Background: Despite the global efforts to antagonize carbapenem-resistant Acinetobacter baumannii (CRAB) spreading, it remains an emerging threat with a related mortality exceeding 40% among critically ill patients. The purpose of this review is to provide evidence concerning the best infection prevention and control (IPC) strategies to fight CRAB spreading in endemic hospitals. Methods: The study was a critical review of the literature aiming to evaluate all available studies reporting IPC measures to control CRAB in ICU and outside ICU in both epidemic and endemic settings in the past 10 years. Results: Among the 12 included studies, the majority consisted of research reports of outbreaks mostly occurred in ICUs. The reported mortality reached 50%. Wide variability was observed related to the frequency of application of recommended CRAB IPC measures among the studies: environmental disinfection (100%); contact precautions (83%); cohorting staff and patients (75%); genotyping (66%); daily chlorhexidine baths (58%); active rectal screening (50%); closing or stopping admissions to the ward (33%). Conclusions: Despite effective control of CRAB spreading during the outbreaks, the IPC measures reported were heterogeneous and highly dependent on the different setting as well as on the structural characteristics of the wards. Reinforced ‘search and destroy’ strategies both on the environment and on the patient, proved to be the most effective measures for permanently eliminating CRAB spreading.

We aimed to assess the impact of COVID-19 on antibiotic consumption (AMC) and antimicrobial resistance (AMR) in the new epidemiological scenario from a cross-national perspective. A quasi-experimental retrospective multicentre ecological study was conducted to explore the impact of COVID-19 on AMC and AMR using routinely generated retrospective time series data. This study included nine Healthcare University Hospitals from Europe and Israel on behalf QUantifying change in Antibiotic Resistance, ANTibiotic use, and INfection control during COVID-19 Epidemics project. Total effects were defined as the difference between the pre-COVID-19 period (ranging from January 2015 or January 2016 to February 2020) and during the COVID-19 pandemic period (March 2020 to July 2021 or December 2021). The outcomes were incidence density (ID) of carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Klebsiella pneumoniae, extended-spectrum beta-lactamase-producing Escherichia coli, vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus, carbapenem-resistant Pseudomonas aeruginosa and Clostridioides difficile, as monthly isolates per 1000 patient days and the monthly AMC ranked according to the Access, Watch, and Reserve WHO classification system. We assessed 15.9 million total hospital bed days, 315 736 COVID-19 bed days, 52 557 monthly bacterial isolates, and 461 739 monthly antimicrobial defined daily doses. The COVID-19 pandemic had a significant impact on the consumption of overall hospital antibiotics combined in all centres except two. Prescriptions for piperacillin/tazobactam, glycopeptides, and ceftazidime/avibactam increased, whereas third-generation cephalosporins, macrolides, and fluoroquinolones returned to pre-pandemic levels after an initial surge, in all centres. A positive relationship between the pandemic intensity and VRE ID was observed in 6 of 9 (66%) centres followed by methicillin-resistant S. aureus-ID and carbapenem-resistant P. aeruginosa-ID 3 of 4 (44%) for both. A negative relationship was found for extended-spectrum beta-lactamase-producing E. coli ID. The COVID-19 pandemic was associated with higher usage of broad-spectrum antibiotics and higher incidence of multidrug-resistant bacteria, with great variability by countries. These results could support international action plans that embed AMR as a priority in the post-COVID-19 era.

Simulation became gradually pivotal in training of health professionals: indeed, it showed an improvement in practical skill of the trainees compared to theoretical lectures. Among others, ACLS (advance cardiovascular life support) courses are now one of the standard learning practices most spread around the world. The primary aim of this study is to evaluate both the level of satisfaction and the clinical thinking that the trainees perceived during an ACLS course. This was performed via the SSE validated scale (Satisfaction with simulation experience scale). The secondary aim was to evaluate if demographics affect the aforementioned perceived satisfaction. a SSE questionnaire was distributed after the ACLS section of practical scenarios, just before the end of the course and of the practical test. 72 questionnaires have been collected. The sample was constituted by 68.1% of females, 44,4% by nurses without a master's degree, and 52,8% personnel that works outside of a critical care setting. QTOT Median score was 89 (IQR=86-90), DTOT Median's 45 (IQR= 44.25-45), RTOT Median's 25 (IQR=22-25), LTOT Median was 20 (IQR=19-20). Conclusions: The ACLS course attains a high grade of satisfaction on all of the three aspects evaluated by the questionnaire. The perception was not influenced by the demographics.