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The Effect of Infection Precautions on Colonization of Nursing Staff with Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae in Three Beirut Hospitals

Nicholas Haddad,J. Ghosn

Published 2020 in Unknown venue

ABSTRACT

Background: ESBL-PE are emerging worldwide. This study assesses the effect of contact precaution (CP) on ESBL-PE-colonization rates among nurses in 3 hospitals in Beirut, where ESBL is endemic, to define risk factors for colonization, and evaluate the ongoing use of CP to prevent ESBL-PE transmission to healthy nurses. Methods: Cross-sectional, non-randomized study completed in three hospitals. Hospital 1 required CP, Hospital 2 recently stopped CP, and Hospital 3 had stopped it 3 years previously. Questionnaires and stool-collection containers were distributed to all patient care nurses in those 3 hospitals. Returned samples were tested using agar dilution technique. Results: 269 of 733 nurses volunteered; 140 met inclusion criteria (no recent hospitalization, antibiotic use, known ESBL-PE colonization). 15% were ESBL-positive. Compared to nurses from Hospital 3, nurses from Hospital 1 were 59% less likely to be colonized, while nurses from Hospital 2 were 62% more likely to be colonized. Discussion: In hospitals where CP is ongoing for ESBL-positive patients, transmission to nursing staff was reduced. Additionally, a work experience of 2-4 years increased the odds of ESBL-PE colonization in comparison with longer nursing experience. HIGHLIGHTS : • We examined the impact of contact precautions (CP) for Extended spectrum beta-lactamase- producing Enterobacteriaceae (ESBL-PE) colonized patients on rates of ESBL-PE colonization in nursing staff. • We found significantly decreased rates of colonization in nurses from a hospital utilizing CP, and significantly increased rates of colonization among nurses from a hospital that recently • discontinued CP, compared with nurses from a hospital that had discontinued CP 3 years previously. • Findings suggest that contact precaution may be required to prevent ESBL-PE transmission from patients to nursing staff.

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