Extended-spectrum β-lactamase-producing Enterobacteriaceae in French nursing homes: an association between high carriage rate among residents, environmental contamination, poor conformity with good hygiene practice, and putative resident-to-resident transmission.

摘要: Objective We evaluated the spread of multidrug-resistant Enterobacteriaceae in 38 nursing homes (NHs) Centre region France. Methods conducted a multicenter prevalence study and extended-spectrum β-lactamase- carbapenemase-producing (ESBLE CPE, respectively) colonization 1,155 residents. The colonizing isolates were studied by randomly amplified polymorphic DNA typing. observed hygiene practices contamination environment 8 NHs. Results A total 114 residents ESBLE carriers (9.9%); none CPE carriers. 82.6% Escherichia coli. was associated with poor health status (P = .002), malignancy .006), urinary incontinence .007), fecal previous hospitalization .033), carbapenem treatment .040). clonal relationship between within NHs suggested resident-to-resident transmission 15 recovered from 6 232 bedrooms studied. 1,533 observations revealed low rates conformity for hand (25.7%), use gloves (45.9%) protective clothing (13.3%), waste management (46.7%). Conformity correlated inversely carriage rates. Conclusions In most participating NHs, improved application standard precautions during care is needed, greater efforts to clean are required.