Practice and attitudes of infection control staff towards diagnostic stewardship measures

In recent years, diagnostic stewardship has gained importance worldwide as part of antibiotic stewardship and infection control programs. However, the specific involvement of infection control (IC) teams in this area has not been studied.

A volunteer survey of participants at the 2024 Freiburg Conference on Infection Prevention and Therapy was conducted to assess attitudes and practices regarding diagnostic stewardship.

The majority of the 182 participants worked in German hospitals with established IC-committees (91.2%), antibiotic stewardship teams (43.4%), and laboratory commissions (24.7%).For sepsis diagnosis, at least two pairs of blood cultures are usually taken, which is in line with the guidelines; 14.3% use the "six-pack" rule (three pairs), and 28.6% take all cultures from one puncture site. For many clinical tests -except of stool tests and C-reactive protein - less than 50% rated their use as "appropriate", indicating a need for improvement. Interleukin 6 and beta-D-glucan are rarely used.Strategies such as reflex tests and cascade reporting are only used occasionally and are viewed with scepticism in some cases. Screening for methicillin resistant Staphylococcus aureus and Vancomycin resistant enterococci was rated as "appropriate" by over 60%, while screening for multidrug-resistant Gram-negative bacteria was rated as such by 50%. In the area of IC, 32.4% reported inadequate sampling of surfaces and 33.2% of staff hands.

Subjective assessments and a heterogeneous participant structure limit the survey, and subgroup analyses are not possible due to the small number of cases. However, the results show chances for education and integration of IC teams in diagnostic stewardship programs.