TY - JOUR
T1 - Screening patients at admission to Copenhagen hospitals for carriage of resistant bacteria after contact with health care systems abroad, 2016-2019
AU - Westerholt, Marc
AU - Hasman, Henrik
AU - Hansen, Dennis Schrøder
AU - Roer, Louise
AU - Hansen, Thomas Arn
AU - Petersen, Andreas
AU - Holzknecht, Barbara Juliane
N1 - Copyright © 2021 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.
PY - 2021/12
Y1 - 2021/12
N2 - OBJECTIVES: Patients having previous contact with healthcare systems abroad are routinely screened for resistant bacteria on admission to hospitals in Copenhagen. This study aimed to present carriage prevalence and geographical risk stratification, as well as phenotypic and genotypic characterisation of resistant isolates.METHODS: This study included screening samples analysed at one department of clinical microbiology in Copenhagen from 2016-2019. Patients who had previous contact with healthcare systems abroad within 6 months were screened at admission for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE) and carbapenemase-producing organisms (CPO). Isolates were characterised phenotypically and by whole-genome sequencing. The relative frequency of positive findings stratified by geographical regions correlated with relative frequency of Danish residents' travel destinations.RESULTS: Of 2849 screening sets included in the study, 103 (3.6%) were positive. A total of 120 resistant isolates were detected (36 MRSA, 31 VRE and 53 CPO). The carrier prevalence for MRSA was 1.3%, 1.1% for VRE and 1.5% for CPO. Southern and Western Asia were overrepresented travel destinations in positive screening sets (41%). For VRE, 40% were related to Southern Europe, which also represented 35% of travel destinations. Genotypic characterisation confirmed a heterogenous genomic background reflecting global distribution of resistant clones.CONCLUSIONS: Exposure targeted screening identified a substantial number of asymptomatic carriers of MRSA, VRE and CPO with heterogenous genetic backgrounds. Although some geographical regions were overrepresented, the complex epidemiology of the different pathogens did not allow a restriction of the screening strategy to certain geographical regions.
AB - OBJECTIVES: Patients having previous contact with healthcare systems abroad are routinely screened for resistant bacteria on admission to hospitals in Copenhagen. This study aimed to present carriage prevalence and geographical risk stratification, as well as phenotypic and genotypic characterisation of resistant isolates.METHODS: This study included screening samples analysed at one department of clinical microbiology in Copenhagen from 2016-2019. Patients who had previous contact with healthcare systems abroad within 6 months were screened at admission for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE) and carbapenemase-producing organisms (CPO). Isolates were characterised phenotypically and by whole-genome sequencing. The relative frequency of positive findings stratified by geographical regions correlated with relative frequency of Danish residents' travel destinations.RESULTS: Of 2849 screening sets included in the study, 103 (3.6%) were positive. A total of 120 resistant isolates were detected (36 MRSA, 31 VRE and 53 CPO). The carrier prevalence for MRSA was 1.3%, 1.1% for VRE and 1.5% for CPO. Southern and Western Asia were overrepresented travel destinations in positive screening sets (41%). For VRE, 40% were related to Southern Europe, which also represented 35% of travel destinations. Genotypic characterisation confirmed a heterogenous genomic background reflecting global distribution of resistant clones.CONCLUSIONS: Exposure targeted screening identified a substantial number of asymptomatic carriers of MRSA, VRE and CPO with heterogenous genetic backgrounds. Although some geographical regions were overrepresented, the complex epidemiology of the different pathogens did not allow a restriction of the screening strategy to certain geographical regions.
KW - Carbapenemase-producing organisms (CPO)
KW - International travellers
KW - Methicillin-resistant Staphylococcus aureus (MRSA)
KW - Screening
KW - Vancomycin-resistant Enterococci (VRE)
UR - http://www.scopus.com/inward/record.url?scp=85118795566&partnerID=8YFLogxK
U2 - 10.1016/j.ijantimicag.2021.106452
DO - 10.1016/j.ijantimicag.2021.106452
M3 - Journal article
C2 - 34648944
SN - 0924-8579
VL - 58
SP - 106452
JO - International Journal of Antimicrobial Agents
JF - International Journal of Antimicrobial Agents
IS - 6
M1 - 106452
ER -