1
|
Rohde AM, Zweigner J, Wiese-Posselt M, Schwab F, Behnke M, Kola A, Obermann B, Knobloch JKM, Feihl S, Querbach C, Gebhardt F, Mischnik A, Ihle V, Schröder W, Armean S, Peter S, Tacconelli E, Hamprecht A, Seifert H, Vehreschild MJGT, Kern WV, Gastmeier P. Incidence of infections due to third generation cephalosporin-resistant Enterobacteriaceae - a prospective multicentre cohort study in six German university hospitals. Antimicrob Resist Infect Control 2018; 7:159. [PMID: 30603083 PMCID: PMC6307128 DOI: 10.1186/s13756-018-0452-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/11/2018] [Indexed: 11/10/2022] Open
Abstract
Background Infections caused by third generation cephalosporin-resistant Enterobacteriaceae (3GCREB) are an increasing healthcare problem. We aim to describe the 3GCREB infection incidence and compare it to prevalence upon admission. In addition, we aim to describe infections caused by 3GCREB, which are also carbapenem resistant (CRE). Methods In 2014-2015, we performed prospective 3GCREB surveillance in clinically relevant patient specimens (screening specimens excluded). Infections counted as hospital-acquired (HAI) when the 3GCREB was detected after the third day following admission, otherwise as community-acquired infection (CAI). Results Of 578,420 hospitalized patients under surveillance, 3367 had a 3GCREB infection (0.58%). We observed a similar 3GCREB CAI and HAI incidence (0.28 and 0.31 per 100 patients, respectively). The most frequent pathogen was 3GCR E. coli, in CAI and HAI (0.15 and 0.12 per 100 patients). We observed a CRE CAI incidence of 0.006 and a HAI incidence of 0.008 per 100 patients (0.014 per 1000 patient days). Conclusions Comparing the known 3GCREB admission prevalence of the participating hospitals (9.5%) with the percentage of patients with a 3GCREB infection (0.58%), we conclude the prevalence of 3GCREB in university hospitals to be about 16 times higher than suggested when only patients with 3GCREB infections are considered. Moreover, we find the HAI and CAI incidence caused by CRE in Germany to be relatively low.
Collapse
Affiliation(s)
- Anna M Rohde
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,2Charité - Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgstraße 27, 12203 Berlin, Germany
| | - Janine Zweigner
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,2Charité - Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgstraße 27, 12203 Berlin, Germany.,3Department of Infection Control and Hygiene, University Hospital Cologne, Kerpener Straße 62, 50937 Köln, Germany
| | - Miriam Wiese-Posselt
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,2Charité - Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgstraße 27, 12203 Berlin, Germany
| | - Frank Schwab
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,2Charité - Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgstraße 27, 12203 Berlin, Germany
| | - Michael Behnke
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,2Charité - Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgstraße 27, 12203 Berlin, Germany
| | - Axel Kola
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,2Charité - Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgstraße 27, 12203 Berlin, Germany
| | - Birgit Obermann
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,4Department of Infectious Diseases and Microbiology, Institute for Medical Microbiology, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Johannes K-M Knobloch
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,4Department of Infectious Diseases and Microbiology, Institute for Medical Microbiology, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23562 Lübeck, Germany.,11Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Susanne Feihl
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,5Institute for Medical Microbiology, Immunology and Hygiene, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Christiane Querbach
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,5Institute for Medical Microbiology, Immunology and Hygiene, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Friedemann Gebhardt
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,5Institute for Medical Microbiology, Immunology and Hygiene, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Alexander Mischnik
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,6Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
| | - Vera Ihle
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,6Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
| | - Wiebke Schröder
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,7Division of Infectious Diseases, Department of Internal Medicine 1, University Hospital Tübingen, Otfried-Müller-Straße 12, 72076 Tübingen, Germany
| | - Sabina Armean
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,7Division of Infectious Diseases, Department of Internal Medicine 1, University Hospital Tübingen, Otfried-Müller-Straße 12, 72076 Tübingen, Germany
| | - Silke Peter
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,8Institute for Medical Microbiology and Hygiene, University Hospital Tübingen, Elfriede-Aulhorn-Straße 6, 72076 Tübingen, Germany
| | - Evelina Tacconelli
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,7Division of Infectious Diseases, Department of Internal Medicine 1, University Hospital Tübingen, Otfried-Müller-Straße 12, 72076 Tübingen, Germany
| | - Axel Hamprecht
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,9Institute for Medical Microbiology, Immunology and Hygiene, University Hospital Cologne, Goldenfelsstrasse 19-21, 50935 Köln, Germany
| | - Harald Seifert
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,9Institute for Medical Microbiology, Immunology and Hygiene, University Hospital Cologne, Goldenfelsstrasse 19-21, 50935 Köln, Germany
| | - Maria J G T Vehreschild
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,10Department I of Internal Medicine, University Hospital of Cologne, Herderstraße 52-54, 50931 Köln, Germany
| | - Winfried V Kern
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,6Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
| | - Petra Gastmeier
- 1German Center for Infection Research (DZIF), Inhoffenstraße 7, 38124 Braunschweig, Germany.,2Charité - Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgstraße 27, 12203 Berlin, Germany
| | | |
Collapse
|