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Control of emerging extensively drug-resistant organisms (eXDRO) in France: a survey among infection preventionists from 286 healthcare facilities

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Abstract

We performed a multicenter survey in May–June 2012 to assess strategies in preventing the spread of emerging extensively drug-resistant organisms (eXDRO), including glycopeptide-resistant enterococci and carbapenemase-producing Enterobacteriaceae, in a convenient sample of French healthcare facilities (HCFs). The collected data included organization and measures to: (1) identify patients at risk for carrying eXDRO, (2) investigate and control sporadic cases or outbreaks, and (3) describe prior 2010–2012 episodes with one or more colonized patients. Of the 286 participating HCFs, 163 (57 %) and 134 (47 %) reported having a specific procedure to detect repatriates or patients hospitalized in foreign countries within the last year, respectively. Among the 97 HCFs with prior at-risk patient management experience, contact precautions, hospitalization in a single room, and screening for eXDRO carriage were quasi-systematically performed (n = 92/97, 95 %). The alleged time between admission and alert ranged from 24 to 48 h after the patient’s admission; 203 (71 %) HCFs recommended obtaining three successive negative screening samples to declare a patient free of eXDRO colonization. During the last two years, 64 HCFs (23 %) had to manage at least one eXDRO case, with a total of 20 outbreaks with more than one secondary case. This first national survey shows that French HCFs were not totally ready to control eXDRO spread in 2012. Their previous experiences and capacities in controlling eXDRO outbreaks are quite heterogeneous from one hospital to another. Further researches are needed in order to understand the constraints in applying national guidance.

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Acknowledgments

The French Society of Hospital Hygiene thanks all the participants and particularly Karine Lebascle for uploading the questionnaire to a website for online participation.

Funding

No specific funding has been received.

Conflict of interest

The authors have declared that no potential conflict of interest exists.

Author contributions

DL, JCL, PA, BC, SV, CR, BG, and PB contributed to the study design, data analyses, interpretation of results, writing and revision of the manuscript; DL, JCL, BG, and PB contributed to the statistical analysis and revised the manuscript; DL, JCL, PA, BC, SV, CR, BG, and PB contributed to the data collection, and manuscript writing and revision. All authors have approved the final manuscript for publication.

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Correspondence to D. Lepelletier.

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Lepelletier, D., Lucet, J.C., Astagneau, P. et al. Control of emerging extensively drug-resistant organisms (eXDRO) in France: a survey among infection preventionists from 286 healthcare facilities. Eur J Clin Microbiol Infect Dis 34, 1615–1620 (2015). https://doi.org/10.1007/s10096-015-2396-8

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  • DOI: https://doi.org/10.1007/s10096-015-2396-8

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