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Multicenter Study
. 2018 Aug 20;18(1):25.
doi: 10.1186/s12873-018-0178-1.

Cross sectional study of multiresistant bacteria in Danish emergency departments: prevalence, patterns and risk factors for colonization (AB-RED project)

Christian B Mogensen  1 , Helene Skjøt-Arkil  2 , Annmarie T Lassen  3 , Isik S Johansen  4 , Ming Chen  5 , Poul Petersen  6 , Karen V Andersen  7 , Svend Ellermann-Eriksen  8 , Jørn M Møller  9 , Marc Ludwig  10 , David Fuglsang-Damgaard  11 , Finn Nielsen  12 , Dan B Petersen  13 , Ulrich S Jensen  14 , Flemming S Rosenvinge  15
Affiliations
Multicenter Study

Cross sectional study of multiresistant bacteria in Danish emergency departments: prevalence, patterns and risk factors for colonization (AB-RED project)

Christian B Mogensen et al. BMC Emerg Med. .

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: Colonization; Emergency department; Multiresistant bacteria.

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Conflict of interest statement

Ethics approval and consent to participate

The project is approved by the Regional Committees on Health Research Ethics for Southern Denmark (no S-20170182), registered by the Danish Data Protection Agency (Journal nr. 17/44444) and by clinicaltrials.gov (NCT03352167).

Oral and written participant information is prepared and accepted by the Regional Ethics committee guidelines for this.

Collecting the samples can be slightly unpleasant for the patients but do not pose a health risk. The procedures will be performed in single rooms to secure privacy.

Patients who meet national and/or local requirements for examination of resistant bacteria/CD screening must have the procedures performed concurrently and independently of the project.

There are no further patient contact in the study unless the patients request to be informed about the results of the microbiological tests. If this is the case the patients will be contacted digitally by a Danish secured mail distribution system used by public authorities and hospitals. If the microbiological tests reveal resistant bacteria where the hospitals have a duty of notification (MRSA) the patient will also be informed. In these situations the patients will be recommended to contact their general practitioner and have the test repeated. The patient will receive contact information to a specialist in infectious diseases for further information.

Informed written consent with signature will be obtained from all participants before inclusion in the study. The patients have the right of revocation and the patient data will be deleted from the study.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Antimicrobial resistance: global report on surveillance 2014. WHO; 2014. http://www.who.int/drugresistance/documents/surveillancereport.
    1. DANMAP Use of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from food animals, food and humans in Denmark; 2016. www.danmap.org. ISSN 1600-2032
    1. Bell BG, Schellevis F, Stobberingh E, Goossens H, Pringle M. A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infect Dis. 2014;14(1):13. doi: 10.1186/1471-2334-14-13. - DOI - PMC - PubMed
    1. Lessa FC, Mu Y, Bamberg WM, Beldavs ZG, Dumyati GK, Dunn JR, Farley MM, Holzbauer SM, Meek JI, Phipps EC. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015;372(9):825–834. doi: 10.1056/NEJMoa1408913. - DOI - PMC - PubMed
    1. Levy SB: Antibiotic resistance: consequences of inaction. Clin Infect Dis 2001, 33(Supplement_3):S124-S129. - PubMed

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