ΑΝΑΚΟΙΝΩΣΗ (PRESENTATION)                                           Βιβλιογραφική αναφορά (Citation)

IDEA Medical Newsletter 2014:1,1. Available at http://www.idea-lab.gr/newslet20140101.htm

 

 

Selective vs. Universal Screening for Extended Spectrum Beta Lactamases (ESBL) in a Tertiary Hospital

Papakonstantinou D., Cadwgan A., Bodasing N.

Department of Infectious Diseases University Hospital of North Staffordshire (UHNS)

 

Introduction & Objectives

Rising antibiotic resistance and the decreasing effectiveness of antibiotics are currently threatening the global community.

We aimed to compare selective screening for ESBL with universal screening in an Infectious Diseases (ID) Unit.

Patients & Methods

This study was conducted during October and December 2013 in the Infectious Diseases ward of University Hospital of North Staffordshire.

Data was collected on all patients admitted to the ID unit during October 2013, when hospital guidelines on ESBL screening were followed, and in December 2013 when universal screening for ESBL was carried out.

The hospital guidelines recommend ESBL screening in patients who were admitted with a long-term urinary catheter in situ, patients who have a history of ESBL or Multi-Gram negative bacilli (MGNB), patients who have had an overnight stay in any healthcare facility or care home in the last 12 months in UK or abroad and patients who have travelled outside Europe in the previous 12 months.

Patients’ data and results were collected from the hospital’s electronic systems.

Results

Fifty and fifty-eight patients were admitted in the Infectious Diseases ward during October and December 2013 respectively.

During October 28/50 patients were screened for ESBL; one of these was found to be colonised with ESBL (2.0%). Out of the remaining twenty two patients, who were not screened, 10 (45%) fulfilled criteria for screening. All of these had a previous inpatient stay or an overnight admission within the last 12 months.

During December all 58 admissions were screened for ESBL and 5 were positive (8.6%). Out of these, 3 had an inpatient stay, 1 was tagged previously ESBL positive and 1 did not have any identifiable risk factors.

 

There was no significant difference between the 2 groups in terms of number of positive ESBL screens {chi squared test (p> 0.10)}

Conclusions

Almost half the admissions to the ID unit in whom screening was indicated were not tested for ESBL.

There is a need for further education on the importance of ESBL screening.

A universal screening policy may be more effective at identification of patients colonised with ESBL.

A further study with a larger sample size is planned to evaluate the impact of a universal screening policy.

 

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