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Contact Precautions for Preventing Nosocomial Transmission of Extended-Spectrum β Lactamase-Producing Escherichia coli: A Point/Counterpoint Review.

  • Tschudin-Sutter S Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Switzerland.
  • Lucet JC Infection Control Program, Bichat University Hospital, Paris, France.
  • Mutters NT Heidelberg University Hospital, Department of Infectious Diseases.
  • Tacconelli E Division of Infectious Diseases, Department of Internal Medicine I, German Center for Infection Research (DZIF), Tübingen University Hospital,Germany.
  • Zahar JR Infection Control Unit, Microbiology Department, Avicenne Hospital, Paris-Nord University (UHR SMBH), Bobigny, France.
  • Harbarth S Infection Control Programme, Geneva University Hospitals and Medical School, Switzerland.
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  • 2017-04-06
Published in:
  • Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. - 2017
ESBL-EC
ESBL-producing Escherichia coli
contact precautions
nosocomial transmission
Anti-Bacterial Agents
Carrier State
Cross Infection
Escherichia coli
Escherichia coli Infections
Female
Hospitals
Humans
Infection Control
Male
beta-Lactamases
English Contact precautions have been recommended for hospitalized patients colonized or infected with extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC). Despite such recommendations, a steady, worldwide increase of ESBL-EC has been reported. We discuss arguments in favor of and against contact precautions for ESBL-EC carriers. Healthcare settings with high ESBL-EC colonization pressure, extended hospital stay, and close contact between patients may serve as amplification platforms, further accelerating transmission. However, the evidence base for justifying the implementation of contact precautions for all ESBL-EC carriers remains weak. Until more high-level evidence is available, we support the attitude that hospitals and countries should carefully evaluate their decision on whether to implement contact precautions for ESBL-EC carriers. It is likely that a majority of patients and wards do not need to rely on contact precautions for preventing nosocomial ESBL-EC transmission in nonepidemic settings, without harming patient safety, providing sufficient compliance with standard precautions and ongoing surveillance.
Language
  • English
Open access status
bronze
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Persistent URL
https://folia.unifr.ch/global/documents/242799
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