Universität zu Köln

Boldt, Anne-Catherine, Schwab, Frank, Rohde, Anna M., Kola, Axel, Bui, Minh Trang, Maertin, Nayana, Kipnis, Marina, Schroeder, Christin, Leistner, Rasmus ORCID: 0000-0002-1225-9023, Wiese-Posselt, Miriam, Zweigner, Janine, Gastmeier, Petra ORCID: 0000-0001-5520-4287 and Denkel, Luisa A. (2018). Admission prevalence of colonization with third-generation cephalosporin-resistant Enterobacteriaceae and subsequent infection rates in a German university hospital. PLoS One, 13 (8). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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Abstract

Background Many 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/Methods In 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. Results Of 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). Conclusions Admission 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Boldt, Anne-Catherine UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwab, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Rohde, Anna M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kola, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Bui, Minh Trang UNSPECIFIED UNSPECIFIED UNSPECIFIED Maertin, Nayana UNSPECIFIED UNSPECIFIED UNSPECIFIED Kipnis, Marina UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Leistner, Rasmus UNSPECIFIED orcid.org/0000-0002-1225-9023 UNSPECIFIED Wiese-Posselt, Miriam UNSPECIFIED UNSPECIFIED UNSPECIFIED Zweigner, Janine UNSPECIFIED UNSPECIFIED UNSPECIFIED Gastmeier, Petra UNSPECIFIED orcid.org/0000-0001-5520-4287 UNSPECIFIED Denkel, Luisa A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-178642
DOI:	10.1371/journal.pone.0201548
Journal or Publication Title:	PLoS One
Volume:	13
Number:	8
Date:	2018
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LACTAMASE-PRODUCING ENTEROBACTERIACEAE; BLOOD-STREAM INFECTIONS; HIGH-RISK PATIENTS; EXTENDED-SPECTRUM; ESCHERICHIA-COLI; FECAL CARRIAGE; (ESBL)-PRODUCING ENTEROBACTERIACEAE; ANTIMICROBIAL SUSCEPTIBILITY; CTX-M; BACTEREMIA Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17864