부산대학교 도서관

Highlights • This paper described risk factors associated with carriage of extensively-drug-resistant bacteria at admission in a French hospital. • Repatriation is the only factor associated with a higher risk of carriage on multi-variate analysis. • Thirty-five percent of carriers had not been hospitalized previously in the preceding 12 months. • The most frequent enzyme involved in the community spreading is OXA-48 and concerns Enterobacteriaceae. • The spread of carbapenemase-producing Enterobacteriaceae in the community must lead to the revision of screening policies. ABSTRACT Background Extensively-drug-resistant bacteria (XDRB) have emerged as a major source of resistance. Hospitalization abroad seems to be the major risk factor associated with carriage, and numerous reports have warned about the risk of in-hospital transmission. However, little is known regarding possible community transmission. Methods A retrospective matched case–control study was conducted in a Parisian teaching hospital, which included patients admitted to hospital with a history of travel abroad over the preceding 12 months. Each XDRB carrier at admission (case) was matched with two non-carriers (controls) hospitalized in the same ward and admitted during the same month. Aim To describe and identify risk factors associated with XDRB carriage at admission. Findings Forty-six cases and 92 controls were enrolled. The results of univariate and multi-variate analyses showed that health repatriation was the only factor associated with a higher risk of carrying XDRB (odds ratio 3.22, 95% confidence interval 1.23–7.84; P =0.01). Surprisingly, one-third of the study population had not been hospitalized abroad within the preceding 12 months. The most frequently identified XDRB species were Escherichia coli (36%), Enterococcus spp. (17%) and Klebsiella pneumoniae (9%), and the most frequently identified enzyme was OXA-48 (36%). Conclusion In this retrospective study, health repatriation was the only risk factor for XDRB carriage identified at admission. Furthermore, the data suggest community-onset transmission. Therefore, there is an urgent need to conduct studies in high-risk countries to identify the risk factors associated with community carriage. [ABSTRACT FROM AUTHOR]