Post by Jörg Janne Vehreschild

Ten years ago, we in the German Center for Infection Research and partners set out to design a multicentre, stepped-wedge, cluster-interventional trial. Our goal was to disentangle how infection prevention and antimicrobial stewardship (AMS) measures interact, and to quantify the effect of defined intervention bundles on colonization and infection with multidrug-resistant bacteria and Clostridioides difficile.and several associated partners. This was anything but simple: complex, layered interventions; tight interdisciplinary and interprofessional coordination; harmonized SOPs; and privacy-preserving linkage of heterogeneous data at different granularities—much of it enabled by extraordinary in-kind contributions from participating centres and their highly committed teams. We’re delighted (and a little proud) that PI Annika Y. Classen has now published the main results of our study in Clinical Microbiology and Infection (https://lnkd.in/ejJfSZpC). Indeed, AMS measures were able to reduce Clostridium difficile infections in participating centers. The study also contributes to the body of evidence that AMS is safe and recommended even in high-risk patient groups of hematology/oncology departments. At the same time, we may need new strategies how to improve impact in departments with a strong baseline level of AMS services. Key takeaways - AMS measures were associated with a reduction in C. difficile infections across participating centres. - The data add to the evidence that AMS is safe and recommended even in high-risk haematology/oncology populations. - In departments with already strong baseline AMS services, additional gains may require new strategies and implementation approaches. Grateful to everyone who made this possible—clinical teams, infection control, pharmacy, data and IT colleagues, and site leadership across all centres. Excited to keep pushing on pragmatic, data-driven AMS that improves patient outcomes. Authors: Dr. Thilo Dietz, Luisa Durán Graeff, Simone Eisenbeis, Petra Gastmeier, Siri Göpel, Armin Hoffmann, Florian Hölzl, Nadja Käding, Winfried Kern, Evelyn Kramme, Cristina Belmar Campos, Florian Maurer, Prof. Dr. Harald Seifert, Dr. med. Arne Meißner, Anna M. Rohde, Holger Prof. Dr. Rohde, Jan Rupp, Evelina Tacconelli, Sarah Walker, Janine Zweigner, Janne Vehreschild