Recurrent joint infection caused by a multidrug-resistant capnophilic ST131 O25H4 strain.

We report a case of a native knee septic arthritis and subsequent osteomyelitis due to a CO-dependent (capnophilic) multidrug-resistant ST131 O25:H4 strain. Capnophilic phenotype made microbiology investigation challenging; susceptibility testing could not be performed and the organism did not grow in the urine culture using standard method. The combination of unique virotype and capnophilia may have contributed to the aggressiveness of this organism and the initial unsuccessful carbapenem course, leading to recurrent infection.

Impact of mandatory nucleic acid amplification test (NAAT) testing approval on hospital-onset infection (HO-CDI) rates: A diagnostic stewardship intervention.

Misclassification of colonization as hospital-onset infection (HO-CDI) can lead to unnecessary treatment of patients and substantial financial penalties for hospitals. We successfully implemented mandatory PCR testing approval as a strategy to optimize testing, which was associated with a significant decline in the monthly incidence of HO-CDI rates and lowering of our standardized infection ratio to 0.77 (from 1.