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Pasricha J, Koessler T, Harbarth S, et al. Carriage of extended-spectrum beta-lactamase-producing enterobacteriacae among internal medicine patients in Switzerland. Antimicrob Resist Infect Control. 2013;2:20doi: 10.1186/2047-2994-2-20.
Pasricha, J., Koessler, T., Harbarth, S., Schrenzel, J., Camus, V., Cohen, G., Perrier, A., Pittet, D., & Iten, A. (2013). Carriage of extended-spectrum beta-lactamase-producing enterobacteriacae among internal medicine patients in Switzerland. Antimicrobial resistance and infection control, 220. https://doi.org/10.1186/2047-2994-2-20
Pasricha, Janet, et al. "Carriage of extended-spectrum beta-lactamase-producing enterobacteriacae among internal medicine patients in Switzerland." Antimicrobial resistance and infection control vol. 2 (2013): 20. doi: https://doi.org/10.1186/2047-2994-2-20
Pasricha J, Koessler T, Harbarth S, Schrenzel J, Camus V, Cohen G, Perrier A, Pittet D, Iten A. Carriage of extended-spectrum beta-lactamase-producing enterobacteriacae among internal medicine patients in Switzerland. Antimicrob Resist Infect Control. 2013 Jun 12;2:20. doi: 10.1186/2047-2994-2-20. eCollection 2013. PMID: 23759067; PMCID: PMC3711782.
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Antimicrob Resist Infect Control. 2013 Jun 12;2:20. doi: 10.1186/2047-2994-2-20. eCollection 2013.

Carriage of extended-spectrum beta-lactamase-producing enterobacteriacae among internal medicine patients in Switzerland.

Antimicrobial resistance and infection control

Janet Pasricha, Thibaud Koessler, Stephan Harbarth, Jacques Schrenzel, Véronique Camus, Gilles Cohen, Arnaud Perrier, Didier Pittet, Anne Iten

Affiliations

  1. Infection Control Program, University of Geneva Hospitals and Medical Faculty, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva 14, Switzerland ; The Jenner Institute, University of Oxford, Oxford, UK.
  2. Department of General Internal Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
  3. Infection Control Program, University of Geneva Hospitals and Medical Faculty, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva 14, Switzerland.
  4. Central Laboratory of Bacteriology, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
  5. Division of Medico-Economic Analysis, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
  6. Infection Control Program, University of Geneva Hospitals and Medical Faculty, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva 14, Switzerland ; WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
  7. Infection Control Program, University of Geneva Hospitals and Medical Faculty, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva 14, Switzerland ; Department of General Internal Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.

PMID: 23759067 PMCID: PMC3711782 DOI: 10.1186/2047-2994-2-20

Abstract

BACKGROUND: The incidence of extended-spectrum beta-lactamase producing-enterobacteriacae (ESBL-E) infection is rising worldwide. We aimed to determine the prevalence and nosocomial acquisition rate of ESBL-E as well as the risk factors for ESBL-E carriage and acquisition amongst patients consecutively admitted to 13 internal medicine units at our hospital who were not previously known to be ESBL-E carriers.

FINDINGS: We screened all patients admitted or transferred to internal medicine units for ESBL-E on admission and discharge using rectal swabs. Of 1072 patients screened, 51 (4.8%) were carriers of an ESBL-E at admission. Of 473 patients who underwent admission and discharge screening, 21 (4.4%) acquired an ESBL-E. On multivariate analysis, diabetes mellitus without end-organ complications (OR 2.87 [1.09-7.08]), connective tissue disease (OR 7.22 [1.17-44.59]), and liver failure (OR 8.39 [1.55-45.45]) were independent risk factors for carriage of an ESBL-E upon admission to hospital (area under the ROC curve, 0.68). Receipt of a first- or second-generation cephalosporin (OR 9.25 [2.22-37.82]), intra-hospital transfer (OR 6.68 [1.71-26.06]), and a hospital stay >21 days (OR 25.17 [4.18-151.68]) were associated with acquisition of an ESBL-E during hospitalisation; whilst admission from home was protective (OR 0.16 [0.06-0.39]) on univariate regression. No risk profile with sufficient accuracy to predict previously unknown carriage on admission or acquisition of ESBL-E could be developed using readily available patient information.

CONCLUSIONS: ESBL-E carriage is endemic amongst internal medicine patients at our institution. We were unable to develop a clinical risk profile to accurately predict ESBL-E carriage amongst these patients.

Keywords: Antimicrobial resistance; Extended-spectrum beta-lactamase producing enterobacteraciae; Infection control

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