Duration of carriage of carbapenem-resistant Enterobacteriaceae following hospital discharge

Zimmerman, Frederic S.; Assous, Marc V.; Bdolah‐Abram, Tali; Lachish, Tamar; Yinnon, Amos M.; Wiener-Well, Yonit

doi:10.1016/j.ajic.2012.09.020

Cited by 146 publications

(112 citation statements)

References 23 publications

Supporting

Mentioning

107

Contrasting

Unclassified

Order By: Relevance

“…79 Similarly, among KPC-producing CRE carriers in a university hospital in Israel, the index culture being a clinical culture (vs surveillance culture) was associated with longer mean time to negativity. 87 Recurrent hospitalization between the first and last culture was also associated with a longer time to clearance of CRE colonization. This finding was also reported in a case-control study of risk factors for CRE recurrence in Israel, where a shorter time between the last positive CRE culture and presumed eradication, recurrent hospitalization, and the presence of a foreign body at the time of presumed eradication were associated with CRE recurrence.…”

Section: Patient Groups At Risk For Prolonged Colonizationmentioning

confidence: 99%

“…[21][22][23][78][79][80][81][82][83][84][85][86][87][88][89][90] Most studies were conducted in the acute-care setting [21][22][23][79][80][81]83,85,87,[89][90][91] and identified a population of patients infected and/or colonized with MDR-E, either ESBL-E or CRE, or MDR-Enterobacteriaceae defined by resistance to multiple classes of drugs. Patients were assessed for persistence of colonization at study-specific intervals and variable durations of follow-up.…”

Section: Duration Of Colonizationmentioning

confidence: 99%

“…Patients were assessed for persistence of colonization at study-specific intervals and variable durations of follow-up. The definition of "clearance" varied between a single negative screening culture, 79,87,90 at least 2 negative screening cultures, 21,23,81,84 or at least 3 negative screening cultures swabs. 80,85,91 ESBL-E.…”

Section: Duration Of Colonizationmentioning

confidence: 99%

See 2 more Smart Citations

Duration of Contact Precautions for Acute-Care Settings

Banach

Bearman

Barnden³

et al. 2018

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

purposeThis expert guidance document (EG) provides recommendations regarding discontinuation of contact precautions (CP) at the individual patient level in acute-care hospitals employing CP for 1 or more of the following organisms: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Clostridium difficile, and multidrug-resistant Enterobacteriaceae (MDR-E), including carbapenem-resistant Enterobacteriaceae (CRE) and extended-spectrum β-lactamase (ESBL)-producing organisms. This document also provides a review of the role of molecular testing in guiding decisions pertaining to duration of CP for patients with these organisms. The guidance does not address decisions regarding the initiation of CP for any specific organism.Previously published guidelines describe components of CP and identify situations in which CP should be used; currently, however, few publications address the issue of how long CP should be maintained. At the time of publication, decisions related to implementation of CP for select, endemic organisms are made by individual facilities based on factors such as institutional epidemiology, resources, organizational priorities, and previously published guidance, and these vary widely. The SHEA Guidelines Committee (GLC) selected this topic to address when CP should be discontinued for individual patients in acute-care settings that employ CP for the aforementioned organisms.Although the organisms addressed are frequently encountered in other settings (eg, nursing homes, long-term acute-care facilities, rehabilitation centers, outpatient medical care settings), additional considerations may affect the application of these recommendations outside the acute-care hospital environment. authorsThe authors consist of current and past members of the SHEA Guidelines Committee (GLC), who serve as volunteers. All authors are involved at their respective institutions in the development of policies pertaining to CP, either directly or in an advisory role. intended useSpecial-topic EG documents are developed to address areas of relatively narrow scope that lack the level of evidence required for a formal guideline but are important for the provision of safe and effective healthcare. As such, systematic grading of evidence level is not provided for individual recommendations. Each EG is based on a synthesis of limited evidence, theoretical rationale, current practices, practical considerations, the opinion of the writing group, and consideration of potential harms where applicable. Within the EG, a summary list of recommendations is provided, along with their respective rationales. We also conducted a survey of the SHEA Research Network (SRN).No EG can anticipate all situations and this EG is not meant to be a substitute for individual judgment by qualified professionals. methods Expert Guidance DevelopmentThis EG follows the process outlined in the Handbook for SHEA-Sponsored Guidelines and Expert Guidance Documents. 10 The topic of duration of CP was among those proposed and ...

show abstract

Section: Patient Groups At Risk For Prolonged Colonizationmentioning

confidence: 99%

Section: Duration Of Colonizationmentioning

confidence: 99%

See 1 more Smart Citation

Duration of Contact Precautions for Acute-Care Settings

Banach

Bearman

Barnden³

et al. 2018

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…The duration of isolation for CRE (and for many other MDROs) is not well defined. CRE can be carried for ≥12 months, [33] and if patients are identified as CRE carriers, it may be valuable to be able to identify them on readmission to hospital. Screening to document elimination of carriage can be attempted; however, it has been suggested that there should be at least two negative cultures (and possibly a negative polymerase chain reaction test) before a known CRE carrier patient can be regarded as no longer carrying this organism.…”

Section: Screening and Decolonisationmentioning

confidence: 99%

Role of infection control in combating antibiotic resistance

Whitelaw

2015

S Afr Med J

View full text Add to dashboard Cite

“…To the Editor, Carbapenem-resistant Enterobacteriaceae (CRE) is moving towards becoming a major health problem in Turkey as well as southern Europe (1)(2)(3)(4)(5)(6)(7). CRE infections are of major public health concern due to limited treatment options and high mortality (2).…”

mentioning

confidence: 99%