XDRB carriers among travelers: One-third were never hospitalized previously.

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XDRB carriers among travelers: One-third were never hospitalized previously.

Int J Antimicrob Agents. 2018 Jun 12;:

Authors: Macaux L, Ndoye O, Cordel H, Pomares TB, Seytre D, Bouchaud O, Cohen Y, Zahar JR, Carbonnelle E

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, and it included admitted patients with a history of travel abroad during the preceding 12 months. Each XDRB carrier at admission (case) was matched to 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.
FINDING: Forty-six cases and 92 controls were enrolled. The results of univariate and multivariate analyses showed that only health repatriation was associated with a higher risk of carrying XDRB (OR = 3.22, 95% CI [1.23-7.84], p = 0.01). Surprisingly, one third of the study's population were not hospitalized abroad within the preceding 12 months. The most frequently identified XDRB species were Escherichia coli (36%), Enterococcus sp. (17%) and Klebsiella pneumoniae (9%), whereas the most frequently identified enzyme was oxa-48 (36%).
CONCLUSION: In our retrospective study, health repatriation was the only risk factor for XDRB carriage identified at admission. Furthermore, our data suggests a community-onset transmission. It is thus urgent and important to conduct studies in high-risk countries to identify the risk factors associated with community carriage.

PMID: 29906564 [PubMed - as supplied by publisher]

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