Carriage of ESBL-producing Enterobacteriaceae in French hospitals: the PORTABLSE study

Pilmis, Benoît; Cattoir, Vincent; Lecointe, Didier; Limelette, Anne; Grall, I.; Mizrahi, Assaf; Marcadé, G.; Poîlane, I.; Guillard, Thomas; Bourgeois-Nicolaos, Nadège; Zahar, Jean‐Ralph; Monnier, Alban Le

doi:10.1016/j.jhin.2017.11.022

Cited by 51 publications

(45 citation statements)

References 30 publications

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“…In the present study, the overall prevalence of ESBL was 66/404(16.3%) which is concordant with a report in France (17.7%) (27). However, it was lower than a report in Tikur Anbesa Specialized Hospital, Addis Abeba (52%) (13), Madagaskar 49% 28 (37).…”

Section: T a B L Esupporting

confidence: 89%

Extended-Spectrum Beta-Lactamase and Carbapenemase Producing Enterobacteriaceae among Patients with Gastrointestinal Complaints in North West Ethiopia

Worku

Getie

Moges

et al. 2019

Preprint

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Background Antimicrobial resistance is an increasing threat to health systems which leads to treatment failure, high treatment costs and increased mortality. Infections due to extended spectrum beta-lactamase (ESBL) and carbapenemase producing Enterobacteriaceae(CPE) impose a major global issues, because they are usually resistance to multiple antimicrobial agents. Data on the fecal ESBL producing Enterobacteriaceae (ESBL-PE) and CPE in developing countries including Ethiopia is limited mainly due to resource constraints. Thus, the aim of this study was to determine the prevalence of MDR, ESBL and CPE among patients with gastrointestinal complaints at the University of Gondar Comprehensive Specialized Hospital, Gondar; Northwest Ethiopia.Materials and Methods A Hospital based cross-sectional study was conducted among 384 patients with gastrointestinal complaints from January - April 2019 at the University of Gondar Comprehensive Specialized Hospital. A stool sample was aseptically collected and inoculated on MacConkey agar plate. After getting pure colonies, biochemical testing and antimicrobial susceptibility testing were done following standard microbiological techniques. ESBL production was screened by using ceftazidime and cefotaxime and confirmed using a combined disk diffusion test based on CLSI 2019 guidline. Carbapenemases were screened by meropenem disc and confirmed by modified carbapenem inactivation method. Data was checked, cleaned and entered using Epi-Info version 7.1 and transferred to SPSS version 20 for analysis. P-value <0.05 at 95% CI was considered as statistically significant.Result Out of the 384 study participants, 404 Enterobacteriaceae were isolated. Among these, 196 (48.5%) were MDR. The overall prevalence of fecal ESBL and CPE were 66(16.3%) and 4(1%) respectively. Of the total ESBL-PE, E.coli 41/66(62.1%) and K.pneumoniae 18/66(27.3%) were the most predominant isolates.Conclusion Finding high rate of MDR Enterobacteriaceae,ESBL-PE and CPE require strict infection control measures and careful selection of empirical therapy in the study area. Therefore, active surveillance with large sample size and better infection prevention and control is needed.

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Section: T a B L Esupporting

confidence: 89%

Extended-Spectrum Beta-Lactamase and Carbapenemase Producing Enterobacteriaceae among Patients with Gastrointestinal Complaints in North West Ethiopia

Worku

Getie

Moges

et al. 2019

Preprint

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“…ESBL transmission is complex and not yet fully understood, especially regarding community-associated risk factors including cultural and nutritional habits [ 3 ]. Recently, living in Parisean area was identified with an elevated risk of ESBL-E colonization [ 39 ]. Certain urban areas might represent a surrogate parameter for the complexity of risk factors for ESBL-E colonization.…”

Section: Discussionmentioning

confidence: 99%

Admission prevalence of colonization with third-generation cephalosporin-resistant Enterobacteriaceae and subsequent infection rates in a German university hospital

et al. 2018

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BackgroundMany patients admitted to a hospital are already colonized with multi-drug resistant organisms (MDRO) including third-generation cephalosporin-resistant Enterobacteriaceae (3GCREB). The aim of our study was to determine the prevalence of rectal 3GCREB colonization at admission to a large German university hospital and to estimate infection incidences. In addition, risk factors for 3GCREB colonization were identified.Materials/MethodsIn 2014 and 2015, patients were screened for rectal colonization with 3GCREB and filled out a questionnaire on potential risk factors at admission to a non-intensive care unit (non-ICU). All patients were retrospectively monitored for bacterial infections. Descriptive, univariable and multivariable logistic regression analyses were conducted to identify risk factors for 3GCREB colonization at admission.ResultsOf 4,013 patients included, 10.3% (n = 415) were rectally colonized with 3GCREB at admission. Incidence of nosocomial infections was 3.5 (95% CI 2.0–6.1) per 100 patients rectally colonized with 3GCREB compared to 2.3 (95% CI 1.8–3.0, P = 0.213) per 100 3GCREB negative patients.Independent risk factors for 3GCREB colonization were prior colonization / infection with MDRO (OR 2.30, 95% CI 1.59–3.32), prior antimicrobial treatment (OR 1.97, 95% CI 1.59–2.45), male sex (OR 1.38, 95% CI 1.12–1.70), prior travelling outside Europe (OR 2.39, 95% CI 1.77–3.22) and places of residence in the Berlin districts Charlottenburg-Wilmersdorf (OR 1.52, 95% CI 1.06–2.18), Friedrichshain-Kreuzberg (OR 2.32, 95% CI 1.44–3.74) and Mitte (OR 1.73, 95% CI 1.26–2.36).ConclusionsAdmission prevalence of rectal colonization with 3GCREB was high, while infection incidence did not significantly differ between patients rectally colonized or not with 3GCREB at hospital admission. In consequence, hospitals should prioritize improvement of standard precautions including hand hygiene to prevent infections among all patients irrespective of their 3GCREB status at hospital admission.

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“…The worldwide spreading of extended spectrum beta-lactamase producing Enterobacterales (ESBL-E) represents a major problem encountered at an increasing frequency in ICU [2,3]. Among ICU patients, between 5 and 25% are ESBL-E carriers [4][5][6]. Whereas a previous carriage is the major risk factor associated with VAP related to ESBL-E [7,8], only 5-20% of the ESBL-E carriers will develop a VAP related to ESBL-E [9,10].…”

Section: Introductionmentioning

confidence: 99%

Semi-quantitative cultures of throat and rectal swabs are efficient tests to predict ESBL-Enterobacterales ventilator-associated pneumonia in mechanically ventilated ESBL carriers

et al. 2020

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Purpose: In ICU patients with carriage of extended spectrum beta-lactamase producing Enterobacterales (ESBL-E) and suspected Gram-negative bacilli ventilator-associated pneumonia (GNB-VAP), the quantification of the rectal and throat ESBL-E carriage might predict the ESBL-E involvement in GNB-VAP. Our aim was to evaluate whether a semiquantitative assessment of rectal/throat ESBL-E carriage can predict ESBL-E-associated VAP in medical ICU patients. Methods: From May 2014 to May 2017, all ESBL-E carriers had a semi-quantitative assessment of ESBL-E density in swabs cultures. For those who developed GNB-VAP (diagnosed using bronchoalveolar lavage or plugged telescopic catheter with significant quantitative culture), the last positive swab collected at least 48 h before GNB-VAP onset was selected. Clinical data were extracted from a prospectively collected database. Results: Among 365 ESBL-E carriers, 82 developed 107 episodes of GNB-VAP (ESBL-E VAP, n = 50; and non-ESBL-E GNB-VAP, n = 57) after 13 days of mechanical ventilation in median. Antimicrobials use before VAP onset was similar between groups. The last swabs were collected 5 days in median before VAP onset. ESBL-E. coli carriers developed ESBL-E VAP less frequently (n = 13, 34%) than others (n = 32, 67.3%, p < .01). Throat swab positivity (39 (78%) vs. 12 (23%), p < .

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Carriage of ESBL-producing Enterobacteriaceae in French hospitals: the PORTABLSE study

Cited by 51 publications

References 30 publications

Extended-Spectrum Beta-Lactamase and Carbapenemase Producing Enterobacteriaceae among Patients with Gastrointestinal Complaints in North West Ethiopia

Extended-Spectrum Beta-Lactamase and Carbapenemase Producing Enterobacteriaceae among Patients with Gastrointestinal Complaints in North West Ethiopia

Admission prevalence of colonization with third-generation cephalosporin-resistant Enterobacteriaceae and subsequent infection rates in a German university hospital

Semi-quantitative cultures of throat and rectal swabs are efficient tests to predict ESBL-Enterobacterales ventilator-associated pneumonia in mechanically ventilated ESBL carriers

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