In national surveys of infection preventionists in Israel (n = 15), the United States (n = 415), and Thailand (n = 100), we found that views of organizational culture track well with these countries' cultural dimension scores of power distance and individualism. Our findings highlight the importance of considering cultural dimensions when implementing infection prevention efforts.

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BackgroundCentral line-associated bloodstream infection (CLABSI) is among the most common preventable infectious complications in patients in intensive care units (ICU). In 2011, the Israel National Center for Infection Control initiated a nationwide CLABSI prevention programme.AimTo evaluate the impact of different components of the programme on CLABSI and non-CLABSI rates in medical-surgical ICUs.

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Background: We sought to determine incidence of common hospital-acquired bacteria among coronavirus disease 2019 (COVID-19) patients in Israeli general hospitals during the first year of the pandemic.

Methods: We analyzed routinely collected incidence data to determine hospital acquisition of the following sentinel bacteria: e, , , , , , , and . We examined 3 acquisition measures: (1) sentinel bacteria, (2) sentinel bacteremia, and (3) antimicrobial-resistant sentinel bacteremia.

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Background: The incidence of Escherichia coli bloodstream infections (BSI) is high and increasing. We aimed to describe the effect of season and temperature on the incidence of E. coli BSI and antibiotic-resistant E.

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Background: Limited data exist on long-term consequences of bloodstream infections (BSIs). We aimed to examine incidence, 1-year mortality, and years of potential life lost (YPLL) following BSI. We estimated the relative contribution of hospital-onset BSI (HO-BSI) and antibiotic-resistant BSI to incidence, mortality and YPLL.

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Background: Healthcare-associated infection (HAI) is a common and largely preventable cause of morbidity and mortality. The COVID-19 pandemic has presented unprecedented challenges to health systems. We conducted a national survey to ascertain hospital characteristics and the use of HAI prevention measures in Israel.

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Nationwide studies on hospital-onset bloodstream infections (HO-BSIs) are scarce. To describe incidence, mortality and antimicrobial resistance (AMR) of HO-BSI caused by eight sentinel bacteria in Israel, we used laboratory-based BSI surveillance data from 1 January 2018 to 31 December 2019. All hospitals reported positive blood cultures growing , , , , , , and .

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Objectives: Escherichia coli is the leading cause of bloodstream infection (BSI). The incidence of E. coli BSI caused by antibiotic-resistant strains is increasing.

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Non-tuberculous mycobacteria (NTM) are opportunistic pathogens that cause illness primarily in the elderly, in the immunocompromised or in patients with underlying lung disease. Since 2013, a global outbreak of NTM infection related to heater-cooler units (HCU) used in cardio-thoracic surgery has been identified. This outbreak was caused by a single strain of .

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This study aims to examine the prevalence and risk factors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sero-positivity in health care workers (HCWs), a main risk group, and assess the sero-incidence of SARS-CoV-2 infection between the first and second waves of coronavirus disease 2019 (COVID-19) in Israel. A longitudinal study was conducted among 874 HCWs from nine hospitals. Demographics, health information, and blood samples were obtained at baseline (first wave-April-May 2020) and at follow-up ( = 373) (second wave-September-November 2020).

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Article Synopsis
  • The study aimed to evaluate the effectiveness of Israeli national policy for discontinuing carrier status in individuals with carbapenemase-producing Enterobacterales (CPE) post-decolonization based on the type of carbapenemase involved.
  • Researchers conducted a retrospective cohort study on 1694 individuals, comparing those colonized with KPC- and NDM-producing Enterobacterales to determine rates of reverting to carrier status after isolation.
  • Results showed that only 7.9% reverted to carrier status, with no significant difference in rates between carriers of KPC and NDM, suggesting that decolonization outcomes are similar regardless of the specific carbapenemase type.
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Background: In June 2018, the Ministry of Health received notification from 2 hospitals about 2 patients who presented with overwhelming sepsis that developed within 24 hours after a dental procedure. We describe the investigation of this outbreak.

Methods: The epidemiologic investigation included site visits in 2 dental clinics and interviews with all involved healthcare workers.

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Objective: To determine the effect of 2 regulations issued by the Israel Ministry of Health on coronavirus disease 2019 (COVID-19) infections and quarantine among healthcare workers (HCWs) in general hospitals.

Design: Before-and-after intervention study without a control group (interrupted time-series analysis).

Setting: All 29 Israeli general hospitals.

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We characterized 57 isolates from a 2-phase clonal outbreak of New Delhi metallo-β-lactamase-producing Eschericha coli, involving 9 Israeli hospitals; all but 1 isolate belonged to sequence-type (ST) 410. Most isolates in the second phase harbored blaKPC-2 in addition to blaNDM-5. Genetic sequencing revealed most dual-carbapenemase-producing isolates to be monophyletically derived from a common ancestor.

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Objectives: To systematically summarize the evidence on how to collect, analyse and report antimicrobial resistance (AMR) surveillance data to inform antimicrobial stewardship (AMS) teams providing guidance on empirical antibiotic treatment in healthcare settings.

Methods: The research group identified 10 key questions about the link between AMR surveillance and AMS using a checklist of 9 elements for good practice in health research priority settings and a modified 3D combined approach matrix, and conducted a systematic review of published original studies and guidelines on the link between AMR surveillance and AMS.

Results: The questions identified focused on AMS team composition; minimum infrastructure requirements for AMR surveillance; organisms, samples and susceptibility patterns to report; data stratification strategies; reporting frequency; resistance thresholds to drive empirical therapy; surveillance in high-risk hospital units, long-term care, outpatient and veterinary settings; and surveillance data from other countries.

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Infections caused by extended-spectrum beta-lactamase-producing (ESBL-KP) are on a constant rise and are a noted cause of outbreaks in neonatal intensive care units (NICUs). We used whole genome sequencing (WGS) to investigate the epidemiology of consecutive and overlapping outbreaks caused by ESBL-KP in NICUs in three hospitals in close proximity. Clonality of 43 ESBL-KP isolates from 40 patients was determined by BOX-PCR.

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The IR Biotyper is a new automated typing system based on Fourier-transform infrared (FT-IR) spectroscopy that gives results within 4 h. We aimed (i) to use the IR Biotyper to retrospectively analyze an outbreak of extended-spectrum beta-lactamase-producing (ESBL-KP) in a neonatal intensive care unit and to compare results to BOX-PCR and whole-genome sequencing (WGS) results as the gold standard and (ii) to assess how the cutoff values used to define clusters affect the discriminatory power of the IR Biotyper. The sample consisted of 18 isolates from 14 patients.

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