Duration and predictors of colonization with MDR Escherichia coli upon rehospitalization: a retrospective cohort...

Multi-drug-resistant (MDR) Escherichia coli display a growing infection-control concern in hospitals, yet the duration of faecal carriage and risk factors for persistence are incompletely understood.

In this retrospective cohort study, 217 patients with a positive rectal screening for MDR E. coli and a re-admission with repeated screenings were included. Time to clearance was analysed using Kaplan-Meier methods. Risk factors were determined with regression analysis.

At rehospitalization, 51.6% of patients remained colonized. Analysis estimated a median colonization duration of 9.26 months; nearly 20% remained colonized for several years. ICD-10 (International Statistical Classification of Diseases and Related Health Problems, 10^th Revision) category K (diseases of the digestive system) was associated with higher rate of persistence (odds ratio 2.07, P = 0.02).

Colonization with MDR E. coli for a median of around 9 months underscores the relevance of control at re-admission. The association of gastrointestinal (GI) diseases with prolonged carriage suggests that targeted risk-based screening strategies may be appropriate. Approximately half of patients colonized with MDR E. coli remain colonized at first re-admission, and the median carriage duration is around 9 months. A minority may carry the organism for several years. GI diseases lead to a higher risk for prolonged colonization.