Healthcare Antibiotic Resistance Prevalence – DC (HARP-DC): A Regional Prevalence Assessment of Carbapenem-Resistant Enterobacteriaceae (CRE) in Healthcare Facilities in Washington, District of Columbia
| Autor: | Princy Kumar, Jo Anne Nelson, Brendan Sinatro, Milena Walker, Glenn Wortmann, Jacqueline Reuben, Preetha Iyengar, Sylvia Clagon, Jane Hooker, Gary L. Little, Diane White, Gail Jernigan, Trevor Wagner, Kathleen Hansen, Nancy Donegan, Angella Browne, Mary McFadden, Xiaoyan Song, Janet Mirdamadi, Michael Yochelson, Roberta L. DeBiasi, Morris Blaylock, Jo Ellen Harris, Harp Study Team, Brenda Dockery, Kimary Harmon |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) medicine.medical_specialty Epidemiology 030106 microbiology Antimicrobial susceptibility Carbapenem-resistant enterobacteriaceae 030501 epidemiology Skilled Nursing Real-Time Polymerase Chain Reaction beta-Lactam Resistance Young Adult 03 medical and health sciences Antibiotic resistance Enterobacteriaceae Environmental health Health care Prevalence medicine Humans Aged Skilled Nursing Facilities Aged 80 and over Cross Infection business.industry Public health Enterobacteriaceae Infections Facility type Middle Aged Inpatient rehabilitation facility Hospitals Nursing Homes Infectious Diseases Carbapenems District of Columbia Female 0305 other medical science business |
| Zdroj: | Infection Control & Hospital Epidemiology. 38:921-929 |
| ISSN: | 1559-6834 0899-823X |
| Popis: | OBJECTIVECarbapenem-resistant Enterobacteriaceae (CRE) are a significant clinical and public health concern. Understanding the distribution of CRE colonization and developing a coordinated approach are key components of control efforts. The prevalence of CRE in the District of Columbia is unknown. We sought to determine the CRE colonization prevalence within healthcare facilities (HCFs) in the District of Columbia using a collaborative, regional approach.DESIGNPoint-prevalence study.SETTINGThis study included 16 HCFs in the District of Columbia: all 8 acute-care hospitals (ACHs), 5 of 19 skilled nursing facilities, 2 (both) long-term acute-care facilities, and 1 (the sole) inpatient rehabilitation facility.PATIENTSInpatients on all units excluding psychiatry and obstetrics-gynecology.METHODSCRE identification was performed on perianal swab samples using real-time polymerase chain reaction, culture, and antimicrobial susceptibility testing (AST). Prevalence was calculated by facility and unit type as the number of patients with a positive result divided by the total number tested. Prevalence ratios were compared using the Poisson distribution.RESULTSOf 1,022 completed tests, 53 samples tested positive for CRE, yielding a prevalence of 5.2% (95% CI, 3.9%–6.8%). Of 726 tests from ACHs, 36 (5.0%; 95% CI, 3.5%–6.9%) were positive. Of 244 tests from long-term-care facilities, 17 (7.0%; 95% CI, 4.1%–11.2%) were positive. The relative prevalence ratios by facility type were 0.9 (95% CI, 0.5–1.5) and 1.5 (95% CI, 0.9–2.6), respectively. No CRE were identified from the inpatient rehabilitation facility.CONCLUSIONA baseline CRE prevalence was established, revealing endemicity across healthcare settings in the District of Columbia. Our study establishes a framework for interfacility collaboration to reduce CRE transmission and infection.Infect Control Hosp Epidemiol 2017;38:921–929 |
| Databáze: | OpenAIRE |
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