Currently browsing category

J Travel Med

Risk Factors for Colonization With Multidrug-Resistant Bacteria Among Patients Admitted to the Intensive Care Unit After Returning From Abroad.

Risk Factors for Colonization With Multidrug-Resistant Bacteria Among Patients Admitted to the Intensive Care Unit After Returning From Abroad.

J Travel Med. 2015 Jun 17;

Authors: Angue M, Allou N, Belmonte O, Lefort Y, Lugagne N, Vandroux D, Montravers P, Allyn J

Abstract
BACKGROUND: Few national recommendations exist on management of patients returning from abroad and all focus on hospitalized patients. Our purpose was to compare, in an intensive care unit (ICU), the admission prevalence and acquisition of multidrug-resistant (MDR) bacteria carriage in patients with («Abroad») or without («Local») a recent stay abroad, and then identify the risk factors in «Abroad» patients.
METHODS: In this retrospective study, we reviewed charts of all the patients hospitalized in the ICU unit from January 2011 through July 2013 with hygiene samplings performed. We identified all patients who had stayed abroad («Abroad») within 6 months prior to ICU admission.
RESULTS: Of 1,842 ICU patients, 129 (7%) «Abroad» patients were reported. In the «Abroad» group, the rate of MDR strain carriage was higher at admission (33% vs 6.7%, p < 0.001) and also more often diagnosed during the ICU stay (acquisition rate: 17% vs 5.2%, p < 0.001) than in «Local» patients. Risk factors associated with MDR bacteria carriage at admission in «Abroad» patients were diabetes mellitus [odds ratio (OR) 5.1 (1.7-14.8), p = 0.003] and «hospitalization abroad with antibiotic treatment» [OR 10.7 (4.2-27.3), p < 0.001]. Hospitalization abroad without antibiotic treatment was not identified as a risk factor.
CONCLUSIONS: The main factor associated with MDR bacteria carriage after a stay abroad seems to be a hospitalization abroad only in case of antibiotic treatment abroad. Screening and isolation of «Abroad» patients should be recommended, even in case of a first negative screening.

PMID: 26081076 [PubMed – as supplied by publisher]

High Rate of Multidrug-Resistant Gram-Negative Bacilli Carriage and Infection in Hospitalized Returning Travelers: A Cross-Sectional Cohort Study.

Related Articles

High Rate of Multidrug-Resistant Gram-Negative Bacilli Carriage and Infection in Hospitalized Returning Travelers: A Cross-Sectional Cohort Study.

J Travel Med. 2015 May 22;

Authors: Epelboin L, Robert J, Tsyrina-Kouyoumdjian E, Laouira S, Meyssonnier V, Caumes E, MDR-GNB Travel Working Group

Abstract
BACKGROUND: Carriage of and infection with multidrug-resistant Gram-negative bacilli (MDR-GNB) are a potential cause of concern in travelers with no history of hospitalization abroad.
METHODS: All consecutive returning travelers hospitalized in our department between February 2012 and January 2013 were prospectively screened for MDR-GNB gastrointestinal tract carriage or infection. We compared the prevalence of MDR-GNB in travelers to a non-travelers nonexposed group. Then among the travelers, MDR-GNB carriers were compared to noncarriers to determine risk factors of acquisition of MDR-GNB.
RESULTS: Overall, 359 patients (191 travelers, 168 non-travelers) were included, and 25 (6.4%), including 23 travelers, harbored MDR-GNB. Five travelers had an MDR-GNB infection while 18 were asymptomatic enteric carriers. MDR-GNB carriage or infection was significantly more frequent in travelers (11.0% vs 1.2% for non-travelers, odds ratio (OR) = 11.3, p < 0.001) and in patients born outside France (OR = 1.67; p = 0.03). Among travelers, in multivariate analysis, factors independently associated with MDR-GNB carriage or infection were traveling to Asia (OR = 3.1; p = 0.01) and visiting friends and relatives (VFR) or migrants (OR=3.6; p = 0.01).
CONCLUSIONS: The 10-fold higher prevalence rate of MDR-GNB in travelers raises the issues of systematic screening of all travelers, and of the choice of first line antibiotic therapy when treating urinary tract infections in travelers, especially those VFR, migrants, and those returning from Asia.

PMID: 25997830 [PubMed – as supplied by publisher]