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Submitted on 3 Jun 2020
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Extended-spectrum beta-lactamase-producing
Enterobacteriacae (ESBLE): significant increase of the prevalence of carriage in elderly residents between 2010
and 2013
- D. Roux, H. Cochard, Sandra dos Santos Borges, Roland Quentin, . Infection Control Study Group, Nathalie van der Mee-Marquet
To cite this version:
- D. Roux, H. Cochard, Sandra dos Santos Borges, Roland Quentin, . Infection Control Study Group, et al.. Extended-spectrum beta-lactamase-producing Enterobacteriacae (ESBLE): significant increase of the prevalence of carriage in elderly residents between 2010 and 2013. 24. European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2014), May 2014, Barcelone, Spain. 2014.
�hal-02741749�
P1614
Poster Session VI
Controling infections in long-term care facilities
EXTENDED-SPECTRUM BETA-LACTAMASE-PRODUCING ENTEROBACTERIACAE (ESBLE):
SIGNIFICANT INCREASE OF THE PREVALENCE OF CARRIAGE IN ELDERLY RESIDENTS BETWEEN 2010 AND 2013.
D. Roux1, H. Cochard1, S. Borges Dos Santos2, R. Quentin2, -. Infection Control Study Group3, N. Van der Mee-Marquet2
1Réseau des Hygiénistes du Centre, University Hospital, TOURS, France ; 2Microbiology and Hygiene, University Hospital, TOURS, France ; 3Réseau des Hygiénistes du Centre, Nursing Homes, TOURS, France
Objectives
To evaluate the spread of ESBLE in nursing homes (NHs), we conducted two multicentre one day point-prevalence studies in the Centre region of France (2.7 M inhabitants), the first in 2010 and the second in 2013, and evaluated ESBLE colonisation of 1620 residents.
Methods
37 NHs in 2010, and 38 in 2013 participated in the study (total beds 5141 and 4799 respectively). 19 NHs participated in both studies. 1620 residents were enrolled (465 in 2010, 1155 in 2013), including 1159 women and 461 men. Data were collected for all residents (age and sex, physical disability, urinary and faecal incontinence, comorbidities, recent hospitalisation and antibiotic use prior to inclusion in the study). Rectal swabs or first morning urine samples were used to screen residents for ESBLE carriage. The colonising isolates were genotyped.
Results
Most characteristics were similar for the residents of the 2 studies. Residents enrolled in 2010 and 2013 did only differ significantly for age and sex (more females and less residents >85 y in 2013). Many were not able to walk unassisted (51%) and incontinent (65% urinary- and 47% faecal-). Diabetes mellitus was reported for 15% of the residents. 17% had recently been hospitalised, and 35% had recently been treated with antibiotics.
The prevalence of ESBLE carriage increased significantly between 2010 and 2013. In 2010, 6 residents were ESBLE carriers (2 %) and the carriage rate was between 0 and 10% according to the NH. In 2013, 114 residents were ESBLE carriers (10%) and the carriage rate was between 0 and 29%
according to the NH. The ESBLE included 99 E. coli (67% of ESBLE in 2010, 82% in 2013).
By comparison with non carriers, ESBLE carriers were in a poorer state of health. ESBLE colonisation was signi?cantly associated with urinary incontinence, faecal incontinence, recent hospitalisation and antibiotic treatment.
Genotyping of the ESBLE strains revealed two or more residents carrying E. coli belonging to the same clone in none of the 37 NHs in 2010, and in 23 of the 38 NHs in 2013, suggestive of intra-NH resident-to- resident transmission. The NHs were distributed into 2 groups: one with low ESBLE carriage rates and no intra-NH ESBLE spread, and the second with high rates and putative intra-NH ESBLE spread.
Conclusion
Our findings show rapid changes in the epidemiology of ESBL-E. coli in NHs and raise the question of the factors that favour intra-NH spread. We alert about the need to investigate this point, and to conduct routinely such survey to monitor the phenomenon and to provide information for adapting preventive strategies in NHs.
