Systematic screening for digestive carriage of extended-spectrum β-lactamase-producing Enterobacterales (E-ESBL) at hospital readmission among patients with past history of E-ESBL colonization or infection

Abstract

Background: Extended-spectrum β-lactamase-producing Enterobacterales (E-ESBL) are commensal multidrug-resistant (MDR) bacteria of the digestive tract whose prevalence has risen sharply worldwide and in Europe over the past two decades.

Aim: To assess digestive carriage at hospital readmission of a large cohort of 2509 patients with E-ESBL carriage over a five-year survey; 833 (33%) patients were readmitted at least once.

Methods: A retrospective, single-centre survey conducted at a tertiary care hospital in France.

Findings: Among patients with several hospital readmissions (range: 2-13), the proportion of patients still E-ESBL-colonized at hospital readmission, detected by systematic screening for E-ESBL colonization, was >80% within an 18-month period after prior hospitalization with the first E-ESBL isolation.

Conclusion: There is a need to reconsider the continuation of systematic screening for E-ESBL colonization because of a high rate of patients still colonized at hospital readmission over a long period of time.

Keywords: Digestive carriage; E-ESBL; Hospital readmission; Isolation measures.