AbiGhosn Joanna, AlAsmar Mike, Abboud Edmond, Bailey Beth A, Haddad Nicholas
Radiology, Rafik Hariri University Hospital, Beirut, LBN.
Department of Internal Medicine, Division of Cardiology, American University of Beirut, Beirut, LBN.
Cureus. 2022 Apr 5;14(4):e23849. doi: 10.7759/cureus.23849. eCollection 2022 Apr.
Background and objective Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) are rapidly emerging worldwide. This study aimed to assess the effect of contact precaution (CP) on ESBL-PE-colonization rates among nurses in three hospitals in Beirut, Lebanon, where ESBL is endemic, in order to define the risk factors for colonization. Accordingly, the ongoing use of CP to prevent ESBL-PE transmission to healthy nurses was evaluated. Methods This cross-sectional study was conducted in three hospitals. Hospital 1 required CP, Hospital 2 had recently stopped CP, and Hospital 3 had stopped it three years previously. Questionnaires and stool-collection containers were distributed to all patient care nurses in those three hospitals. The Returned samples were tested using the agar dilution technique. Results A total of 269 out of 733 nurses volunteered to participate; 140 met the inclusion criteria (no recent hospitalization, antibiotic use, or known ESBL-PE colonization) and provided samples. Among them, 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. Conclusion In hospitals where CP is in place for ESBL-positive patients, ESBL-PE prevalence in nursing staff was significantly lower. Additionally, a work experience of two to four years increased the odds of ESBL-PE colonization in comparison with longer nursing experience. CP may be a justifiable means of protection against ESBL-PE transmission to healthy nurses. The risk factors for colonization were discontinuation of CP and a shorter clinical work experience.
背景与目的 产超广谱β-内酰胺酶肠杆菌科细菌（ESBL-PE）在全球范围内迅速出现。本研究旨在评估接触预防措施（CP）对黎巴嫩贝鲁特三家医院护士中ESBL-PE定植率的影响，在贝鲁特ESBL为地方流行，以确定定植的风险因素。因此，对持续使用CP预防ESBL-PE传播给健康护士进行了评估。方法 本横断面研究在三家医院开展。医院1要求采取CP措施，医院2最近停止了CP措施，医院3三年前就已停止。向这三家医院的所有患者护理护士发放问卷和粪便收集容器。对回收的样本采用琼脂稀释技术进行检测。结果 733名护士中共有269名自愿参与；140名符合纳入标准（近期无住院、未使用抗生素或无已知ESBL-PE定植）并提供了样本。其中，15%的样本ESBL呈阳性。与医院3的护士相比，医院1的护士被定植的可能性低59%，而医院2的护士被定植的可能性高62%。结论 在对ESBL阳性患者采取CP措施的医院中，护理人员的ESBL-PE患病率显著较低。此外，与更长的护理工作经验相比，两到四年的工作经验增加了ESBL-PE定植的几率。CP可能是防止ESBL-PE传播给健康护士的合理保护手段。定植的风险因素是停止CP措施和较短的临床工作经验。
