Evidence map›Paper›PMID 36912321›Full record

Trial reportInfection control and hospital epidemiology2023

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.

Friederike Maechler, Frank Schwab, Sonja Hansen, Michael Behnke, Marc J Bonten, Rafael Canton, Cristina Diaz Agero, Carolina Fankhauser, Stephan Harbarth, Benedikt D Huttner and 3 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Infection control and hospital epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Friederike MaechlerInstitute of Hygiene and Environmental Medicine, Universitätsmedizin - CharitéBerlin, Germany.ORCID 0000-0002-9554-3133
Frank SchwabInstitute of Hygiene and Environmental Medicine, Universitätsmedizin - CharitéBerlin, Germany.ORCID 0000-0002-6666-725X
Sonja HansenInstitute of Hygiene and Environmental Medicine, Universitätsmedizin - CharitéBerlin, Germany.ORCID 0000-0001-5551-4672
Michael BehnkeInstitute of Hygiene and Environmental Medicine, Universitätsmedizin - CharitéBerlin, Germany.ORCID 0000-0002-3993-9651
Marc J BontenDepartment of Medical Microbiology and Infection Control, University Medical Center Utrecht, Utrecht, Netherlands.ORCID 0000-0002-9095-9201
Rafael CantonServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria, Madrid.ORCID 0000-0003-1675-3173
Cristina Diaz AgeroServicio de Medicina Preventiva y Salud Pública Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria, Madrid.
Carolina FankhauserInfection Control Program, Geneva University Hospitals and Medical School, Geneva, Switzerland.
Stephan HarbarthInfection Control Program, Geneva University Hospitals and Medical School, Geneva, Switzerland.ORCID 0000-0002-3551-1025
Benedikt D HuttnerInfection Control Program, Geneva University Hospitals and Medical School, Geneva, Switzerland.ORCID 0000-0002-1749-9464
Axel KolaInstitute of Hygiene and Environmental Medicine, Universitätsmedizin - CharitéBerlin, Germany.ORCID 0000-0003-4333-5663
Petra GastmeierInstitute of Hygiene and Environmental Medicine, Universitätsmedizin - CharitéBerlin, Germany.
R-GNOSIS WP5 Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe 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).

methodsThis 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.

resultsBetween 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).

conclusionsEven 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.

Indexed as

Cross InfectionEnterobacteriaceae Infectionsbeta-LactamasesEnterobacteriaceaeHumansQuarantinebeta-Lactamases

Identifiers

PMID36912321
PMCPMC10507499

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Registered trials

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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.