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Scientific article
Open access
English

Quantification of time delay between screening and subsequent initiation of contact isolation for carriers of extended-spectrum beta-lactamase (ESBL)–producing Enterobacterales : A post hoc subgroup analysis of the R-GNOSIS WP5 Trial

Published inInfection control and hospital epidemiology, vol. 44, no. 9, p. 1410-1416
Publication date2023-03-13
First online date2023-03-13
Abstract

Abstract Objectives:

The aim of this study was to quantify the time delay between screening and initiation of contact isolation for carriers of extended-spectrum beta-lactamase (ESBL)–producing Enterobacterales (ESBL-E).

Methods:

This study was a secondary analysis of contact isolation periods in a cluster-randomized controlled trial that compared 2 strategies to control ESBL-E (trial no. ISRCTN57648070). Patients admitted to 20 non-ICU wards in Germany, the Netherlands, Spain, and Switzerland were screened for ESBL-E carriage on admission, weekly thereafter, and on discharge. Data collection included the day of sampling, the day the wards were notified of the result, and subsequent ESBL-E isolation days.

Results:

Between January 2014 and August 2016, 19,122 patients, with a length of stay ≥2 days were included. At least 1 culture was collected for 16,091 patients (84%), with a median duration between the admission day and the day of first sample collection of 2 days (interquartile range [IQR], 1–3). Moreover, 854 (41%) of all 2,078 ESBL-E carriers remained without isolation during their hospital stay. In total, 6,040 ESBL-E days (32% of all ESBL-E days) accrued for patients who were not isolated. Of 2,078 ESBL-E-carriers, 1,478 ESBL-E carriers (71%) had no previous history of ESBL-E carriage. Also, 697 (34%) were placed in contact isolation with a delay of 4 days (IQR, 2–5), accounting for 2,723 nonisolation days (15% of ESBL-E days).

Conclusions:

Even with extensive surveillance screening, almost one-third of all ESBL-E days were nonisolation days. Limitations in routine culture-based ESBL-E detection impeded timely and exhaustive implementation of targeted contact isolation.

eng
Funding
  • European Commission - Resistance in Gram-Negative Organisms: Studying Intervention Strategies [282512]
Citation (ISO format)
MAECHLER, Friederike et al. Quantification of time delay between screening and subsequent initiation of contact isolation for carriers of extended-spectrum beta-lactamase (ESBL)–producing Enterobacterales : A post hoc subgroup analysis of the R-GNOSIS WP5 Trial. In: Infection control and hospital epidemiology, 2023, vol. 44, n° 9, p. 1410–1416. doi: 10.1017/ice.2022.285
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ISSN of the journal0899-823X
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Technical informations

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