Healthcare personnel intestinal colonization with multidrug-resistant organisms

January 31, 2018 at 11:21 pm

Clinical Microbiology and Infection January 2018 V.24 N.1 p82.e1–82.e4   

B.K. Decker, A.F. Lau, J.P. Dekker, C.D. Spalding, N. Sinaii, S. Conlan, D.K. Henderson, J.A. Segre, K.M. Frank, T.N. Palmore

Objectives

This study aims to assess the association between patient contact and intestinal carriage of multidrug-resistant organisms (MDRO) by sampling healthcare personnel (HCP) and staff without patient contact.

Methods

For this observational study, we recruited 400 HCP who worked in our 200-bed research hospital and 400 individuals without patient contact between November 2013 and February 2015. Participants submitted two self-collected perirectal swabs and a questionnaire. Swabs were processed for multidrug-resistant Gram-negative bacteria and vancomycin-resistant enterococci (VRE). Questionnaires explored occupational and personal risk factors for MDRO carriage.

Results

Among 800 participants, 94.4% (755/800) submitted at least one swab, and 91.4% (731/800) also submitted questionnaires. Extended spectrum β-lactamase-producing organisms were recovered from 3.4% (26/755) of participants, and only one carbapenemase-producing organism was recovered. No VRE were detected. The potential exposure of 68.9% (250/363) of HCP who reported caring for MDRO-colonized patients did not result in a rate of MDRO carriage among HCP (4.0%; 15/379) significantly higher than that of staff without patient contact (3.2%; 12/376; p 0.55).

Conclusions

This is the largest US study of HCP intestinal MDRO carriage. The low colonization rate is probably reflective of local community background rates, suggesting that HCP intestinal colonization plays a minor role in nosocomial spread of MDROs in a non-outbreak setting.

abstract

http://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(17)30270-7/fulltext

PDF

http://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(17)30270-7/pdf

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Entry filed under: Antimicrobianos, Bacterias, Epidemiología, Health Care-Associated Infections, Infecciones nosocomiales, Metodos diagnosticos, REPORTS, Resistencia bacteriana, Sepsis, Update.

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