Work

Prevention of carbapenemase-producing Enterobacterales outbreaks: evaluation of a simplified contact screening policy

Year: 2026

Type: article

Abstract: Introduction The control of carbapenemase-producing Enterobacterales (CPE) relies on screening high-risk patients for carriage, enforcing hygiene measures, and identifying and managing outbreaks of CPE-carriers through contact screening. Human and material constraints and the rising prevalence of CPE led to local adaptations in our center. The main objective was to evaluate the impact of a simplified contact screening policy targeting a limited subset of exposed patients on CPE outbreak detection and the secondary objective was to identify additional risk factors associated with these outbreaks. Methods A retrospective cohort study included hospital stays exceeding 24 hours of CPE carriers admitted to medical, surgical, obstetrics, and rehabilitation wards at Brest University Hospital between 2012 and 2022. We used multivariable mixed-effects logistic regression to assess the impact of our screening policy and identify outbreak risk factors. Results A total of 279 hospital stays involving 154 patients were included, with 43 outbreaks identified (15.4%). Three independent factors were associated with outbreak detection: systematic screening of all contact patients (adjusted OR = 3.65, 95% CI 1.51–8.84; p = 0.004), longer hospital stay (adjusted OR = 1.02 per day, 95% CI 1.01–1.04; p = 0.006), and fecal incontinence of the index patient (adjusted OR = 2.80, 95% CI 1.10–8.17; p = 0.030). Discussion Subset contact screening was associated with fewer detected outbreaks than systematic screening, illustrating the trade-off between resource optimization and outbreak detection. As CPE epidemiology evolves, more pragmatic screening strategies focusing on patients or settings at highest risk should be evaluated while maintaining robust infection prevention and control practices.

Source: Infection Prevention in Practice

DOI: 10.1016/j.infpip.2026.100597