Akel Azzi, Hélène Marini, Ludivine Boulet, Marion Lottin, Thomas Vermeulin, Hervé Vergnes, Stéphane Edet, Laurence Guet, Frank Le Roy, Véronique Merle
{"title":"Reported practices and difficulties for preventing emerging highly resistant bacteria in hemodialysis: the PHYDEL survey.","authors":"Akel Azzi, Hélène Marini, Ludivine Boulet, Marion Lottin, Thomas Vermeulin, Hervé Vergnes, Stéphane Edet, Laurence Guet, Frank Le Roy, Véronique Merle","doi":"10.3205/dgkh000659","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>Chronic hemodialysis patients are at risk of Vancomycin-resistant Enterocci (VRE) and carbapenemase-producing Enterobacteriaceae (CPE) carriage. France has released guidelines to prevent the spread of VRE-CPE carriage in hospitals. However, the hemodialysis setting is confronted with specific problems that are not always addressed by guidelines. Infection control practices regarding VRE-CPE transmission in the hemodialysis setting have not been described in the literature. The aim of our survey was to assess declared practices regarding VRE-CPE identification and management in French hemodialysis units (HDU).</p><p><strong>Methods: </strong>A cross-sectional survey was conducted in a random sample of 200 French HDU (excluding peritoneal dialysis and exclusive pediatric hemodialysis units) regarding their declared organization for identifying VRE-CPE carriers, the type and duration of precautions implemented, and reported difficulties. Data were collected via an e-mail questionnaire, and completed by a short telephone interview with an infection control nurse.</p><p><strong>Results: </strong>103 HDU agreed to participate. A minority of HDU had implemented a system to identify patients requiring screening or were able to keep track of VRE-CPE carriers and contacts via a computerized system. When managing VRE-CPE carriers, less than one-third of HDU employed caregivers, and strategies to discontinue precautions varied widely between HDU. HDU staff complained mainly about the lack of national specific guidelines for VRE-CPE in the hemodialysis setting, insufficient information regarding patients' VRE-CPE status, and difficulties in convincing patients to accept screening.</p><p><strong>Conclusion: </strong>This survey highlights heterogeneous practices and routine difficulties in VPE-CPE patients' management which would probably benefit from guidelines tailored to the hemodialysis setting.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"21 ","pages":"Doc50"},"PeriodicalIF":1.1000,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386495/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"GMS Hygiene and Infection Control","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3205/dgkh000659","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Aim: Chronic hemodialysis patients are at risk of Vancomycin-resistant Enterocci (VRE) and carbapenemase-producing Enterobacteriaceae (CPE) carriage. France has released guidelines to prevent the spread of VRE-CPE carriage in hospitals. However, the hemodialysis setting is confronted with specific problems that are not always addressed by guidelines. Infection control practices regarding VRE-CPE transmission in the hemodialysis setting have not been described in the literature. The aim of our survey was to assess declared practices regarding VRE-CPE identification and management in French hemodialysis units (HDU).
Methods: A cross-sectional survey was conducted in a random sample of 200 French HDU (excluding peritoneal dialysis and exclusive pediatric hemodialysis units) regarding their declared organization for identifying VRE-CPE carriers, the type and duration of precautions implemented, and reported difficulties. Data were collected via an e-mail questionnaire, and completed by a short telephone interview with an infection control nurse.
Results: 103 HDU agreed to participate. A minority of HDU had implemented a system to identify patients requiring screening or were able to keep track of VRE-CPE carriers and contacts via a computerized system. When managing VRE-CPE carriers, less than one-third of HDU employed caregivers, and strategies to discontinue precautions varied widely between HDU. HDU staff complained mainly about the lack of national specific guidelines for VRE-CPE in the hemodialysis setting, insufficient information regarding patients' VRE-CPE status, and difficulties in convincing patients to accept screening.
Conclusion: This survey highlights heterogeneous practices and routine difficulties in VPE-CPE patients' management which would probably benefit from guidelines tailored to the hemodialysis setting.
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