Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-26T07:37:51.137Z Has data issue: false hasContentIssue false
  • English
  • Français

Control of Enterobacteriaceae Producing Extended-Spectrum Beta-Lactamase in Intensive Care Units: Rectal Screening May Not Be Needed in Non-Epidemic Situations

Published online by Cambridge University Press:  02 January 2015

Michelle Thouverez ,
Daniel Talon  and
Xavier Bertrand
Michelle Thouverez
Affiliation:
Service d'Hygiène Hospitalière et d'Epidémiologie Moléculaire, CHU Jean Minjoz, Besançon cedex, France
Daniel Talon
Affiliation:
Service d'Hygiène Hospitalière et d'Epidémiologie Moléculaire, CHU Jean Minjoz, Besançon cedex, France
Xavier Bertrand*
Affiliation:
Service d'Hygiène Hospitalière et d'Epidémiologie Moléculaire, CHU Jean Minjoz, Besançon cedex, France
*
Service d'Hygiène Hospitalière, CHU Jean Minjoz, 25030 Besançon cedex, France
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To evaluate the usefulness of screening cultures in the control of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in intensive care units (ICUs).

Design:

A 4-year retrospective study.

Setting:

Two adult ICUs of a university-affiliated public hospital in France.

Results:

A total of 7,777 specimens were analyzed and 28 (0.97%) of 2,883 screened patients had a positive result on a screening test, among the 3,678 admitted patients. Thirteen of these 28 patients were only carriers; 4 were carriers and then were colonized or infected 2, 2, 3, and 8 days later, respectively; and 11 were colonized or infected before a screening test was positive. Cluster analysis showed that the occurrence of ESBL-producing Enterobacteriaceae cross-transmission within both ICUs was limited to 9 cases. Thus, most cases (19 of 28) were probably imported. Surveillance cultures failed to detect 9 of the 19 cases.

Conclusion:

The low prevalence of ESBL-producing Enterobacteriaceae carriers on admission (0.45%) and the relative ineffectiveness of our screening test to detect imported cases suggest that systematic detection of ESBL-producing Enterobacteriaceae in ICU patients is not cost-effective and that the use of clinical cultures may be sufficient to control ESBL-producing Enterobacteriaceae in non-epidemic situations.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 10 , October 2004 , pp. 838 - 841
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Comité Technique National des Infections Nosocomiales. Maitrise de la diffusion des bactéries multirésistantes aux antibiotiques: recommandations pour les etablissements de santé. Paris: Ministère de l'Emploi et de la solidarité; 1999.Google Scholar
2. Albertini, MT, Benoit, C, Berardi, L, et al. Surveillance of methicillin-resistant Staphylococcus aureus (MRSA) and Enterobacteriaceae producing extended-spectrum beta-lactamase (EBLSE) in Northern France: a five-year multicentre incidence study. J Hosp Infect 2002;52:107–113.Google Scholar
3. Kliebe, C, Nies, BA, Meyer, JF, Tolxdorff-Neutzling, RM, Wiedermann, B. Evolution of plasmid-coded resistance to broad-spectrum cephalosporins. Antimicrob Agents Chemother 1985;28:302–307.10.1128/AAC.28.2.302Google Scholar
4. De Champs, C, Sirot, D, Chanai, C, Bonnet, R, Sirot, AJ. A 1998 survey of extended-spectrum beta-lactamases in Enterobacteriaceae in France. Antimicrob Agents Chemother 2000;44:3177–3179.10.1128/AAC.44.11.3177-3179.2000Google Scholar
5. Eveillard, M, Biendo, M, Canarelli, B, et al. Spread of Enterobacteriaceae producing broad-spectrum beta-lactamase and the development of their incidence over a 16-month period in a university hospital center [in French!. Pathol Biol (Paris) 2001;49:515–521.10.1016/S0369-8114(01)00204-8Google Scholar
6. Girou, E, Pujade, G, Legrand, P, Cizeau, F, Brun-Buisson, C. Selective screening of carriers for control of methicillin-resistant Staphylococcus aureus (MRSA) in high-risk hospital areas with a high level of endemic MRSA. Clin Infect Dis 1998;27:543–550.10.1086/514695Google Scholar
7. Chaix, C, Durand-Zaleski, I, Alberti, C, Brun-Buisson, C. Control of endemic methicillin-resistant Staphylococcus aureus: a cost-benefit analysis in an intensive care unit. JAMA 1999;282:1745–1751.10.1001/jama.282.18.1745Google Scholar
8. Talon, DR, Bertrand, X. Methicillin-resistant Staphylococcus aureus in geriatric patients: usefulness of screening in a chronic-care setting. Infect Control Hosp Epidemiol 2001;22:505–509.10.1086/501941Google Scholar
9. Soussy, CJ, Carret, G, Cavallo, JD, et al. Antibiogram Committee of the French Microbiology Society: report 2000-2001 [in French], Pathol Biol (Paris) 2000;48:832–871.Google Scholar
10. Talon, D, Dupont, MJ, Lesne, J, Thouverez, M, Michel-Briand, Y. Pulsed-field gel electrophoresis as an epidemiological tool for clonal identification Aeromonas hydrophila . J Appl Bacteriol 1996;80:277–282.10.1111/j.1365-2672.1996.tb03220.xGoogle Scholar
11. Bertrand, X, Hocquet, D, Boisson, K, Siebor, C, Plésiat, P, Talon, D. Molecular epidemiology of Enterobacteriaceae producing extended-spectrum beta-lactamase in a French university-affiliated hospital. Int J Antimicrob Agents 2003;22:128–133.10.1016/S0924-8579(03)00098-0Google Scholar
12. Bosi, C, Daviri-Regli, A, Bornet, C, Mallea, M, Pages, JM, Boliet, C. Most Enterobacter aerogenes strains in France belong to a prevalent clone. J Clin Microbiol 1999;37:2165–2169.10.1128/JCM.37.7.2165-2169.1999Google Scholar