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Background/Objectives: Infection prevention and control (IPC) programs combine pathogen-targeted measures (e.g., admission screening) with hospital-wide standard precautions (e.g., hand hygiene, HH). We assessed temporal associations between screening, HH, antimicrobial stewardship (AMS), and hospital-level outcomes in a tertiary paediatric hospital. Methods: This study was a retrospective hospital-wide ecological time-series at the Children’s Memorial Health Institute. Annual aggregate data: 2011–2024 for screening, colonisation, and healthcare-associated infections (HAIs) with alert pathogens; 2016–2024 for antibiotic consumption (ATC J01, systemic antibacterials). Process indicators: number of screening tests and alcohol-based hand rub (ABHR) consumption per 1000 patient-days (PD). Outcomes: colonisations/HAIs per 1000 PD and defined daily doses (DDD) per 1000 PD overall and by class. Trends used linear regression and Spearman’s rank correlation. Results: Screening intensity increased from 39 to 150/1000 PD (slope +8.3/year; R2 = 0.90; p 2 × baseline). Overall ATC J01 showed no long-term linear trend (~278–356 DDD/1000 PD; +2.57/year; p = 0.46), but class mix shifted: carbapenems, fluoroquinolones, and amoxicillin–clavulanate decreased; third/fourth-generation cephalosporins, piperacillin/tazobactam, and glycopeptides increased. Conclusions: In this tertiary paediatric setting, expansion of risk-based admission screening and sustained implementation of horizontal IPC measures were accompanied by increased detection of colonisation with alert pathogens, while MDRO-attributable HAIs remained low and stable at the hospital level. Over the same period, AMS activity coincided with a redistribution in antibiotic class use without a clear long-term reduction in total antibiotic consumption. These hospital-level findings are descriptive and hypothesis-generating; causal inference is limited by the ecological study design, and the heterogeneous, multispecialty structure of a tertiary paediatric centre.
Tukendorf et al. (Mon,) studied this question.