Spontaneous decolonization during hospitalization in intensive care unit patients colonized by extended-spectrum beta-lactamase-producing Enterobacterales

J Hosp Infect. 2020 Nov;106(3):500-503. doi: 10.1016/j.jhin.2020.07.029. Epub 2020 Jul 31.

Abstract

This study aimed to analyse the frequency of occurrence of spontaneous decolonization in intensive care unit patients colonized by extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) in order to assess the added value of continuing weekly ESBL-E rectal carriage screening in these patients. In total, 49,468 weekly rectal screening samples taken from 20,846 patients over 12 years were included. Among the 4280 ESBL-E carriers, only 109 patients (2.5%) could be considered decolonized at the end of their hospitalization with at least three consecutive negative samples. Overall, 7957 samples (16.1%) were requested for patients already identified as ESBL-E carriers. Avoiding unnecessary weekly screening following positive ESBL-E colonization results could decrease nursing and laboratory work loads.

Keywords: Colonization; Contact precautions; Critical care; Extended-spectrum beta-lactamase; Infection control.

MeSH terms

  • Aged
  • Carrier State / epidemiology
  • Cross Infection / epidemiology
  • Enterobacteriaceae / enzymology
  • Enterobacteriaceae / physiology*
  • Enterobacteriaceae Infections / microbiology
  • Enterobacteriaceae Infections / prevention & control*
  • Enterobacteriaceae Infections / transmission
  • Female
  • Hospitalization
  • Humans
  • Infection Control / methods*
  • Intensive Care Units / statistics & numerical data*
  • Male
  • Middle Aged
  • Rectum / microbiology*
  • Retrospective Studies
  • beta-Lactamases

Substances

  • beta-Lactamases