Major ArticleHow important is patient-to-patient transmission in extended-spectrum β-lactamase Escherichia coli acquisition
Section snippets
Study design and patient population
This study was approved by the Institutional Review Board of the University of Maryland, Baltimore. This study utilized a prospective cohort of adult patients admitted to the medical ICU (MICU) and surgical ICU (SICU) of the University of Maryland Medical Center (UMMC) between September 1, 2001, and September 1, 2004. The UMMC is a tertiary care facility in Baltimore, Maryland. The MICU is a 10-bed, private room unit providing care to patients who have acute or potentially life-threatening
Results
There were 1806 patients admitted to the MICU and SICU during the 3-year study period who had admission and discharge cultures obtained. Compliance with obtaining perianal surveillance cultures (admission and discharge) was greater than 90% on average. Mean demographics of these patients are as follows: age, 55.7 years; female, 46%; Charlson score, 2.3; chronic disease score, 7.8; average time in hospital before ICU admission, 2.6 days; average numbers of days in the ICU, 6.8 days.
Ninety-seven
Discussion
In this study, we quantified the amount of patient-to-patient transmission of ESBL-producing E coli that occurred in a tertiary care hospital over a 3-year period. To our knowledge, we are the first to focus this quantification for ESBL-producing E coli in the setting of gastrointestinal colonization. We found that, of the 23 patients who acquired colonization with ESBL-producing bacteria, 3 (13%) had patient-to-patient transmission, defined as similar PFGE type and epidemiologic hospital time
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Supported by the National Institutes of Health grants K23 AI01752-01A1 and R01 AI60859-01A1.