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Risk factors for acquisition of oxa-48-producing klebsiella pneumonia among contact patients: a multicentre study

Abstract : BACKGROUND: Cohorting carbapenemase-producing Enterobacteriaceae (CPE) carriers during hospitalization limits in-hospital spreading. OBJECTIVE: To identify risk factors for CPE acquisition among contacts of an index patient in non-cohorted populations. METHODS: A multicentre retrospective matched case-control study was conducted in five hospitals. Each contact patient (case) who acquired Klebsiella pneumoniae (KP)-OXA-48 from an index patient was compared to three contact (controls) with the same index patients matched with hospitalization in the same unit and similar exposure times. RESULTS: Fifty-one secondary cases and 131 controls were included. By univariate analysis, exposure time (odds ratio: 1.06; 95% confidence interval: 1.02-1.1; P = 0.006), concomitant infection at admission (3.23; 1.42-7.35; P = 0.005), antimicrobial therapy within the last month before hospitalization (2.88; 1.34-6.2; P = 0.007), antimicrobial therapy during the exposure time (5.36; 2.28-12.6; P < 0.001), use of at least one invasive procedure (2.99; 1.25-7.15; P = 0.014), number of invasive procedures (1.52; 1.05-2.19; P = 0.025), and geographical proximity (2.84; 1.15-7.00; P = 0.023) were associated with CPE acquisition. By multivariate analysis, antimicrobial therapy during the exposure time (odds ratio: 6.36; 95% confidence interval: 2.46-16.44; P < 0.001), at least one invasive procedure (2.92; 1.04-8.17; P = 0.041), and geographical proximity (3.69; 1.15-11.86; P = 0.028) were associated with acquisition. CONCLUSIONS: In this study, geographical proximity, invasive procedure, and antimicrobial therapy during exposure time were significantly associated with KP-OXA-48 acquisition.
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https://hal.univ-lille.fr/hal-02559039
Contributeur : Lilloa Université de Lille <>
Soumis le : jeudi 30 avril 2020 - 09:59:18
Dernière modification le : mercredi 10 juin 2020 - 12:16:02

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D. Hilliquin, Rémi Le Guern, V. Thepot Seegers, Caroline Neulier, A. Lomont, et al.. Risk factors for acquisition of oxa-48-producing klebsiella pneumonia among contact patients: a multicentre study. Journal of Hospital Infection, WB Saunders, 2018, The Journal of hospital infection, 98, pp.253-259. ⟨10.1016/j.jhin.2017.08.024⟩. ⟨hal-02559039⟩

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