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Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
Published on: March 3, 2023
Faecal carriage of multidrug-resistant bacteria and associated risk factors: results from a point prevalence study
Patrick Grohs1, Aurélie Vilfaillot2,3, Jean Ralph Zahar4
1Laboratoire de microbiologie, Hôpital Européen Georges Pompidou, Paris, France.
Objectives:
Since 2003, incidences of carbapenemase-producing Gram-negative bacilli (CP-GNB) and vancomycin-resistant Enterococcus faecium (VRE) have steadily increased in France. We therefore conducted a point prevalence study to estimate carriage rates of CP-GNB, VRE and ESBL-producing Enterobacterales (ESBL-PE) and associated risk factors.
Methods:
Between September 2019 and January 2020, all inpatients hospitalized on a given day in 11 teaching hospitals in the Paris urban area were eligible. Patient interviews and rectal swab screening results were recorded by dedicated nurses. The swabs were plated onto selective chromogenic media and processed using the GeneXpert® system.
Results:
Of 2396 patients, 364 (15.2%) yielded at least one multiresistant bacterial isolate, including 29 CP-GNB carriers (1.2%), 13 VRE carriers (0.5%) and 338 ESBL-PE carriers (14%). In 15 patients (4.4% of ESBL-PE carriers and 36.6% of CP-GNB/VRE carriers), concomitant CP-GNB/VRE and ESBL-PE carriage was observed. In 7/29 CP-GNB and 7/13 VRE carriers, carbapenemase production and vanA in the screening samples was only detected with Xpert® tests. The OXA-48 gene was predominant in 13/34 CP-GNB isolates from 29 carriers. From the 338 ESBL-PE carriers, 372 isolates were recovered, mainly Escherichia coli (61.2%). Among 379 children, 1.1% carried a CP-GNB/VRE strain, and 12.4% carried an ESBL strain. Previous hospitalization outside mainland France, previous antimicrobial treatment and previous ESBL-PE carriage were the main risk factors associated with CP-GNB and/or VRE carriage.
Conclusions:
The low CP-GNB and VRE prevalence likely reflects the French policy to limit intrahospital spread of CP-GNB and VRE strains.
Insights
This study found low carriage rates of carbapenemase-producing Gram-negative bacilli (CP-GNB) and vancomycin-resistant Enterococcus faecium (VRE) in Paris hospitals. Previous international travel and antimicrobial use were key risk factors for carrying these multidrug-resistant organisms.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Carbapenemase-producing Gram-negative bacilli (CP-GNB) and vancomycin-resistant Enterococcus faecium (VRE) are critical threats to public health.
- Incidences of CP-GNB and VRE have been increasing in France since 2003.
Purpose of the Study:
- To estimate the prevalence of CP-GNB, VRE, and ESBL-producing Enterobacterales (ESBL-PE) carriage among hospitalized patients in Paris.
- To identify risk factors associated with the carriage of these multidrug-resistant organisms.
Main Methods:
- A point prevalence study was conducted in 11 Paris teaching hospitals between September 2019 and January 2020.
- Patient interviews and rectal swab screenings were performed, with swabs processed using selective media and the GeneXpert® system.
Main Results:
- Of 2396 patients, 1.2% carried CP-GNB, 0.5% carried VRE, and 14% carried ESBL-PE.
- Previous hospitalization outside mainland France, prior antimicrobial treatment, and previous ESBL-PE carriage were significant risk factors for CP-GNB/VRE carriage.
- The OXA-48 gene was the predominant carbapenemase identified.
Conclusions:
- The observed low prevalence of CP-GNB and VRE suggests the effectiveness of French policies aimed at curbing intrahospital transmission.
- Continued surveillance and targeted interventions remain crucial for managing multidrug-resistant organisms in healthcare settings.
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