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ABSTRACT: Background
Carbapenemase-producing Enterobacteriaceae (CPE) are an emerging threat for healthcare providers worldwide.Objectives
To determine CPE carriage rates and risk factors in an unselected hospital cohort at the time of admission.Methods
We approached 4567 patients within 72 h of admission to provide a rectal swab and answer a questionnaire on risk factors for carriage. Rectal swabs were cultured for carbapenem-resistant organisms on chromogenic and non-chromogenic agar, and tested for carbapenemase production by PCR (Check-Direct CPE). The study was approved by the NHS Research Ethics Committee.Results
Only 6 CPE were cultured from 5 (0.1%) of 4006 patients who provided a rectal swab; only 1 was cultured using non-chromogenic media. An additional 76 culture-negative rectal swabs were initially PCR positive, but none grew a carbapenem-resistant organism despite enrichment culture and only two were positive when retested several months later by Check-Direct and a second PCR assay (Cepheid GeneXpert® Carba-R). A modified Ct cut-off of <35 would have resolved these apparent false-positives. 40% of patients had a risk factor that should prompt screening and pre-emptive isolation as defined by UK CPE guidelines but only 8.1% and 20.2% of these patients had been screened and pre-emptively isolated by clinical teams, respectively. Overseas hospitalization was the only significant risk factor for CPE carriage (P?ConclusionsThis study highlights a very low carriage rate of CPE. Hospitalization abroad is the most important risk factor to guide admission screening in this low-prevalence setting.
SUBMITTER: Otter JA
PROVIDER: S-EPMC5890656 | biostudies-literature | 2016 Dec
REPOSITORIES: biostudies-literature
The Journal of antimicrobial chemotherapy 20160811 12
<h4>Background</h4>Carbapenemase-producing Enterobacteriaceae (CPE) are an emerging threat for healthcare providers worldwide.<h4>Objectives</h4>To determine CPE carriage rates and risk factors in an unselected hospital cohort at the time of admission.<h4>Methods</h4>We approached 4567 patients within 72 h of admission to provide a rectal swab and answer a questionnaire on risk factors for carriage. Rectal swabs were cultured for carbapenem-resistant organisms on chromogenic and non-chromogenic ...[more]