ESBL-colonization at ICU admission: impact on subsequent infection, carbapenem-consumption, and outcome

Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America
Aurélien Emmanuel MartinezSarah Tschudin-Sutter

Abstract

To determine whether colonization with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) predicts the risk for subsequent infection and impacts carbapenem-consumption and outcome in intensive care unit (ICU) patients. Prospective cohort study. The 2 ICUs in the University Hospital Basel in Switzerland. All patients admitted to the 2 ICUs providing mechanical ventilation and an expected ICU stay >48 hours. Patients were routinely screened for ESBL-PE carriage by rectal swab on admission. Competing risk regression analyses were applied to calculate hazard ratios (HRs) for infection with ESBL-PE and mortality. Length of hospital stay, length of ICU stay, and duration of carbapenem exposure were compared using the Mann-Whitney U test. Among 302 patients, 24 (8.0%) were colonized with ESBL-PE on ICU admission. Infections with ESBL-PE occurred in 4 patients, of whom 3 (75%) were identified as ESBL-PE colonized on admission. ESBL-PE colonization on admission was associated with subsequent ESBL-PE infection (hazard ratio [HR], 25.52; 95% confidence interval [CI], 2.40-271.41; P = .007) and exposure to carbapenems (HR, 2.42; 95% CI, 1.01-5.79; P = .047), whereas duration of carbapenem exposure did not differ in rel...Continue Reading

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Citations

Jan 24, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Anthony D HarrisJ Kristie Johnson
Jul 1, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Isabelle VockSarah Tschudin-Sutter
Aug 1, 2020·Therapeutic Advances in Gastroenterology·Alexa Choy, Daniel E Freedberg
Jan 7, 2020·Current Opinion in Anaesthesiology·Jan J De WaeleIsabel Leroux-Roels
Jan 17, 2021·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Benoît PilmisAlban Le Monnier
Jul 24, 2021·Journal of Infection Prevention·Alain Kenfak-FoguenaChristiane Petignat
Jul 24, 2021·Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS·Sebastian Schulz-Stübner
Dec 7, 2019·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Luisa A DenkelRasmus Leistner
Aug 18, 2021·Journal of Medical Microbiology·Philipp HofmannAyola A Adegnika

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