Tags

Type your tag names separated by a space and hit enter

Carriage of ESBL-producing Enterobacteriaceae in French hospitals: the PORTABLSE study.
J Hosp Infect. 2018 Mar; 98(3):247-252.JH

Abstract

BACKGROUND

Currently, contact precautions are recommended for patients colonized or infected with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE). Recent studies have challenged this strategy. This study aimed to assess the rate of ESBL-PE faecal carriage among hospitalized patients according to type of hospital ward, and to identify risk factors associated with carriage.

METHODS

A point prevalence study was conducted in five different types of hospital ward [medical, surgical, intensive care unit (ICU), after care and rehabilitation, and geriatric] in eight French hospitals. All patients included in the study provided a fresh stool sample.

RESULTS

In total, 554 patients were included in the study, with a median age of 73 years (range 60-82 years). The overall faecal carriage rate of ESBL-PE was 17.7%. The most frequently encountered species among ESBL-PE was Escherichia coli (71.4%), followed by Klebsiella pneumoniae (14.3%). Risk factors associated with ESBL-PE faecal carriage on univariate analysis were: living in the Paris region (P<0.01) and hospitalization on a geriatric ward (P<0.01). Interestingly, the cumulative duration of hospital stay before screening was not associated with a significantly higher prevalence of ESBL-PE carriage, regardless of ward type. The ESBL-PE colonization rate was much higher for patients hospitalized on geriatric wards (28.1%) and ICUs (21.7%) compared with those for patients hospitalized on surgical wards (14.8%), medical wards (12.8%) or aftercare and rehabilitation (11.2%).

CONCLUSION

The overall prevalence of ESBL-PE faecal carriage was 17.7%, with only 21% of patients identified previously as carriers. The delay between admission and screening was not associated with an increase in ESBL-PE faecal carriage.

Authors+Show Affiliations

Equipe Mobile de Microbiologie clinique, Groupe Hospitalier Paris Saint-Joseph, Paris, France.Laboratoire de Microbiologie, CHU de Caen, Caen, France.Unité Fonctionnelle d'Hygiène Hospitalière et de Lutte contre les Infections Nosocomiales, Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France.Laboratoire de Bactériologie-Virologie-Hygiène, CHU Reims, Hôpital Robert Debré, UFR de Médecine, EA4687, Université de Reims Champagne-Ardenne Reims, France.Clinique de Champigny, Champigny sur Marne, France.Laboratoire de Microbiologie clinique, Groupe Hospitalier Paris Saint-Joseph, Paris, France; EA4043 Unité Bactéries pathogènes et Santé (UBaPS), Université Paris-Sud, Paris Saclay, Chatenay-Malabry, France.Laboratoire de Microbiologie, Hôpital Louis Mourier, Colombes, France.Laboratoire de Microbiologie, Hôpital Jean Verdier, Bondy, France.Laboratoire de Bactériologie-Virologie-Hygiène, CHU Reims, Hôpital Robert Debré, UFR de Médecine, EA4687, Université de Reims Champagne-Ardenne Reims, France.EA4043 Unité Bactéries pathogènes et Santé (UBaPS), Université Paris-Sud, Paris Saclay, Chatenay-Malabry, France; Service de Bactériologie et hygiène, Hôpital Antoine Béclère, Clamart, France.IAME, UMR 1137, Université Paris 13, Sorbonne Paris Cité, Département de Microbiologie Clinique, Unité de Contrôle et de Prévention du risque Infectieux, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, CHU Avicenne, Bobigny, France. Electronic address: jeanralph.zahar@aphp.fr.Laboratoire de Microbiologie clinique, Groupe Hospitalier Paris Saint-Joseph, Paris, France; EA4043 Unité Bactéries pathogènes et Santé (UBaPS), Université Paris-Sud, Paris Saclay, Chatenay-Malabry, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29222035

Citation

Pilmis, B, et al. "Carriage of ESBL-producing Enterobacteriaceae in French Hospitals: the PORTABLSE Study." The Journal of Hospital Infection, vol. 98, no. 3, 2018, pp. 247-252.
Pilmis B, Cattoir V, Lecointe D, et al. Carriage of ESBL-producing Enterobacteriaceae in French hospitals: the PORTABLSE study. J Hosp Infect. 2018;98(3):247-252.
Pilmis, B., Cattoir, V., Lecointe, D., Limelette, A., Grall, I., Mizrahi, A., Marcade, G., Poilane, I., Guillard, T., Bourgeois Nicolaos, N., Zahar, J. R., & Le Monnier, A. (2018). Carriage of ESBL-producing Enterobacteriaceae in French hospitals: the PORTABLSE study. The Journal of Hospital Infection, 98(3), 247-252. https://doi.org/10.1016/j.jhin.2017.11.022
Pilmis B, et al. Carriage of ESBL-producing Enterobacteriaceae in French Hospitals: the PORTABLSE Study. J Hosp Infect. 2018;98(3):247-252. PubMed PMID: 29222035.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Carriage of ESBL-producing Enterobacteriaceae in French hospitals: the PORTABLSE study. AU - Pilmis,B, AU - Cattoir,V, AU - Lecointe,D, AU - Limelette,A, AU - Grall,I, AU - Mizrahi,A, AU - Marcade,G, AU - Poilane,I, AU - Guillard,T, AU - Bourgeois Nicolaos,N, AU - Zahar,J-R, AU - Le Monnier,A, Y1 - 2017/12/06/ PY - 2017/10/04/received PY - 2017/11/29/accepted PY - 2017/12/10/pubmed PY - 2018/8/23/medline PY - 2017/12/10/entrez KW - Enterobacteriaceae KW - Extended spectrum beta-lactamase KW - Faecal carriage SP - 247 EP - 252 JF - The Journal of hospital infection JO - J. Hosp. Infect. VL - 98 IS - 3 N2 - BACKGROUND: Currently, contact precautions are recommended for patients colonized or infected with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE). Recent studies have challenged this strategy. This study aimed to assess the rate of ESBL-PE faecal carriage among hospitalized patients according to type of hospital ward, and to identify risk factors associated with carriage. METHODS: A point prevalence study was conducted in five different types of hospital ward [medical, surgical, intensive care unit (ICU), after care and rehabilitation, and geriatric] in eight French hospitals. All patients included in the study provided a fresh stool sample. RESULTS: In total, 554 patients were included in the study, with a median age of 73 years (range 60-82 years). The overall faecal carriage rate of ESBL-PE was 17.7%. The most frequently encountered species among ESBL-PE was Escherichia coli (71.4%), followed by Klebsiella pneumoniae (14.3%). Risk factors associated with ESBL-PE faecal carriage on univariate analysis were: living in the Paris region (P<0.01) and hospitalization on a geriatric ward (P<0.01). Interestingly, the cumulative duration of hospital stay before screening was not associated with a significantly higher prevalence of ESBL-PE carriage, regardless of ward type. The ESBL-PE colonization rate was much higher for patients hospitalized on geriatric wards (28.1%) and ICUs (21.7%) compared with those for patients hospitalized on surgical wards (14.8%), medical wards (12.8%) or aftercare and rehabilitation (11.2%). CONCLUSION: The overall prevalence of ESBL-PE faecal carriage was 17.7%, with only 21% of patients identified previously as carriers. The delay between admission and screening was not associated with an increase in ESBL-PE faecal carriage. SN - 1532-2939 UR - https://www.unboundmedicine.com/medline/citation/29222035/Carriage_of_ESBL_producing_Enterobacteriaceae_in_French_hospitals:_the_PORTABLSE_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0195-6701(17)30649-7 DB - PRIME DP - Unbound Medicine ER -