Bopp, Tamara C; Marchesi, Martina; Zihlmann, Reto; Sax, Hugo; Wolfensberger, Aline (2023). Identifying patients at high risk for multidrug-resistant organisms after hospitalization abroad. Infection control and hospital epidemiology, 44(8), pp. 1281-1288. Cambridge University Press 10.1017/ice.2022.256
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OBJECTIVES
We quantified the percentage of multidrug-resistant organism (MDRO) carriers among repatriated patients. We identified factors associated with MDRO carriage, and we evaluated the yield of MDRO detection per screened body site.
DESIGN
Retrospective cohort study.
SETTING
A tertiary-care center in Switzerland.
PATIENTS
Adult patients after a stay in a healthcare institution abroad.
METHODS
Patients were screened for MDRO carriage. Standard sites, including nose and throat, groins, and (since mid-2018) rectum, and risk-based sites (wounds, urine, tracheal secretion) were sampled. MDROs were defined as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum β-lactamase (ESBL)- and carbapenemase-producing Enterobacterales (CPE), multidrug-resistant (MDR) Enterobacterales, and MDR nonfermenting gram-negative rods. Risk factors for MDRO carriage were assessed using multivariate logistic regression.
RESULTS
Between May 2017 and April 2019, 438 patients were screened and 107 (24.4%) tested positive for an MDRO, predominantly ESBL-producing and MDR Enterobacterales. Risk factors for MDRO colonization were the length of stay in hospital abroad, antibiotic treatment with 'Watch' and 'Reserve' antibiotics, and region of hospitalization abroad. Rectal swabs had the highest yield for detecting patients with MDR intestinal bacteria, but nose/throat and groins, or wound samples were more sensitive for MRSA or nonfermenting gram-negative organisms, respectively.
CONCLUSIONS
We identified risk factors for MDRO carriage and body sites with the highest yield for a specific MDRO, which might help to target screening and isolation and reduce screening costs.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology |
UniBE Contributor: |
Sax, Hugo Siegfried |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0899-823X |
Publisher: |
Cambridge University Press |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
14 Mar 2023 08:54 |
Last Modified: |
26 Aug 2023 00:12 |
Publisher DOI: |
10.1017/ice.2022.256 |
PubMed ID: |
36912341 |
BORIS DOI: |
10.48350/180002 |
URI: |
https://boris.unibe.ch/id/eprint/180002 |
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