Cross sectional study of multiresistant bacteria in Danish emergency departments

Prevalence, patterns and risk factors for colonization (AB-RED project)

Christian B. Mogensen*, Helene Skjøt-Arkil, Annmarie T. Lassen, Isik S. Johansen, Ming Chen, Poul Petersen, Karen V. Andersen, Svend Ellermann-Eriksen, Jørn M. Møller, Marc Ludwig, David Fuglsang-Damgaard, Finn Nielsen, Dan B. Petersen, Ulrich S. Jensen, Flemming S. Rosenvinge

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Resumé

BACKGROUND: Multiresistant bacteria (MRB) is an increasing problem. Early identification of patients with MRB is mandatory to avoid transmission and to target the antibiotic treatment. The emergency department (ED) is a key player in the early identification of patients who are colonized with MRB. There is currently sparse knowledge of both prevalence and risk factors for colonization with MRSA, ESBL, VRE, CPE and CD in acutely admitted patients in Western European countries including Denmark. To develop evidence-based screening tools for identifying carriers of resistant bacteria among acutely admitted patients, systematic collection of information on risk factors and exposures is required. Since a geographical variation is suspected, it is desirable to include emergency departments across the country. The aim of this project is to provide a comprehensive overview of prevalence and risk factors for MRSA, ESBL, VRE, CPE and CD colonization in patients admitted to Danish ED's. The objectives are to describe the prevalence and demography of resistance, co-infections, to identify risk factors for carrier state and to develop and validate a screening tool for identification of carriers.

METHODS: Multicenter descriptive and analytic cross-sectional survey from January-May 2018 of around 10.000 acutely admitted patients > 18 years in 8 EDs for carrier state and risk factors for antibiotic resistant bacteria. Information about the background and possible risk factors for carrier status together with swabs from the nose, throat and rectum is collected and analyzed for MRSA, ESBL, VRE, CPE and CD. The prevalence of the resistant bacteria are calculated at hospital level, regional level and national level and described with relation to residency, sex, age and risk factors. A screening model for identification of carrier stage of resistant bacteria is developed and validated.

DISCUSSION: The study will provide the prevalence of colonized patients with resistant bacteria on arrival to the ED and variation in demographic patterns, and will develop a clinical tool to identify certain risk groups. This will enable the clinician to target antibiotic treatments and to reduce the in-hospital spreading of resistant bacteria. This knowledge is important for implementing and evaluating antimicrobial stewardships, screening and infection control strategies.

TRIAL REGISTRATION: Clinicaltrials.gov : NCT03352167 (registration date: 20. November 2017).

OriginalsprogEngelsk
Artikelnummer25
TidsskriftBMC Emergency Medicine
Vol/bind18
Udgave nummer1
Antal sider7
ISSN1471-227X
DOI
StatusUdgivet - 20. aug. 2018

Fingeraftryk

Hospital Emergency Service
Cross-Sectional Studies
Sex Factors
Age Factors
Denmark
Internship and Residency
Infection Control
Coinfection
Nose
Rectum

Citer dette

Mogensen, Christian B. ; Skjøt-Arkil, Helene ; Lassen, Annmarie T. ; Johansen, Isik S. ; Chen, Ming ; Petersen, Poul ; Andersen, Karen V. ; Ellermann-Eriksen, Svend ; Møller, Jørn M. ; Ludwig, Marc ; Fuglsang-Damgaard, David ; Nielsen, Finn ; Petersen, Dan B. ; Jensen, Ulrich S. ; Rosenvinge, Flemming S. / Cross sectional study of multiresistant bacteria in Danish emergency departments : Prevalence, patterns and risk factors for colonization (AB-RED project). I: BMC Emergency Medicine. 2018 ; Bind 18, Nr. 1.
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title = "Cross sectional study of multiresistant bacteria in Danish emergency departments: Prevalence, patterns and risk factors for colonization (AB-RED project)",
abstract = "BACKGROUND: Multiresistant bacteria (MRB) is an increasing problem. Early identification of patients with MRB is mandatory to avoid transmission and to target the antibiotic treatment. The emergency department (ED) is a key player in the early identification of patients who are colonized with MRB. There is currently sparse knowledge of both prevalence and risk factors for colonization with MRSA, ESBL, VRE, CPE and CD in acutely admitted patients in Western European countries including Denmark. To develop evidence-based screening tools for identifying carriers of resistant bacteria among acutely admitted patients, systematic collection of information on risk factors and exposures is required. Since a geographical variation is suspected, it is desirable to include emergency departments across the country. The aim of this project is to provide a comprehensive overview of prevalence and risk factors for MRSA, ESBL, VRE, CPE and CD colonization in patients admitted to Danish ED's. The objectives are to describe the prevalence and demography of resistance, co-infections, to identify risk factors for carrier state and to develop and validate a screening tool for identification of carriers.METHODS: Multicenter descriptive and analytic cross-sectional survey from January-May 2018 of around 10.000 acutely admitted patients > 18 years in 8 EDs for carrier state and risk factors for antibiotic resistant bacteria. Information about the background and possible risk factors for carrier status together with swabs from the nose, throat and rectum is collected and analyzed for MRSA, ESBL, VRE, CPE and CD. The prevalence of the resistant bacteria are calculated at hospital level, regional level and national level and described with relation to residency, sex, age and risk factors. A screening model for identification of carrier stage of resistant bacteria is developed and validated.DISCUSSION: The study will provide the prevalence of colonized patients with resistant bacteria on arrival to the ED and variation in demographic patterns, and will develop a clinical tool to identify certain risk groups. This will enable the clinician to target antibiotic treatments and to reduce the in-hospital spreading of resistant bacteria. This knowledge is important for implementing and evaluating antimicrobial stewardships, screening and infection control strategies.TRIAL REGISTRATION: Clinicaltrials.gov : NCT03352167 (registration date: 20. November 2017).",
keywords = "Age Factors, Bacteria/isolation & purification, Carbapenem-Resistant Enterobacteriaceae/isolation & purification, Clostridium difficile/isolation & purification, Cross-Sectional Studies, Denmark, Drug Resistance, Multiple, Bacterial, Emergency Service, Hospital/statistics & numerical data, Enterotoxins, Humans, Methicillin-Resistant Staphylococcus aureus/isolation & purification, Prevalence, Research Design, Residence Characteristics, Risk Factors, Sex Factors, Socioeconomic Factors, Vancomycin-Resistant Enterococci/isolation & purification",
author = "Mogensen, {Christian B.} and Helene Skj{\o}t-Arkil and Lassen, {Annmarie T.} and Johansen, {Isik S.} and Ming Chen and Poul Petersen and Andersen, {Karen V.} and Svend Ellermann-Eriksen and M{\o}ller, {J{\o}rn M.} and Marc Ludwig and David Fuglsang-Damgaard and Finn Nielsen and Petersen, {Dan B.} and Jensen, {Ulrich S.} and Rosenvinge, {Flemming S.}",
year = "2018",
month = "8",
day = "20",
doi = "10.1186/s12873-018-0178-1",
language = "English",
volume = "18",
journal = "B M C Emergency Medicine",
issn = "1471-227X",
publisher = "BioMed Central",
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Cross sectional study of multiresistant bacteria in Danish emergency departments : Prevalence, patterns and risk factors for colonization (AB-RED project). / Mogensen, Christian B.; Skjøt-Arkil, Helene; Lassen, Annmarie T.; Johansen, Isik S.; Chen, Ming; Petersen, Poul; Andersen, Karen V.; Ellermann-Eriksen, Svend; Møller, Jørn M.; Ludwig, Marc; Fuglsang-Damgaard, David; Nielsen, Finn; Petersen, Dan B.; Jensen, Ulrich S.; Rosenvinge, Flemming S.

I: BMC Emergency Medicine, Bind 18, Nr. 1, 25, 20.08.2018.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Cross sectional study of multiresistant bacteria in Danish emergency departments

T2 - Prevalence, patterns and risk factors for colonization (AB-RED project)

AU - Mogensen, Christian B.

AU - Skjøt-Arkil, Helene

AU - Lassen, Annmarie T.

AU - Johansen, Isik S.

AU - Chen, Ming

AU - Petersen, Poul

AU - Andersen, Karen V.

AU - Ellermann-Eriksen, Svend

AU - Møller, Jørn M.

AU - Ludwig, Marc

AU - Fuglsang-Damgaard, David

AU - Nielsen, Finn

AU - Petersen, Dan B.

AU - Jensen, Ulrich S.

AU - Rosenvinge, Flemming S.

PY - 2018/8/20

Y1 - 2018/8/20

N2 - BACKGROUND: Multiresistant bacteria (MRB) is an increasing problem. Early identification of patients with MRB is mandatory to avoid transmission and to target the antibiotic treatment. The emergency department (ED) is a key player in the early identification of patients who are colonized with MRB. There is currently sparse knowledge of both prevalence and risk factors for colonization with MRSA, ESBL, VRE, CPE and CD in acutely admitted patients in Western European countries including Denmark. To develop evidence-based screening tools for identifying carriers of resistant bacteria among acutely admitted patients, systematic collection of information on risk factors and exposures is required. Since a geographical variation is suspected, it is desirable to include emergency departments across the country. The aim of this project is to provide a comprehensive overview of prevalence and risk factors for MRSA, ESBL, VRE, CPE and CD colonization in patients admitted to Danish ED's. The objectives are to describe the prevalence and demography of resistance, co-infections, to identify risk factors for carrier state and to develop and validate a screening tool for identification of carriers.METHODS: Multicenter descriptive and analytic cross-sectional survey from January-May 2018 of around 10.000 acutely admitted patients > 18 years in 8 EDs for carrier state and risk factors for antibiotic resistant bacteria. Information about the background and possible risk factors for carrier status together with swabs from the nose, throat and rectum is collected and analyzed for MRSA, ESBL, VRE, CPE and CD. The prevalence of the resistant bacteria are calculated at hospital level, regional level and national level and described with relation to residency, sex, age and risk factors. A screening model for identification of carrier stage of resistant bacteria is developed and validated.DISCUSSION: The study will provide the prevalence of colonized patients with resistant bacteria on arrival to the ED and variation in demographic patterns, and will develop a clinical tool to identify certain risk groups. This will enable the clinician to target antibiotic treatments and to reduce the in-hospital spreading of resistant bacteria. This knowledge is important for implementing and evaluating antimicrobial stewardships, screening and infection control strategies.TRIAL REGISTRATION: Clinicaltrials.gov : NCT03352167 (registration date: 20. November 2017).

AB - BACKGROUND: Multiresistant bacteria (MRB) is an increasing problem. Early identification of patients with MRB is mandatory to avoid transmission and to target the antibiotic treatment. The emergency department (ED) is a key player in the early identification of patients who are colonized with MRB. There is currently sparse knowledge of both prevalence and risk factors for colonization with MRSA, ESBL, VRE, CPE and CD in acutely admitted patients in Western European countries including Denmark. To develop evidence-based screening tools for identifying carriers of resistant bacteria among acutely admitted patients, systematic collection of information on risk factors and exposures is required. Since a geographical variation is suspected, it is desirable to include emergency departments across the country. The aim of this project is to provide a comprehensive overview of prevalence and risk factors for MRSA, ESBL, VRE, CPE and CD colonization in patients admitted to Danish ED's. The objectives are to describe the prevalence and demography of resistance, co-infections, to identify risk factors for carrier state and to develop and validate a screening tool for identification of carriers.METHODS: Multicenter descriptive and analytic cross-sectional survey from January-May 2018 of around 10.000 acutely admitted patients > 18 years in 8 EDs for carrier state and risk factors for antibiotic resistant bacteria. Information about the background and possible risk factors for carrier status together with swabs from the nose, throat and rectum is collected and analyzed for MRSA, ESBL, VRE, CPE and CD. The prevalence of the resistant bacteria are calculated at hospital level, regional level and national level and described with relation to residency, sex, age and risk factors. A screening model for identification of carrier stage of resistant bacteria is developed and validated.DISCUSSION: The study will provide the prevalence of colonized patients with resistant bacteria on arrival to the ED and variation in demographic patterns, and will develop a clinical tool to identify certain risk groups. This will enable the clinician to target antibiotic treatments and to reduce the in-hospital spreading of resistant bacteria. This knowledge is important for implementing and evaluating antimicrobial stewardships, screening and infection control strategies.TRIAL REGISTRATION: Clinicaltrials.gov : NCT03352167 (registration date: 20. November 2017).

KW - Age Factors

KW - Bacteria/isolation & purification

KW - Carbapenem-Resistant Enterobacteriaceae/isolation & purification

KW - Clostridium difficile/isolation & purification

KW - Cross-Sectional Studies

KW - Denmark

KW - Drug Resistance, Multiple, Bacterial

KW - Emergency Service, Hospital/statistics & numerical data

KW - Enterotoxins

KW - Humans

KW - Methicillin-Resistant Staphylococcus aureus/isolation & purification

KW - Prevalence

KW - Research Design

KW - Residence Characteristics

KW - Risk Factors

KW - Sex Factors

KW - Socioeconomic Factors

KW - Vancomycin-Resistant Enterococci/isolation & purification

U2 - 10.1186/s12873-018-0178-1

DO - 10.1186/s12873-018-0178-1

M3 - Journal article

VL - 18

JO - B M C Emergency Medicine

JF - B M C Emergency Medicine

SN - 1471-227X

IS - 1

M1 - 25

ER -