Universität zu Köln

Biehl, L. M., Higgins, P., Wille, T., Peter, K., Hamprecht, A., Peter, S., Doerfel, D., Vogel, W., Haefner, H., Lemmen, S., Panse, J., Rohde, H., Klupp, E. -M., Schafhausen, P., Imirzalioglu, C., Falgenhauer, L., Salmanton-Garcia, J., Stecher, M., Vehreschild, J. J., Seifert, H. and Vehreschild, M. J. G. T. (2019). Impact of single-room contact precautions on hospital-acquisition and transmission of multidrug-resistant Escherichia coli: a prospective multicentre cohort study in haematological and oncological wards. Clin. Microbiol. Infect., 25 (8). S. 1013 - 1021. OXFORD: ELSEVIER SCI LTD. ISSN 1469-0691

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Abstract

Objectives: Colonization and infection with third-generation cephalosporin-resistant Escherichia coli (3GCR-EC) are frequent in haematological and oncological patients. In this high-risk setting, German guidelines recommend single-room contact precautions (SCP) for patients with 3GCR-EC that are non-susceptible to fluoroquinolones (F3GCR-EC). However, this recommendation is controversial, as evidence is limited. Methods: We performed a prospective, multicentre cohort study at four haematology and oncology departments assessing the impact of SCP on hospital-acquired colonization or bloodstream infection (BSI) with F3GCR-EC. Two sites performed SCP for F3GCR-EC patients including single rooms, gloves and gowns (SCP sites), and two did not (NCP sites). Active screening for 3GCR-EC was performed and isolates were characterized with molecular typing methods including whole genome sequencing and core genome multiple locus sequence typing to assess patient-to-patient transmission. Potential confounders were assessed by competing-risk regression analysis. Results: Within 12 months, 1386 patients at NCP sites and 1582 patients at SCP sites were included. Hospital-acquisition of F3GCR-EC was observed in 22/1386 (1.59%) and 16/1582 (1.01%) patients, respectively (p 0.191). There were 3/1386 (0.22%) patients with BSI caused by F3GCR-EC at NCP sites and 4/1582 (0.25%) at SCP sites (p 1.000). Patient-to-patient transmission occurred in three cases at NCP and SCP sites each (p 1.000). The number of patients needed to screen in order to prevent one patient-to-patient transmission of F3GCR-EC was determined to be 3729. Conclusions: Use of SCP had no significant impact on hospital-acquisition or patient-to-patient transmission of F3GCR-EC in this high-risk setting. (C) 2019 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Biehl, L. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Higgins, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wille, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Peter, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamprecht, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Peter, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Doerfel, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vogel, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Haefner, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lemmen, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Panse, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rohde, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Klupp, E. -M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schafhausen, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Imirzalioglu, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Falgenhauer, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Salmanton-Garcia, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stecher, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, J. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, M. J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-134298
DOI:	10.1016/j.cmi.2018.12.029
Journal or Publication Title:	Clin. Microbiol. Infect.
Volume:	25
Number:	8
Page Range:	S. 1013 - 1021
Date:	2019
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1469-0691
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LACTAMASE-PRODUCING ENTEROBACTERIACEAE; HIGH-RISK PATIENTS; COLONIZATION; INFECTION; CESSATION; BACTERIA Multiple languages Infectious Diseases; Microbiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13429