A predictive score for the result of carbapenem-resistant Enterobacterales and vancomycin-resistant enterococci screening.

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  • Additional Information
    • Corporate Authors:
      RéFraLHHa group
    • Source:
      Publisher: W.B. Saunders For The Hospital Infection Society Country of Publication: England NLM ID: 8007166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-2939 (Electronic) Linking ISSN: 01956701 NLM ISO Abbreviation: J Hosp Infect Subsets: MEDLINE
    • Publication Information:
      Publication: London : W.B. Saunders For The Hospital Infection Society
      Original Publication: New York, Academic Press.
    • Subject Terms:
      Mass Screening*/methods ; Vancomycin-Resistant Enterococci*/isolation & purification ; Vancomycin-Resistant Enterococci*/drug effects ; Carbapenem-Resistant Enterobacteriaceae*/isolation & purification ; Carbapenem-Resistant Enterobacteriaceae*/drug effects; Humans ; Retrospective Studies ; France/epidemiology ; Carrier State/microbiology ; Male ; Female ; Enterobacteriaceae Infections/microbiology ; Gram-Positive Bacterial Infections/microbiology ; Middle Aged ; Aged ; Predictive Value of Tests ; Drug Resistance, Multiple, Bacterial ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use
    • Abstract:
      Background: The duration of extensively drug-resistant bacteria (XDR) carriage depends on several factors for which the information can be difficult to recover.
      Aim: To determine whether past screening and clinical results of patients can predict the results of subsequent screening.
      Methods: In total, 256 patients were retrospectively included from 10 healthcare centres in France from January 2014 to January 2022. We created a predictive clearance score, ranging from -5 to +7, that included the number of XDR species and the type of resistance detected in the sample, as well as the time from the last positive sample, the number of previous consecutive negative samples, and obtaining at least one negative PCR result in the collection. This score could be used for the upcoming rectal screening of a patient carrying an XDR as soon as the last screening sample was negative.
      Findings: The negative predictive value was >99% for score ≤0. The median time to achieve XDR clearance was significantly shorter for a score of 0 (443 days (259-705)) than that based on previously published criteria.
      Conclusion: This predictive score shows high performance for the assessment of XDR clearance. Relative to previous guidelines, it could help to lift specific infection prevention and control measures earlier. Nevertheless, the decision should be made according to other factors, such as antimicrobial use and adherence to hand hygiene.
      (Copyright © 2024 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)
    • Contributed Indexing:
      Investigator: C Andonian, Service de Prévention du risque infectieux, CH Métropole Savoie, site d'Aix-les-bains, Aix-les-bains, France.; F Faure-Audebert, Service de Prévention du risque infectieux, CH Métropole Savoie, site d'Aix-les-bains, Aix-les-bains, France.; C Ciotti, Service d'Hygiène Hospitalière, Hôpital Beaujon, Clichy, France.; S Nérome, Service d'Hygiène Hospitalière, Hôpital Beaujon, Clichy, France.; P Foucault-Picher, Service de Prévention et Contrôle de l'Infection, Centre Hospitalo-Universitaire Caen Normandie, Caen, France.; F Grade, Service de Biologie Clinique, Hôpital Foch, Suresnes, France.; M de Fondaumière, Service de Biologie Clinique, Hôpital Foch, Suresnes, France.; C Durand, Service de Biologie Clinique, Hôpital Foch, Suresnes, France.; Y Costa, Microbiologie, Grand Hôpital de l'est francilien, Meaux, France.; JW Decousser, service de Microbiologie clinique et Laboratoire d'hygiène, hôpital Henri Mondor, Créteil, France.; J Robert, Bactériologie et Hygiène, hôpital la Pitié-Salpêtrière, Paris, France.; E Kinziger, Structure interne de gestion des risques, hygiène, qualité (SIGRHYQ), CHI Poissy-Saint-Germain en Laye, Poissy, France.; A Migeon, Structure interne de gestion des risques, hygiène, qualité (SIGRHYQ), CHI Poissy-Saint-Germain en Laye, Poissy, France.; L Zon, Prévention du risque infectieux, hôpital NOVO, Cergy Pontoise, France.; S Delattre, Equipe opérationnelle d'hygiène, Hôpital Raymond-Poincaré, Garches, France.; J Couturier, microbiologie de l'environnement, Hôpital Saint-Antoine, Paris, France.; P Moënne-Locoz, Unité de prévention du risque infectieux, Hôpital Saint-Antoine, Paris, France.; H Faury, Unité de prévention du risque infectieux, Hôpital Saint-Antoine, Paris, France.
      Keywords: Carbapenem-resistant Enterobacterales; Carriage; Extensively drug-resistant bacteria; Predictive score of clearance; Screening; Vancomycin-resistant enterococci
    • Accession Number:
      0 (Anti-Bacterial Agents)
    • Publication Date:
      Date Created: 20240315 Date Completed: 20240531 Latest Revision: 20240531
    • Publication Date:
      20240601
    • Accession Number:
      10.1016/j.jhin.2024.02.024
    • Accession Number:
      38490490