• J. Hosp. Infect. · Mar 2018

    Carriage of ESBL-producing Enterobacteriaceae in French hospitals: the PORTABLSE study.

    • B Pilmis, V Cattoir, D Lecointe, A Limelette, I Grall, A Mizrahi, G Marcade, I Poilane, T Guillard, N Bourgeois Nicolaos, J-R Zahar, and A Le Monnier.
    • Equipe Mobile de Microbiologie clinique, Groupe Hospitalier Paris Saint-Joseph, Paris, France.
    • J. Hosp. Infect. 2018 Mar 1; 98 (3): 247-252.

    BackgroundCurrently, contact precautions are recommended for patients colonized or infected with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE). Recent studies have challenged this strategy. This study aimed to assess the rate of ESBL-PE faecal carriage among hospitalized patients according to type of hospital ward, and to identify risk factors associated with carriage.MethodsA point prevalence study was conducted in five different types of hospital ward [medical, surgical, intensive care unit (ICU), after care and rehabilitation, and geriatric] in eight French hospitals. All patients included in the study provided a fresh stool sample.ResultsIn total, 554 patients were included in the study, with a median age of 73 years (range 60-82 years). The overall faecal carriage rate of ESBL-PE was 17.7%. The most frequently encountered species among ESBL-PE was Escherichia coli (71.4%), followed by Klebsiella pneumoniae (14.3%). Risk factors associated with ESBL-PE faecal carriage on univariate analysis were: living in the Paris region (P<0.01) and hospitalization on a geriatric ward (P<0.01). Interestingly, the cumulative duration of hospital stay before screening was not associated with a significantly higher prevalence of ESBL-PE carriage, regardless of ward type. The ESBL-PE colonization rate was much higher for patients hospitalized on geriatric wards (28.1%) and ICUs (21.7%) compared with those for patients hospitalized on surgical wards (14.8%), medical wards (12.8%) or aftercare and rehabilitation (11.2%).ConclusionThe overall prevalence of ESBL-PE faecal carriage was 17.7%, with only 21% of patients identified previously as carriers. The delay between admission and screening was not associated with an increase in ESBL-PE faecal carriage.Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

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