Short summary

Multiresistant bacteria is an increasing problem. Early identification of patients

with multiresistant bacteria is mandatory to avoid transmission and to target the antibiotic treatment. This study will provide a comprehensive overview of prevalence and risk factors for MRSA, ESBL, VRE, CPE and CD colonization in patients admitted to Danish ED`s. It is a multicenter descriptive and analytic cross-sectional survey of around 5000 acutely admitted patients.

Rationale

Multiresistant bacteria (MRB) is an increasing problem in many parts of the world [1]. In Denmark,

attention has been focused in particular to methicillin resistant Staphylococcus aureus (MRSA), but there has also been an increase in the prevalence of extended-spectrum beta-lactamase-producing enterobacteria (ESBL), vancomycin resistant enterococci (VRE) and carbapenem resistant enterobacteria (CPE). Early identification of patients colonized with resistant bacteria is mandatory to avoid in-hospital transmission and to target the antibiotic treatment to the individual patient. 

There is currently very sparse knowledge of both prevalence and risk factors for colonization with MRSA, ESBL, VRE, CPE and CD in acutely admitted patients. The Danish National Board of Health has published guidelines for targeted screening for isolation of MRSA, based on questionnaires concerning exposure factors. This screening is expected to identify only some of the carriers. In order to clarify the extent of the problem and prioritize the preventive response to the spread of MRB, it is crucial to know the prevalence of these bacteria in unselected acutely admitted patients to the Danish EDs.

The aim of this project is to provide a comprehensive overview of prevalence and risk factors for MRSA, ESBL, VRE, CPE and CD colonization in patients admitted to Danish emergency departments at a national level.

The objectives are: I) To describe the prevalence of MRSA, ESBL, VRE, CPE and CD colonization in unselected, acutely admitted patients and the regional, urban / country and other demographic variations. II) To describe the occurrence of simultaneous patient colonization with two or more resistant bacteria (MRSA, ESBL, VRE, CPE and CD). III) To identify risk factors for colonization with MRSA, ESBL, VRE, CPE and CD IV) Based on the identified risk factors, to develop screening tools for identification of carriers.

Description of the cohort

Acutely admitted adults

Data and biological material

Patients will be swabbing in the rectum, nose and throat and will answer a questionnaire.

Collaborating researchers and departments

Department of Emergency Medicine, Hospital of Southern Denmark, Aabenraa and Danish Institute of Regional Health Research, University of Southern Denmark, Aabenraa

• Post doc Helene Skjøt-Arkil

Department of Clinical Microbiology, Odense University Hospital

• Flemming Rosenvinge

Department of Emergency Medicine, Odense University Hospital and Institute of Clinical Research, University of Southern Denmark

• Professor Annmarie Lassen

Department of Infectious Diseases, Odense University Hospital

• Professor Isik Johansen

Department of Clinical Microbiology, Hospital of Southern Denmark, Sønderborg

• Associate professor Ming Chen

Emergency Department, Regional Hospital West Jutland

• Poul Petersen

Emergency Department, Aarhus University Hospital

• Karen V Andersen

Department of Clinical Microbiology, Aarhus University Hospital

• Svend Ellermann- Eriksen

Emergency Department, Aalborg University Hospital

• Jørn M Møller

Emergency Department, North Denmark Regional Hospital

• Marc Ludwig

Department of Clinical Microbiology, Aalborg University Hospital

• David Fuglsang-Damgaard

Emergency Department, Slagelse Hospital

• Finn Nielsen

Emergency Department, Zealand University Hospital

• Dan B Petersen

Department of Clinical Microbiology, Slagelse Hospital

• Ulrich S Jensen