Seasonal influenza remains a major threat to healthcare facilities, where introduction of the virus can cause disproportionate morbidity and mortality among high-risk inpatients. This narrative review synthesizes current evidence and practice-oriented guidance on the prevention of hospital-acquired influenza. We conducted a targeted literature search using PubMed, guideline repositories for English-language publications from 2000 to 2025, prioritizing systematic reviews, clinical trials, and authoritative guidelines. A multifaceted strategy is emphasized: annual vaccination of healthcare personnel and eligible patients; consistent implementation of standard and transmission-based precautions; attention to environmental cleaning and disinfection; and occupational-health policies that limit presenteeism and workplace exposure. Evidence demonstrates that higher healthcare personnel (HCP) vaccination coverage is associated with lower patient influenza rates and improved survival. Reliable hand hygiene, respiratory source control, early initiation of droplet precautions, and cohorting when single rooms are limited all contribute to interrupting in-facility transmission. Ensuring that ill HCP can remain off duty without penalty further reduces the likelihood of staff-to-patient spread. Collectively, these coordinated measures provide a protective framework and underscore the central role of clinicians and infection-prevention teams in sustaining influenza control within acute-care settings.

Background: Outpatient Parenteral Antimicrobial Therapy (OPAT) has long been established as a safe and cost-effective alternative to inpatient care in Western healthcare systems. In contrast, its implementation across Asia has historically been fragmented and unstructured. A landmark multinational survey in 2017 identified OPAT in Asia as a “missed opportunity,” citing the lack of systematic oversight, standardized protocols, and outcome monitoring systems. Methods: This narrative review examines the evolution of OPAT in Asia over the past decade, synthesizing evidence from regional studies, national policies, and implementation models. Results: The findings demonstrate a clear shift from ad hoc infusion practices toward structured, multidisciplinary OPAT programs in several healthcare systems. These systems increasingly integrate antimicrobial stewardship principles, dedicated care teams, and reimbursement mechanisms. In parallel, innovative models, including hospital-at-home services and elastomeric pump–based continuous infusion, have expanded treatment feasibility while enabling the use of narrower-spectrum antibiotics. Despite these advances, substantial heterogeneity persists. Key barriers include the absence of unified national guidelines, limited monitoring infrastructure, workforce constraints, and regulatory restrictions in certain settings. Resource-limited regions continue to face challenges related to financing, laboratory capacity, and digital health integration. Conclusions: Overall, OPAT in Asia is transitioning from an underrecognized and inconsistently delivered service to an increasingly structured component of infectious disease care. Future priorities include standardized governance, integration with antimicrobial stewardship programs, sustainable reimbursement, digital outcome monitoring, and region-specific evidence on antimicrobial stability and safety.

Catheter-related bloodstream infections (CRBSIs) caused by Leclercia adecarboxylata are uncommon, and polymicrobial cases are even rarer. We report the first documented case caused by co-infection with Leclercia adecarboxylata and Enterobacter cloacae complex (ECC) in a woman with breast cancer undergoing chemotherapy through an indwelling chemoport. Antimicrobial susceptibility testing revealed that both isolates were susceptible to β-lactams, quinolones, and aminoglycosides. The patient achieved complete clinical recovery following intravenous ciprofloxacin therapy and prompt removal of the chemoport. This case highlights the emerging clinical relevance of Leclercia adecarboxylata and Enterobacter cloacae complex as potential pathogens capable of causing polymicrobial bloodstream infections in immunocompromised hosts and underscores the importance of considering rare environmental Gram-negative organisms as potential causes of catheter-related infections, particularly in patients with malignancy or long-term vascular access.

Background: Pulmonary mucormycosis is a life-threatening fungal infection that primarily affects immunocompromised individuals. Underlying malignancy is a recognized risk factor for pulmonary mucormycosis, yet its independent effect on patient outcomes remains uncertain. This study aimed to evaluate the impact of underlying malignancy on the clinical characteristics and 30-day mortality of pulmonary mucormycosis. Methods: We conducted a retrospective cohort study of 163 adults with proven or probable pulmonary mucormycosis at a single center in Taiwan (2021– 2024). Clinical and laboratory variables were compared between groups. Predictors of 30-day all-cause mortality were assessed using Cox proportional hazards regression with purposeful variable selection, and proportional-hazards assumptions were verified using Schoenfeld residuals. Results: The overall 30-day mortality rate was 18.4% (30 of 163 patients). Kaplan–Meier analysis confirmed lower 30-day survival in malignancy patients (log-rank χ² = 27.08, df = 1, p < 0.0001). In multivariable analysis, malignancy (aHR 3.65, 95% CI 1.40– 9.53), neutrophil-to-lymphocyte ratio per 5 units (aHR 1.10, 95% CI 1.05– 1.22), and alkaline phosphatase per 50 U/L (aHR 1.16, 95% CI 1.00– 1.64) were independent predictors of early death. Clinically, patients with malignancy predominantly exhibited a cytopenic–immunosuppressed phenotype, whereas those without malignancy more frequently exhibited a metabolic–inflammatory profile characterized by chronic kidney disease or recent COVID-19. Conclusion: Underlying malignancy independently triples 30‑day mortality in pulmonary mucormycosis. Easily available laboratory markers—neutrophil‑to‑lymphocyte ratio and alkaline phosphatase—also stratify early risk, underscoring the need for phenotype-tailored and timely antifungal management strategies.

Background: Hospital-acquired influenza remains a persistent threat that amplifies morbidity, mortality, length of stay, and operational strain, particularly among older and immunocompromised inpatients. The COVID-19 era reshaped control norms—normalizing N95 use during surges, ventilation improvements, and routine multiplex PCR—creating an opportunity to strengthen hospital outbreak management. Methods: We conducted a targeted narrative review of WHO/CDC/Infectious Diseases Society of America (IDSA) guidance and peer-reviewed studies (January 2015–August 2025), emphasizing adult inpatient care. This narrative review synthesizes recent evidence and discusses theoretical implications for practice, rather than establishing formal guidelines. Evidence was synthesized into pragmatic practice statements on detection, diagnostics, isolation/cohorting, antivirals, chemoprophylaxis, vaccination, surveillance, and communication. Results: Early recognition and test-based confirmation are pivotal. For inpatients, nucleic-acid amplification tests are preferred; negative antigen tests warrant PCR confirmation, and lower-respiratory specimens improve yield in severe disease. A practical outbreak threshold is ≥2 epidemiologically linked, laboratory-confirmed cases within 72 h on the same ward. Effective control may require immediate isolation or cohorting with dedicated staff, strict droplet/respiratory protection, and daily active surveillance. Early oseltamivir (≤48 h from onset or on admission) reduces mortality and length of stay; short-course post-exposure prophylaxis for exposed patients or staff lowers secondary attack rates. Integrated vaccination efforts for healthcare personnel and high-risk patients reinforce workforce resilience and reduce transmission. Conclusions: A standardized, clinician-led bundle—early molecular testing, do-not-delay antivirals, decisive cohorting and Personal protective equipment (PPE), targeted chemoprophylaxis, vaccination, and disciplined communication— could help curb transmission, protect vulnerable patients and staff, and preserve capacity. Hospitals should codify COVID-era layered controls for seasonal influenza and rehearse unit-level outbreak playbooks to accelerate response and recovery. These recommendations target clinicians and infection-prevention leaders in acute-care hospitals.

Background: Pulmonary aspergillosis remains highly lethal despite modern therapy. Although polymerase chain reaction (PCR) has enhanced detection, the clinical significance of its cycle threshold (Ct) values is unclear. The key problem is the lack of validation of Ct values for assessing fungal burden or predicting outcomes, limiting their diagnostic and prognostic utility. Methods: We conducted a retrospective cohort study of 154 adult patients diagnosed with pulmonary aspergillosis at a tertiary medical center in Taiwan (2021– 2024). All patients had a positive Aspergillus PCR from a respiratory specimen. We used receiver operating characteristic (ROC) curve analysis to determine an optimal Ct cutoff for predicting 30-day all-cause mortality and multivariable logistic regression to identify independent predictors. Results: Among 154 patients (mean age 70.5 ± 13.5 years; 48.1% female), the optimal Ct cutoff for predicting 30-day mortality was 30.7 (AUC = 0.65, 95% CI 0.56– 0.73). Patients with a Ct value < 30.7 had significantly higher 30-day mortality than those with a Ct ≥ 30.7 (71.2% vs 43.1%, p = 0.002). After adjusting for clinical and laboratory confounders, a Ct value < 30.7 remained the independent predictor of mortality (adjusted OR 3.07; 95% CI 1.27– 7.39; p = 0.012). Conclusion: A low Aspergillus PCR Ct value is an independent predictor of 30-day mortality in patients with pulmonary aspergillosis. While its discriminative ability is moderate, the Ct value may serve as a valuable predictor to aid in early risk stratification, when interpreted within the overall clinical context.