TY - JOUR
T1 - Carrier prevalence and risk factors for colonisation of multiresistant bacteria in Danish emergency departments
T2 - a cross-sectional survey
AU - Skjøt-Arkil, Helene
AU - Mogensen, Christian Backer
AU - Lassen, Annmarie Touborg
AU - Johansen, Isik S
AU - Chen, Ming
AU - Petersen, Poul
AU - Andersen, Karen V
AU - Ellermann-Eriksen, Svend
AU - Møller, Jørn M
AU - Ludwig, Marc
AU - Fuglsang-Damgaard, David
AU - Nielsen, Finn Erland
AU - Petersen, Dan B
AU - Jensen, Ulrich S
AU - Rosenvinge, Flemming S
PY - 2019/6
Y1 - 2019/6
N2 - OBJECTIVES: The aim of this study was to describe the carrier prevalence and demographic variation of four different multiresistant bacteria (MRB) among acute patients in Danish emergency departments (EDs): methicillin-resistant Staphylococcus aureus (MRSA), carbapenemase-producing enterobacteria (CPE), extended-spectrum beta-lactamase-producing enterobacteria (ESBL) and vancomycin-resistant enterococci (VRE), and to analyse the association of MRB carriage to a range of potential risk factors.DESIGN: Multicentre descriptive and analytic cross-sectional survey.SETTING: Eight EDs and four clinical microbiology departments in Denmark.PARTICIPANTS: Adults visiting the ED.MAIN OUTCOME MEASURES: Swabs from nose, throat and rectum were collected and analysed for MRSA, ESBL, VRE and CPE. The primary outcome was the prevalence of MRB carriage, and secondary outcomes relation to risk factors among ED patients.RESULTS: We included 5117 patients in the study. Median age was 68 years (54-77) and gender was equally distributed. In total, 266 (5.2%, 95% CI 4.6 to 5.8) were colonised with at least one MRB. No significant difference was observed between male and female patients, between age groups and between university and regional hospitals. Only 5 of the 266 patients with MRB were colonised with two of the included bacteria and none with more than two. CPE prevalence was 0.1% (95% CI 0.0 to 0.2), MRSA prevalence was 0.3% (95% CI 0.2 to 0.5), VRE prevalence was 0.4% (95% CI 0.3 to 0.6) and ESBL prevalence was 4.5% (95% CI 3.9 to 5.1). Risk factors for MRB carriage were previous antibiotic treatment, previous hospital stay, having chronic respiratory infections, use of urinary catheter and travel to Asia, Oceania or Africa.CONCLUSION: Every 20th patient arriving to a Danish ED brings MRB to the hospital. ESBL is the most common MRB in the ED. The main risk factors for MRB carriage are recent antibiotic use and travel abroad.TRIAL REGISTRATION NUMBER: NCT03352167;Post-results.
AB - OBJECTIVES: The aim of this study was to describe the carrier prevalence and demographic variation of four different multiresistant bacteria (MRB) among acute patients in Danish emergency departments (EDs): methicillin-resistant Staphylococcus aureus (MRSA), carbapenemase-producing enterobacteria (CPE), extended-spectrum beta-lactamase-producing enterobacteria (ESBL) and vancomycin-resistant enterococci (VRE), and to analyse the association of MRB carriage to a range of potential risk factors.DESIGN: Multicentre descriptive and analytic cross-sectional survey.SETTING: Eight EDs and four clinical microbiology departments in Denmark.PARTICIPANTS: Adults visiting the ED.MAIN OUTCOME MEASURES: Swabs from nose, throat and rectum were collected and analysed for MRSA, ESBL, VRE and CPE. The primary outcome was the prevalence of MRB carriage, and secondary outcomes relation to risk factors among ED patients.RESULTS: We included 5117 patients in the study. Median age was 68 years (54-77) and gender was equally distributed. In total, 266 (5.2%, 95% CI 4.6 to 5.8) were colonised with at least one MRB. No significant difference was observed between male and female patients, between age groups and between university and regional hospitals. Only 5 of the 266 patients with MRB were colonised with two of the included bacteria and none with more than two. CPE prevalence was 0.1% (95% CI 0.0 to 0.2), MRSA prevalence was 0.3% (95% CI 0.2 to 0.5), VRE prevalence was 0.4% (95% CI 0.3 to 0.6) and ESBL prevalence was 4.5% (95% CI 3.9 to 5.1). Risk factors for MRB carriage were previous antibiotic treatment, previous hospital stay, having chronic respiratory infections, use of urinary catheter and travel to Asia, Oceania or Africa.CONCLUSION: Every 20th patient arriving to a Danish ED brings MRB to the hospital. ESBL is the most common MRB in the ED. The main risk factors for MRB carriage are recent antibiotic use and travel abroad.TRIAL REGISTRATION NUMBER: NCT03352167;Post-results.
KW - carbapenemase-producing enterobacteria
KW - carrier prevalence
KW - extended-spectrum beta-lactamase-producing enterobacteria
KW - methicillin resistant staphylococcus aureus
KW - risk factors
KW - vancomycin resistant enterococci
UR - http://www.scopus.com/inward/record.url?scp=85068938989&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2019-029000
DO - 10.1136/bmjopen-2019-029000
M3 - Journal article
C2 - 31253624
SN - 2044-6055
VL - 9
JO - BMJ Open
JF - BMJ Open
IS - 6
M1 - e029000
ER -