Assessing the role of inter-facility patient transfer in the spread of carbapenemase-producing Enterobacteriaceae: the case of France between 2012 and 2015

Nekkab, Narimane; Crépey, Pascal; Astagneau, Pascal; Opatowski, Lulla; Temime, Laura

doi:10.1038/s41598-020-71212-6

Cited by 10 publications

(8 citation statements)

References 21 publications

(37 reference statements)

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“…The linked nature of the data used in this study is another key strength. The impact of inter-facility patient transfer has been studied previously for CPE [13] and other hospital associated infections [21]. These studies have only been able to draw associations between hospital incidence and patient admissions, while this data allowed us to look explicitly at the patterns of those colonised with CPE.…”

Section: Discussionmentioning

confidence: 99%

Carbapenemase-producing Enterobacterales colonisation status does not lead to more frequent admissions: a linked patient study

Lydeamore,

Donker,

et al. 2024

Preprint

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Background. Hospitals in any given region can be considered as part of a network, where facilities are connected to one another - and hospital pathogens potentially spread - through the movement of patients between them. We sought to describe the hospital admission patterns of patients known to be colonised with carbapenemase-producing Enterobacterales (CPE), and compare them with CPE-negative patients. Methods. We performed a linkage study in Victoria, Australia, including datasets with notifiable diseases (CPE notifications) and hospital admissions (admission dates and diagnostic codes) for the period 2011 to 2020. Where the CPE notification date occurred during a hospital admission for the same patient, we identified this as the 'index admission'. We determined the number of distinct health services each patient was admitted to, and time to first admission to a different health service. We compared CPE-positive patients with four cohorts of CPE-negative patients, sampled based on different matching criteria. Results. Of 528 unique patients who had CPE detected during a hospital admission, 222 (42%) were subsequently admitted to a different health service during the study period. Among these patients, CPE diagnosis tended to occur during admission to a metropolitan public hospital (86%, 190/222), whereas there was a greater number of metropolitan private (23%, 52/222) and regional public (18%, 39/222) hospitals for the subsequent admission. Median time to next admission was 4 days (IQR, 0-75 days). Admission patterns for CPE-positive patients was similar to the cohort of CPE-negative patients matched on index admission, time period, and age-adjusted Charlson comorbidity index. Conclusions. Movement of CPE-positive patients between health services is not a rare event. While the most common movement is from one public metropolitan health service to another, there is also a trend for movement from metropolitan public hospitals into private and regional hospitals. CPE-positivity does not appear to impact on hospital admission frequency and timing. These findings support the potential utility of a centralised notification and outbreak management system for CPE positive patients.

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Section: Discussionmentioning

confidence: 99%

Carbapenemase-producing Enterobacterales colonisation status does not lead to more frequent admissions: a linked patient study

Lydeamore,

Donker,

et al. 2024

Preprint

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“…However, the effect of this phenomenon has not been studied in this context. An epidemiologic study in France previous to the pandemic showed that patient transfer between facilities sustained multidrug-resistant pathogens epidemics [9]. Carbapenem resistance among Enterobacterales and NFGNB rose from a baselife of 30.4% to an alarming rate of 43.9%.…”

Section: Discussionmentioning

confidence: 99%

Rising incidence of carbapenem resistant isolates: an Argentinian hospital’s experience. More trouble in the aftermath of the COVID-19 pandemic

Castro¹,

Ubiergo²,

Vicino³

et al. 2022

Iberoam J Med

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Introduction: During COVID-19 outbreaks, disproportionate use of antibiotics, high Intensive Care Units burden and longer in-hospital stays may have aggravated the emergency posed by carbapenem-resistant isolates. Therefore, we set out to determine whether the incidence of carbapenem-resistant isolates rose in a tertiary care center in Santa Fe, Argentina during the period with active cases of COVID-19. Material and methods: In this retrospectively designed analytic epidemiologic study, two periods were defined: Period 1 (without active cases of COVID-19) from September 2019 to August 2020 and Period 2 (starting at the onset of the first wave of COVID-19 in this Institution) from September 2020 to June 2021. All clinically relevant microbiological samples taken during these periods in the Internal Medicine, Surgical and Intensive Care Unit wards were included. The primary analysis of interest was the differential incidence between the two periods, overall and in the Intensive Care Units wards in particular. Results: 9,135 hospitalizations, 50,145 patient-days of analysis. 7,285 clinical samples were taken, with an overall positivity for carbapenem-resistant isolates of 12.1% (n=883). Overall carbapenem-resistant isolates incidence during Period 2 was 2.5 times higher than in Period 1 (2.52 vs 0.955/100 patient-days, p<0.001). Intensive Care Units’ carbapenem-resistant isolates incidence raised from 6.78 to 8.69/100 patient-days in Period 2 (p=0.006). Conclusions: We found alarming rates of carbapenem-resistant isolates in our center, 2.5 times higher in the period following the first wave of COVID-19. This rise was due to a higher amount of clinically relevant microbiological samples taken and to a higher carbapenem resistance among Enterobacteria and non-fermentative Gram-negative bacilli. To our knowledge, this is one of the few Latin-American reports on the effect of the COVID-19 pandemic on carbapenem-resistant isolates incidence.

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Section: Discussionmentioning

confidence: 99%

An outbreak inside an outbreak: rising incidence of carbapenem-resistant isolates during the COVID-19 pandemic. Report from a tertiary care center in Argentina

Castro¹,

Ubiergo²,

Vicino³

et al. 2021

Preprint

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IntroductionCOVID-19 outbreaks have left us to deal with an aftermath on many fronts. In particular, disproportionate use of antibiotics, high ICU burden and longer in-hospital stays during the pandemic have been proposed to aggravate the emergency posed by carbapenem-resistant isolates (CRI), specially through carbapenemase production. However, there have been few reports worldwide regarding changes in CRI incidence and little latinamerican literature.ObjectiveWe set out to determine whether the incidence of CRI rose in a tertiary care center in Santa Fe, Argentina during the time period with active cases of COVID-19.MethodsAnalytic epidemiologic study retrospectively designed. Two time periods were defined: P1 (without active cases of COVID-19) from September, 2019 to August, 2020 and P2 (starting at the onset of the first wave of COVID-19 in this institution) from September, 2020 to June 2021. All clinically-relevant microbiological samples -those meant for diagnostic purposes-taken during the study period from patients in the Internal Medicine and Surgical wards as well as the Intensive Care Units were included. Incidence was calculated by dividing the number of CRI during each time frame by the count of patient-day during that same period, multiplied by a hundred.Results9,135 hospitalizations, 50,145 patient-days of analysis. A total of 7285 clinical samples were taken, with an overall positivity for CRI of 12.1% (n=883). Overall CRI incidence during P2 was 2.5 times higher than in P1 (2.52 vs 0.955/100 patient-days, p <0.001). ICU CRI incidence raised from 6.78 to 8.69/100 patient-days in P2 (p=0.006).ConclusionWe found alarming rates of CRI in our center, 2.5 times higher than previous to the first COVID-19 wave, similar to other reports worldwide. To our knowledge, this is one of the few Latin-American reports on the effect of the COVID-19 pandemic on CRI incidence.

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Assessing the role of inter-facility patient transfer in the spread of carbapenemase-producing Enterobacteriaceae: the case of France between 2012 and 2015

Cited by 10 publications

References 21 publications

Carbapenemase-producing Enterobacterales colonisation status does not lead to more frequent admissions: a linked patient study

Carbapenemase-producing Enterobacterales colonisation status does not lead to more frequent admissions: a linked patient study

Rising incidence of carbapenem resistant isolates: an Argentinian hospital’s experience. More trouble in the aftermath of the COVID-19 pandemic

An outbreak inside an outbreak: rising incidence of carbapenem-resistant isolates during the COVID-19 pandemic. Report from a tertiary care center in Argentina

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