Louise Abramowicz , Michèle Gerard , Delphine Martiny , Marc Delforge , Stéphane De Wit , Deborah Konopnicki
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引用次数: 5
Abstract
Objectives
To characterize the risk factors, impact of screening, and clinical burden of colonization and/or infection by carbapenemase-producing bacteria (CPB) in hospitalized patients.
Method
Retrospective study in a tertiary care hospital between 2008 and 2016.
Results
Among 88 included patients, 41% were colonized, 59% developed an infection, and 69% of all cases were hospital-acquired. Risk factors for CPB contamination included recent invasive medical device (94% of patients), antibiotic therapy (82%), travel abroad (17%), and hospitalization (> 50%) with 80% of all patients with underlying chronic condition. Intestinal carriage represented 89% of all colonization cases and 50% of infections were located in the urinary tract. The recent use of mechanical ventilation devices was significantly more observed in infected patients than colonized patients. The most frequent CPB was Klebsiella pneumoniae and the most frequent carbapenemase was OXA-48. Overall mortality rate was 19%. Prevalence of CPB detection in intensive care units (ICU) based on systematical rectal screen swab upon admission remained < 0.5%. The infected/colonized ratio (CPB colonization cases evolving into an infection) was 23%. The time between CPB infection diagnosis and start of appropriate antimicrobial therapy increased from 1 day in previously screened patients with positive CPB to 4 days in patients with previous negative or absent screening.
Conclusion
Our results emphasize the importance of CPB screening in all ICU patients and in at-risk patients hospitalized in other units, to allow earlier adequate antibiotic therapy in case of infection which occurred in 23% of the colonized patients.
期刊介绍:
L''organe d''expression de la Société de Pathologie Infectieuse de Langue Française (SPILF).
Médecine et Maladies Infectieuses is the official publication of the Société de Pathologie Infectieuse de Langue Française (SPILF). Médecine et Maladies Infectieuses is indexed in the major databases: Medline, Web of Science/Clarivate and Scopus. The journal publishes scientific /research articles, general reviews, short communications and letters, in both English and French. The journal welcomes submissions on the various aspects of infectious pathologies and pathogenic agents. Médecine et Maladies Infectieuses focuses on clinical therapeutics, nosocomial infections, biology, prevention, as well as epidemiology and therapeutics.