D Hilliquin1, R Le Guern2, V Thepot Seegers3, C Neulier4, A Lomont5, V Marie6, C Legeay1, J Merrer4, D Lepelletier7, A M Rogues6, B Grandbastien2, J C Lucet5, J R Zahar8. 1. Unité de Prévention et de Lutte contre les Infections Nosocomiales, CHU Angers, Angers, France. 2. Service de gestion du risque infectieux et des vigilances, CHRU Lille, Lille, France. 3. Institut de Cancérologie de l'Ouest, Département de Biostatistiques, Pôle de Biométrie, Angers, France; SFR ICAT, Université d'Angers, Angers, France. 4. Service de Prévention du Risque Infectieux, CH André Mignot, Versailles, France. 5. Infection Control Unit, Bichat Claude Bernard hôpital, AP-HP, Paris, France. 6. Service d'Hygiene Hospitaliere Groupe Hospitalier Pellegrin, Bordeaux, France; Unité INSERM U1219, Universite de Bordeaux, Bordeaux, France. 7. Service de bactériologie-hygiène hospitalière, CHU Nantes, Nantes, France; Laboratoire MiHAR, Equipe Emergente, Université de Nantes, Nantes, France. 8. IAME, UMR 1137, Université Paris 13, Sorbonne Paris Cité, Paris, France; Département de Microbiologie Clinique, Unité de Contrôle et de Prévention du risque Infectieux, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France. Electronic address: jean-ralph.zahar@aphp.fr.
Abstract
BACKGROUND: Cohorting carbapenemase-producing Enterobacteriaceae (CPE) carriers during hospitalization limits in-hospital spreading. AIM: To identify risk factors for CPE acquisition among contacts of an index patient in non-cohorted populations. METHODS: A multicentre retrospective matched case-control study was conducted in five hospitals. Each contact patient (case) who acquired Klebsiella pneumoniae (KP)-OXA-48 from an index patient was compared to three contact (controls) with the same index patients matched with hospitalization in the same unit and similar exposure times. FINDINGS: Fifty-one secondary cases and 131 controls were included. By univariate analysis, exposure time (odds ratio: 1.06; 95% confidence interval: 1.02-1.1; P = 0.006), concomitant infection at admission (3.23; 1.42-7.35; P = 0.005), antimicrobial therapy within the last month before hospitalization (2.88; 1.34-6.2; P = 0.007), antimicrobial therapy during the exposure time (5.36; 2.28-12.6; P < 0.001), use of at least one invasive procedure (2.99; 1.25-7.15; P = 0.014), number of invasive procedures (1.52; 1.05-2.19; P = 0.025), and geographical proximity (2.84; 1.15-7.00; P = 0.023) were associated with CPE acquisition. By multivariate analysis, antimicrobial therapy during the exposure time (odds ratio: 6.36; 95% confidence interval: 2.46-16.44; P < 0.001), at least one invasive procedure (2.92; 1.04-8.17; P = 0.041), and geographical proximity (3.69; 1.15-11.86; P = 0.028) were associated with acquisition. CONCLUSION: In this study, geographical proximity, invasive procedure, and antimicrobial therapy during exposure time were significantly associated with KP-OXA-48 acquisition.
BACKGROUND: Cohorting carbapenemase-producing Enterobacteriaceae (CPE) carriers during hospitalization limits in-hospital spreading. AIM: To identify risk factors for CPE acquisition among contacts of an index patient in non-cohorted populations. METHODS: A multicentre retrospective matched case-control study was conducted in five hospitals. Each contact patient (case) who acquired Klebsiella pneumoniae (KP)-OXA-48 from an index patient was compared to three contact (controls) with the same index patients matched with hospitalization in the same unit and similar exposure times. FINDINGS: Fifty-one secondary cases and 131 controls were included. By univariate analysis, exposure time (odds ratio: 1.06; 95% confidence interval: 1.02-1.1; P = 0.006), concomitant infection at admission (3.23; 1.42-7.35; P = 0.005), antimicrobial therapy within the last month before hospitalization (2.88; 1.34-6.2; P = 0.007), antimicrobial therapy during the exposure time (5.36; 2.28-12.6; P < 0.001), use of at least one invasive procedure (2.99; 1.25-7.15; P = 0.014), number of invasive procedures (1.52; 1.05-2.19; P = 0.025), and geographical proximity (2.84; 1.15-7.00; P = 0.023) were associated with CPE acquisition. By multivariate analysis, antimicrobial therapy during the exposure time (odds ratio: 6.36; 95% confidence interval: 2.46-16.44; P < 0.001), at least one invasive procedure (2.92; 1.04-8.17; P = 0.041), and geographical proximity (3.69; 1.15-11.86; P = 0.028) were associated with acquisition. CONCLUSION: In this study, geographical proximity, invasive procedure, and antimicrobial therapy during exposure time were significantly associated with KP-OXA-48 acquisition.
Authors: Jean-François Timsit; Matteo Bassetti; Olaf Cremer; George Daikos; Jan de Waele; Andre Kallil; Eric Kipnis; Marin Kollef; Kevin Laupland; Jose-Artur Paiva; Jesús Rodríguez-Baño; Étienne Ruppé; Jorge Salluh; Fabio Silvio Taccone; Emmanuel Weiss; François Barbier Journal: Intensive Care Med Date: 2019-01-18 Impact factor: 17.440
Authors: Fang Kang Lim; Yi Xin Liew; Yiying Cai; Winnie Lee; Jocelyn Q M Teo; Wei Qi Lay; Jasmine Chung; Andrea L H Kwa Journal: Front Cell Infect Microbiol Date: 2020-10-14 Impact factor: 5.293