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ArticleEnfermedades infecciosas y microbiologia clinica (English ed.)2021

Implementation of contact isolation strategy for the containment of extended-spectrum β-lactamase carriers in a University Hospital positively affects the epidemiology of carbapenemase-producing Enterobacterales.

Marta Hernández-García, Cristina Díaz-Agero, Blanca Pérez-Viso, Ana María Sánchez, Nieves López-Fresneña, María Isabel Morosini, Patricia Ruiz-Garbajosa, Rafael Cantón

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Article in Enfermedades infecciosas y microbiologia clinica (English ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Marta Hernández-GarcíaServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain.
Cristina Díaz-AgeroServicio de Medicina Preventiva, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
Blanca Pérez-VisoServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain.
Ana María SánchezServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain.
Nieves López-FresneñaServicio de Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
María Isabel MorosiniServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain.
Patricia Ruiz-GarbajosaServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain.
Rafael CantónServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain. Electronic address: rafael.canton@salud.madrid.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe lack of consensus of control measures to prevent extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) transmission in the hospital setting is of great concern. We describe the prevalence and species distribution of ESBL-E and carbapenemase producing Enterobacterales (CPE) in patients admitted in a tertiary Hospital during an active surveillance screening program for detecting ESBL-E carriers and reducing the ESBL-E transmission (R-GNOSIS Project).

methodsFrom March-2014 to March-2016, 15,556 rectal swabs were collected from 8209 patients admitted in two medical (Gastroenterology, Pneumology) and two surgical (Neurosurgery, Urology) wards. Swabs were seeded onto ChromoID-ESBL and -CARB/OXA-48 agar plates. Growing colonies were identified by MALDI-TOF MS. ESBL and carbapenemases were phenotypically detected. Changes in species diversity (SDI) and distribution over time were analyzed.

resultsESBL-E incidence (8.4%) tended to decrease over time (p=0.003) and CPE carrier prevalence remained unchanged during the study (2%). The contact isolation strategy targeted to reduce ESBL-E transmission was ineffective in reducing ESBL-E carriers but significant differences were observed with CPE (p=0.017). SDI did not change among ESBL-E and E. coli was predominant (78.5%) during the study. K. pneumoniae (54%) was the most frequent CPE species, followed by E. coli (19%). SDI decreased among the CPE population over time mainly due to K. pneumoniae dominance and increased E. coli prevalence in the last part of the study.

conclusionsDuring the R-GNOSIS project, contact precautions were not effective in reducing the ESBL-E transmission but may have had a positive collateral effect on the CPE containment.

Indexed as

Enterobacteriaceae InfectionsEscherichia coliBacterial Proteinsbeta-LactamasesHospitals, UniversityHumansBacterial Proteinsbeta-LactamasescarbapenemaseAdquisición en la comunidadAdquisición nosocomialAislamiento de contactoCarbapenemase-producing EnterobacteralesCommunity-acquisitionContact isolationEnterobacterias productoras de carbapenemasas (EPC)Enterobacterias productoras de β-lactamasas de espectro extendido (BLEE-E)ESBL-producing EnterobacteralesNosocomial acquisitionPrecauciones estándarStandard precautions

Identifiers

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.