Universität zu Köln

Biehl, Lena M. ORCID: 0000-0001-7613-8119, Higgins, Paul G., Stemler, Jannik, Gilles, Meyke, Peter, Silke, Doerfel, Daniela, Vogel, Wichard, Kern, Winfried, V, Goelz, Hanna, Bertz, Hartmut, Rohde, Holger, Klupp, Eva-Maria, Schafhausen, Philippe, Salmanton-Garcia, Jon, Stecher, Melanie, Wille, Julia, Liss, Blasius, Xanthopoulou, Kyriaki ORCID: 0000-0001-8591-8184, Zweigner, Janine, Seifert, Harald and Vehreschild, Maria J. G. T. (2022). Impact of single-room contact precautions on acquisition and transmission of vancomycin-resistant enterococci on haematological and oncological wards, multicentre cohort-study, Germany, January-December 2016. Eurosurveillance, 27 (2). STOCKHOLM: EUR CENTRE DIS PREVENTION & CONTROL. ISSN 1560-7917

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Abstract

Background: Evidence supporting the effectiveness of single-room contact precautions (SCP) in preventing in-hospital acquisition of vancomycin-resistant enterococci (haVRE) is limited. Aim: We assessed the impact of SCP on haVRE and their transmission. Methods: We conducted a prospective, multicentre cohort study in German haematological/oncological departments during 2016. Two sites performed SCP for VRE patients and two did not (NCP). We defined a 5% haVRE- risk difference as non-inferiority margin, screened patients for VRE, and characterised isolates by whole genome sequencing and core genome MLST (cgMLST). Potential confounders were assessed by competing risk regression analysis. Results: We included 1,397 patients at NCP and 1,531 patients at SCP sites. Not performing SCP was associated with a significantly higher proportion of haVRE; 12.2% (170/1,397) patients at NCP and 7.4% (113/1,531) patients at SCP sites (relative risk (RR) 1.74; 95% confidence interval (CI): 1.35-2.23). The difference (4.8%) was below the non-inferiority margin. Competing risk regression analysis indicated a stronger impact of antimicrobial exposure (subdistribution hazard ratio (SHR) 7.46; 95% CI: 4.59-12.12) and underlying disease (SHR for acute leukaemia 2.34; 95% CI: 1.46-3.75) on haVRE than NCP (SHR 1.60; 95% CI: 1.14-2.25). Based on cgMLST and patient movement data, we observed 131 patient-to-patient VRE transmissions at NCP and 85 at SCP sites (RR 1.76; 95% CI: 1.33-2.34). Conclusions: We show a positive impact of SCP on haVRE in a highrisk population, although the observed difference was below the pre-specified non-inferiority margin. Importantly, other factors including antimicrobial exposure seem to be more influential.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Biehl, Lena M. UNSPECIFIED orcid.org/0000-0001-7613-8119 UNSPECIFIED Higgins, Paul G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stemler, Jannik UNSPECIFIED UNSPECIFIED UNSPECIFIED Gilles, Meyke UNSPECIFIED UNSPECIFIED UNSPECIFIED Peter, Silke UNSPECIFIED UNSPECIFIED UNSPECIFIED Doerfel, Daniela UNSPECIFIED UNSPECIFIED UNSPECIFIED Vogel, Wichard UNSPECIFIED UNSPECIFIED UNSPECIFIED Kern, Winfried, V UNSPECIFIED UNSPECIFIED UNSPECIFIED Goelz, Hanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Bertz, Hartmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Rohde, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED Klupp, Eva-Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Schafhausen, Philippe UNSPECIFIED UNSPECIFIED UNSPECIFIED Salmanton-Garcia, Jon UNSPECIFIED UNSPECIFIED UNSPECIFIED Stecher, Melanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Wille, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Liss, Blasius UNSPECIFIED UNSPECIFIED UNSPECIFIED Xanthopoulou, Kyriaki UNSPECIFIED orcid.org/0000-0001-8591-8184 UNSPECIFIED Zweigner, Janine UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Maria J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-691436
DOI:	10.2807/1560-7917.ES.2022.27.2.2001876
Journal or Publication Title:	Eurosurveillance
Volume:	27
Number:	2
Date:	2022
Publisher:	EUR CENTRE DIS PREVENTION & CONTROL
Place of Publication:	STOCKHOLM
ISSN:	1560-7917
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RISK-FACTORS; COLONIZATION; EPIDEMIOLOGY; INFECTIONS; BACTERIA Multiple languages Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69143