Import of multidrug-resistant bacteria from abroad through interhospital transfers, Finland, 2010–2019

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Kajova , M , Khawaja , T , Kangas , J , Mäkinen , H & Kantele , A 2021 , ' Import of multidrug-resistant bacteria from abroad through interhospital transfers, Finland, 2010–2019 ' , Eurosurveillance , vol. 26 , no. 39 , 2001360 . https://doi.org/10.2807/1560-7917.ES.2021.26.39.2001360

Title: Import of multidrug-resistant bacteria from abroad through interhospital transfers, Finland, 2010–2019
Author: Kajova, Mikael; Khawaja, Tamim; Kangas, Jonas; Mäkinen, Hilda; Kantele, Anu
Other contributor: University of Helsinki, HUS Inflammation Center
University of Helsinki, HUS Inflammation Center
University of Helsinki, Department of Medicine




Date: 2021-09-30
Language: eng
Number of pages: 12
Belongs to series: Eurosurveillance
ISSN: 1025-496X
DOI: https://doi.org/10.2807/1560-7917.ES.2021.26.39.2001360
URI: http://hdl.handle.net/10138/335885
Abstract: Background: While 20–80% of regular visitors to (sub)tropical regions become colonised by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE), those hospitalised abroad often also carry other multidrug-resistant (MDR) bacteria on return; the rates are presumed to be highest for interhospital transfers. Aim: This observational study assessed MDR bacterial colonisation among patients transferred directly from hospitals abroad to Helsinki University Hospital. We investigated predisposing factors, clinical infections and associated fatalities. Methods: Data were derived from screening and from diagnostic samples collected between 2010 and 2019. Risk factors of colonisation were identified by multivariable analysis. Microbiologically verified symptomatic infections and infection-related mortality were recorded during post-transfer hospitalisation. Results: Colonisation rates proved highest for transfers from Asia (69/96; 71.9%) and lowest for those within Europe (99/524; 18.9%). Of all 698 patients, 208 (29.8%) were colonised; among those, 163 (78.4%) carried ESBL-PE, 28 (13.5%) MDR Acinetobacter species, 25 (12.0%) meticillin-resistant Staphylococcus aureus, 25 (12.0%) vancomycin-resistant Enterococcus, 14 (6.7%) carbapenemase-producing Enterobacteriaceae, and 12 (5.8%) MDR Pseudomonas aeruginosa; 46 strains tested carbapenemase gene-positive. In multivariable analysis, geographical region, intensive care unit (ICU) treatment and antibiotic use abroad proved to be risk factors for colonisation. Clinical MDR infections, two of them fatal (1.0%), were recorded for 22 of 208 (10.6%) MDR carriers. Conclusions: Colonisation by MDR bacteria was common among patients transferred from foreign hospitals. Region of hospitalisation, ICU treatment and antibiotic use were identified as predisposing factors. Within 30 days after transfer, MDR colonisation manifested as clinical infection in more than 10% of the carriers.
Subject: 3111 Biomedicine
3121 General medicine, internal medicine and other clinical medicine
LACTAMASE-PRODUCING ENTEROBACTERIACEAE
STAPHYLOCOCCUS-AUREUS
RISK-FACTORS
FOREIGN HOSPITALS
ESCHERICHIA-COLI
COLONIZATION
TRAVELERS
CARRIAGE
ACQUISITION
INCREASE
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