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Implementation of an infection control program with emphasis on cohorting to patients with carbapenemase-producing Enterobacteriaceae. The experience of 2 years in a tertiary teaching hospital in northern Portugal

2020-06-04Journal article Open access
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dc.contributor.authorVigário, Ana
dc.contributor.authorGonçalves, João A.
dc.contributor.authorCosta, Ana Rita
dc.contributor.authorPinheiro, Maria Guiomar
dc.contributor.authorReis, Ernestina
dc.contributor.authorOliveira, Júlio R.
dc.date.accessioned2022-07-11T14:30:57Z
dc.date.available2022-07-11T14:30:57Z
dc.date.issued2020-06-04
dc.description.abstractBackground: The emergence of carbapenemase-producing Enterobacterales (CPE) represents a major public health threat. Our purpose was to evaluate a surveillance and cohorting program implemented in patients infected or carriers of CPE. Methods: A prospective registry of CPE carriers or infected patients was analyzed from October 2015 until December 2017. All inpatients presenting with CPE were included in a hospital cohort with dedicated healthcare staff and contact precaution measures. Results: A total of 480 patients were identified, of which 15.8% (n = 76) were infected. Men comprised 56.7% of the cohort (n = 272) and 69.2% (n = 332) were elderly. About 46.3% (n = 222) had a previous hospital admission and 81.7% (n = 392) had at least 1 antibiotic course in the previous 90 days. There was a decline in infected patients in 2017. Periodic and admission screenings accounted for 63% and 74% of cases in 2016 and 2017, with increased detection rate comparing with contact/investigation screenings. In 2017, significantly fewer patients were identified outside the admission/point of prevalence screening (P = .009). In 2017 the proportion of invasive carbapenem-resistant Klebsiella pneumoniae amongst CPE in our center was below the national average (2016: 13.3% vs 5.2%; 2017: 6.6% vs 8.6%). A reduction of the consumption of carbapenems was also observed in 2017. Conclusion: The implementation of the program has increased the number of patients identified by the preventive method and stabilized the emergence of new CPE cases. Furthermore, the program cohort compared well with the national picture, with a lower number of infected patients and a lower proportion of carbapenem-resistant K pneumoniae in invasive specimens. These indicators reflect the added value of the CPE surveillance and cohorting program.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationVigário A, Gonçalves JA, Costa AR, Pinheiro G, Reis E, Oliveira JR. Implementation of an infection control program with emphasis on cohorting to patients with carbapenemase-producing Enterobacteriaceae. The experience of 2 years in a tertiary teaching hospital in northern Portugal. Porto Biomed J. 2020;5(3):e68. doi:10.1097/j.pbj.0000000000000068pt_PT
dc.identifier.doi10.1097/j.pbj.0000000000000068pt_PT
dc.identifier.issn2444-8672
dc.identifier.issn2444-8664
dc.identifier.urihttp://hdl.handle.net/10400.16/2696
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWolters Kluwerpt_PT
dc.relation.publisherversionhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7722402/pdf/pj9-5-e68.pdfpt_PT
dc.subjectactive screeningpt_PT
dc.subjectantimicrobial stewardshippt_PT
dc.subjectcarbapenemase-producing Enterobacteriaceaept_PT
dc.subjectinfection controlpt_PT
dc.subjectsurveillance and isolation programpt_PT
dc.titleImplementation of an infection control program with emphasis on cohorting to patients with carbapenemase-producing Enterobacteriaceae. The experience of 2 years in a tertiary teaching hospital in northern Portugalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceUnited States of Americapt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPagee68pt_PT
oaire.citation.titlePorto Biomedical Journalpt_PT
oaire.citation.volume5pt_PT
person.familyNameFernandes Miranda da Costa
person.familyNamePinheiro
person.givenNameAna Rita
person.givenNameMaria Guiomar
person.identifier.ciencia-idAE17-7093-C7BC
person.identifier.orcid0000-0001-5031-6204
person.identifier.orcid0000-0003-1497-1054
person.identifier.scopus-author-id57194153375
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication84d36115-6e9c-4684-b891-503a5f9ee92d
relation.isAuthorOfPublicationae5810a4-751a-42d0-802f-1bb0e17e0032
relation.isAuthorOfPublication.latestForDiscovery84d36115-6e9c-4684-b891-503a5f9ee92d

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