Background/Objectives: Antimicrobial resistance (AMR) remains a major global threat, with the COVID-19 pandemic influencing its dynamics, although its overall impact remains uncertain. This study analyzed seven-year AMR trends, including the pandemic period, in a tertiary care hospital in Greece that served as a COVID-19 referral center. Methods: Multiresistant bacteria isolated from all biological specimens of hospitalized patients between January 2018 and December 2024 were recorded and classified as multidrug- (MDR), extensively drug- (XDR), or pandrug-resistant (PDR). Overall AMR was defined as the sum of these categories. Annual incidences of overall AMR, its categories, and predominant Gram-negative (A. baumannii, K. pneumoniae, P. aeruginosa) and Gram-positive [methicillin-resistant S. aureus (MRSA), vancomycin-resistant Enterococcus (VRE)] pathogens were analyzed for the entire hospital and by sector (medical, intensive care unit [ICU], surgical). Bloodstream infection (BSI) AMR was also evaluated. Trend analysis was performed using Joinpoint regression. Results: Overall AMR exhibited a transient peak around 2021 across the hospital, except in the surgical sector. A significant rise in average annual percentage change (AAPC) occurred only in the medical sector (p < 0.001). PDR incidence increased hospital-wide (p < 0.001). K. pneumoniae, P. aeruginosa, MRSA, and VRE rose significantly in the medical sector, whereas ICU incidences remained largely stable despite the 2021 peak. A. baumannii showed no significant change. BSI-related AMR increased in the medical sector (p < 0.001) but not in the ICU (p = 0.2). Conclusions: Although overall AMR did not rise uniformly, PDR organisms increased hospital-wide. These findings support updating empiric therapy guidelines, reinforcing infection prevention measures, and translating surveillance data into targeted stewardship actions to enhance patient care.

In our hospital, adherence to the guidelines for peri-operative antimicrobial prophylaxis (PAP) is suboptimal, with overly long courses being common. This practice does not offer any incremental benefit, and it only adds to the burden of antimicrobial consumption, promotes the emergence of antimicrobial resistance, and it is associated with adverse events. Our objective was to study the effect of an electronic reminder on the adherence to each element of PAP after cardiac surgery. We conducted a single center, before and after intervention, prospective cohort study from 1 June 2014 to 30 September 2017. The intervention consisted of a reminder of the hospital guidelines when ordering PAP through the hospital information system. The primary outcome was adherence to the suggested duration of PAP, while secondary outcomes included adherence to the other elements of PAP and incidence of surgical site infections (SSI). We have studied 1080 operations (400 pre-intervention and 680 post-intervention). Adherence to the appropriate duration of PAP increased significantly after the intervention [PRE 4.0% (16/399) vs. POST 15.4% (105/680), chi-square p < 0.001]; however, it remained inappropriately low. Factors associated with inappropriate duration of PAP were pre-operative hospitalization for 4 h, while there were significant differences between the chief surgeons. Unexpectedly, the rate of SSIs increased significantly during the study (PRE 2.8% (11/400) vs. POST 5.9% (40/680), chi-square p < 0.019). The implemented intervention achieved a relative increase in adherence to the guideline-recommended PAP duration; however, adherence was still unacceptably low and further efforts to improve adherence are needed.

Objectives: To evaluate whether a multifaceted educational intervention was associated with changes in healthcare professionals’ knowledge, attitudes, self-reported practices, and catheter-associated urinary tract infection incidence in medical wards. Methods: This before-and-after intervention study was conducted in three internal medicine wards of a tertiary general hospital between September 2023 and December 2025, including a pre-intervention period (September 2023–April 2025), an intervention period (May–June 2025), and a post-intervention period (July–December 2025). The intervention included face-to-face education, interactive discussions, printed materials, posters, and ward-based reminders on evidence-based urinary catheter care. Healthcare professionals completed an anonymous structured questionnaire before and after the intervention, while catheter-associated urinary tract infection surveillance was conducted prospectively. Pre- and post-intervention questionnaire data were analyzed as independent groups. Results: We obtained questionnaire responses from 85 healthcare workers before the intervention and 78 after the intervention. The median total knowledge score increased significantly from 21 (interquartile range [IQR], 19–22) to 23 (IQR, 22–25; P < 0.001). Selected self-reported practices also improved significantly, whereas attitudes and perceptions were generally favorable at baseline and did not change significantly. The overall CAUTI rate decreased from 3.79 to 1.94 episodes per 1,000 catheter-days. After adjustment for ward, the post-intervention period was associated with a significantly lower CAUTI incidence (incidence rate ratio, 0.50; 95% confidence interval, 0.28–0.90; P = 0.020). Conclusion: The educational intervention was associated with improved knowledge, selected improvements in self-reported catheter-care practices, and lower catheter-associated urinary tract infection incidence.