Patients hospitalized abroad as importers of multiresistant bacteria - a cross-sectional study

Show full item record



Permalink

http://hdl.handle.net/10138/224247

Citation

Khawaja , T , Kirveskari , J , Johansson , S , Väisänen , J , Djupsjöbacka , A , Nevalainen , A & Kantele , A 2017 , ' Patients hospitalized abroad as importers of multiresistant bacteria - a cross-sectional study ' , Clinical Microbiology and Infection , vol. 23 , no. 9 . https://doi.org/10.1016/j.cmi.2017.02.003

Title: Patients hospitalized abroad as importers of multiresistant bacteria - a cross-sectional study
Author: Khawaja, T.; Kirveskari, J.; Johansson, S.; Väisänen, J.; Djupsjöbacka, A.; Nevalainen, A.; Kantele, A.
Contributor organization: Infektiosairauksien yksikkö
HUS Inflammation Center
University of Helsinki
Department of Diagnostics and Therapeutics
Clinicum
HUSLAB
Anu Kantele-Häkkinen Research Group
Department of Medicine
Date: 2017-09
Language: eng
Number of pages: 8
Belongs to series: Clinical Microbiology and Infection
ISSN: 1198-743X
DOI: https://doi.org/10.1016/j.cmi.2017.02.003
URI: http://hdl.handle.net/10138/224247
Abstract: Objectives: The pandemic spread of multidrug-resistant (MDR) bacteria poses a threat to healthcare worldwide, with highest prevalence in indigent regions of the (sub) tropics. As hospitalization constitutes a major risk factor for colonization, infection control management in low-prevalence countries urgently needs background data on patients hospitalized abroad. Methods: We collected data on 1122 patients who, after hospitalization abroad, were treated at the Helsinki University Hospital between 2010 and 2013. They were screened for methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE), vancomycin-resistant enterococci, carbapenemase-producing Enterobacteriaceae (CPE), multiresistant Pseudomonas aeruginosa and multiresistant Acinetobacter baumannii. Risk factors for colonization were explored by multivariate analysis. Results: MDR colonization rates were higher for those hospitalized in the (sub) tropics (55%; 208/377) compared with temperate zones (17%; 125/745). For ESBL-PE the percentages were 50% (190/377) versus 12% (92/745), CPE 3.2% (12/377) versus 0.4% (3/745) and MRSA 6.6% (25/377) versus 2.4% (18/745). Colonization rates proved highest in those returning from South Asia (77.6%; 38/49), followed by those having visited Latin America (60%; 9/16), Africa (60%; 15/25) and East and Southeast Asia (52.5%; 94/179). Destination, interhospital transfer, short time interval to hospitalization, young age, surgical intervention, residence abroad, visiting friends and relatives, and antimicrobial use proved independent risk factors for colonization. Conclusions: Post-hospitalization colonization rates proved higher in the (sub) tropics than elsewhere; 11% (38/333) of carriers developed an MDR infection. We identified several independent risk factors for contracting MDR bacteria. The data provide a basis for infection control guidelines in low-prevalence countries (C) 2017 The Author(s). Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases.
Subject: Antimicrobial drug resistance
Hospitalization
Infection control
Multidrug resistance
Travel
LACTAMASE-PRODUCING ENTEROBACTERIACEAE
MULTIDRUG-RESISTANT BACTERIA
RISK-FACTORS
INTERNATIONAL TRAVELERS
MULTICENTER COHORT
FOREIGN HOSPITALS
ESCHERICHIA-COLI
COLONIZATION
ENTEROCOCCUS
NETHERLANDS
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


Files in this item

Total number of downloads: Loading...

Files Size Format View
1_s2.0_S1198743X17300915_main.pdf 1.097Mb PDF View/Open

This item appears in the following Collection(s)

Show full item record