This study will assess the impact of FTIRS typing on the spread of ESBL-E in intensive care units
Multidrug resistant enterobacterales (MDR-E) are a major threat for patients hospitalized in intensive care units (ICUs). To prevent MDR-E spread in ICUs, rectal swabs are routinely performed and cultured on selective media. However, bacterial identification and antimicrobial susceptibility results are not sufficient to diagnose cross transmissions. The gold standard technique is based on genomic analysis that require whole genome sequencing (WGS) of bacteria and followed by multilocus sequence typing (MLST) and Single Nucleotide Polymorphism (SNP) typing. This technology is rather expensive and not applicable in all centers. Fourier Transform InfraRed Spectroscopy (FTIRS) is a developing method for rapid bacterial typing. This technology is simple and results can be obtained in one hour. It is therefore adapted to continuous surveillance of MDR-E. In France, extended spectrum betalactamase producing enterobacteriaceae (ESBL-E) represent the vast majority of MDR-E. We postulate that early diagnosis of cross-transmission by FTIRS may prevent the spread of ESBL-E in ICUs and favor compliance with hygiene measures. The aim of this study will be to assess the impact of systematic FTIRS typing of ESBL-E on ESBL-E cross-transmissions in ICUs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
900
Weekly transmission of FTIRS typing of ESBL-E to centers
CHU CHEN
Caen, France
RECRUITINGBaseline frequency of ESBL-E cross transmission as assessed by WGS
Number of patients with hospital acquired ESBL-E / total number of ESBL-E carriers
Time frame: Month 9 to Month 12 (depending on centers, stepped wedge design)
Post intervention frequency of ESBL-E cross transmission as assessed by WGS
Number of patients with hospital acquired ESBL-E / total number of ESBL-E carriers
Time frame: Month 24
Sensitivity of FTIRS to diagnose cross transmissions compared to WGS
Sensitivity
Time frame: Month 24
Specificity of FTIRS to diagnose cross transmissions compared to WGS
Specificity
Time frame: Month 24
Positive predictive value of FTIRS to diagnose cross transmissions compared to WGS
Positive predictive value
Time frame: Month 24
Negative predictive value of FTIRS to diagnose cross transmissions compared to WGS
Negative predictive value
Time frame: Month 24
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