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Effectiveness of a new decolonisation regimen for eradication of extended-spectrum -lactamase-producing Enterobacteriaceae

Buehlmann, M. and Bruderer, T. and Frei, R. and Widmer, A. F.. (2011) Effectiveness of a new decolonisation regimen for eradication of extended-spectrum -lactamase-producing Enterobacteriaceae. The journal of hospital infection, Vol. 77. pp. 113-117.

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Official URL: http://edoc.unibas.ch/dok/A6002862

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Abstract

Gram-negative bacteria expressing extended-spectrum -lactamases (ESBL) have emerged worldwide. ESBL colonisation can persist for years and may favour ESBL transmission. Interventions include contact isolation precautions and restriction of antibiotic use, but decolonisation (DC) for ESBL is not established. We performed a prospective controlled open-label cohort-study from 1/2000 to 1/2008 to determine the effectiveness of a standardised DC programme. ESBL-positive patients routinely underwent screening from rectum, throat, and urine. DC included: chlorhexidine 0.2% mouth rinse three times daily (throat colonisation), paromomycin 4×1g daily (intestinal colonisation), and oral antibiotics for urinary tract colonisation. ESBL elimination was defined as 1 set of negative follow-up screenings (throat, rectal, urine). Of 100 enrolled patients, 83% of patients were infected and 17% colonised with ESBL. Escherichia coli (71%) and Klebsiella pneumoniae (25%) were the most frequent pathogens. Overall, 76% (76/100) of patients became negative for ESBL at follow-up. Fifty-five percent (42/76) of the successfully treated patients received systemic treatment for infection. Of those who completed DC, 83% (15/18) were free of ESBL at follow-up. DC success correlated with the number of risk factors and colonised sites. DC may be beneficial in a selected group of patients, potentially shortening duration of ESBL colonisation and subsequently reducing the risk for transmission.
Faculties and Departments:03 Faculty of Medicine > Bereich Querschnittsfächer (Klinik) > Labormedizin > Klinische Mikrobiologie (Frei)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Querschnittsfächer (Klinik) > Labormedizin > Klinische Mikrobiologie (Frei)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Infektiologie > Infektiologie (Battegay M)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Infektiologie > Infektiologie (Battegay M)
UniBasel Contributors:Widmer, Andreas F.-X. and Frei, Reno
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Elsevier
ISSN:0195-6701
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:27 Mar 2014 13:13
Deposited On:27 Mar 2014 13:13

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