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Peer-reviewedCC BYInfection Prevention in Practice

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

  • Jérémy Picard1
  • Nicolas Galakhoff2
  • Raoul Baron2
  • Geneviève Héry-Arnaud3
  • Clémence Beauruelle3
  • Hervé Le Bars4
  • Séverine Ansart5
  • Gwenaël Cornec6
  • Anne Coste5
  • Aurore Trameçon7
  • Philippe Saliou8
8 affiliations
  1. 1Infection Prevention and Control Unit, Brest Teaching Hospital, Brest, France; Univ Brest, Inserm, EFS, UMR 1078, GGB, Brest, France; Corresponding author. Address: Jeremy Picard, Université de Bretagne Occidentale, Infection control unit, CHU de Brest Hôpital Morvan, 2 avenue Foch, 29609 BREST CEDEX, France. Tél. +33 (0)2 98 22 38 69.
  2. 2Infection Prevention and Control Unit, Brest Teaching Hospital, Brest, France
  3. 3Department of Infectious Agents, Pole of Biology-Pathology, University Hospital of Brest Brest, France; Univ Brest, Inserm, EFS, UMR 1078, GGB, Brest, France
  4. 4Department of Infectious Agents, Pole of Biology-Pathology, University Hospital of Brest Brest, France
  5. 5Department of Infectious Diseases, CHU Brest, Brest, France; LaTIM, INSERM UMR 1101, Université de Bretagne Occidentale, UBO, Brest, France
  6. 6Department of Physical and Rehabilitation Medicine, CHU Brest, Brest, France; LaTIM, INSERM UMR 1101, Université de Bretagne Occidentale, UBO, Brest, France
  7. 7Department of General Practice, Université de Bretagne Occidentale, Brest, France; ER 7479 SPURBO, Université de Bretagne Occidentale, Brest, France
  8. 8Infection Prevention and Control Unit, Brest Teaching Hospital, Brest, France; Univ Brest, Inserm, EFS, UMR 1078, GGB, Brest, France
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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 centre. 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 h of CPE carriers admitted to medical, surgical, obstetrics, and rehabilitation wards at Brest University Hospital between 2012 and 2022. We used multi-variable 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 odds ratio [aOR], 3.65, 95% confidence interval [CI], 1.51–8.84; P = 0.004), longer hospital stay (aOR, 1.02 per day, 95% CI, 1.01–1.04; P = 0.006), and faecal incontinence of the index patient (aOR, 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 focussing on patients or settings at highest risk should be evaluated while maintaining robust infection prevention and control practices.

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Cite

BibTeXRIS
BibTeX
@article{picard2026prevention,
  title = {{Prevention of carbapenemase-producing Enterobacterales outbreaks: evaluation of a simplified contact screening policy}},
  author = {Jérémy Picard and Nicolas Galakhoff and Raoul Baron and Geneviève Héry-Arnaud and Clémence Beauruelle and Hervé Le Bars and Séverine Ansart and Gwenaël Cornec and Anne Coste and Aurore Trameçon and Philippe Saliou},
  journal = {Infection Prevention in Practice},
  year = {2026},
  month = sep,
  doi = {10.1016/j.infpip.2026.100597},
  url = {https://doi.org/10.1016/j.infpip.2026.100597},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Prevention of carbapenemase-producing Enterobacterales outbreaks: evaluation of a simplified contact screening policy
AU  - Jérémy Picard
AU  - Nicolas Galakhoff
AU  - Raoul Baron
AU  - Geneviève Héry-Arnaud
AU  - Clémence Beauruelle
AU  - Hervé Le Bars
AU  - Séverine Ansart
AU  - Gwenaël Cornec
AU  - Anne Coste
AU  - Aurore Trameçon
AU  - Philippe Saliou
PY  - 2026
DA  - 2026/09/21
JO  - Infection Prevention in Practice
DO  - 10.1016/j.infpip.2026.100597
UR  - https://doi.org/10.1016/j.infpip.2026.100597
AB  - 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 centre. 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 h of CPE carriers admitted to medical, surgical, obstetrics, and rehabilitation wards at Brest University Hospital between 2012 and 2022. We used multi-variable 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 odds ratio [aOR], 3.65, 95% confidence interval [CI], 1.51–8.84; P = 0.004), longer hospital stay (aOR, 1.02 per day, 95% CI, 1.01–1.04; P = 0.006), and faecal incontinence of the index patient (aOR, 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 focussing on patients or settings at highest risk should be evaluated while maintaining robust infection prevention and control practices.
SN  - 2590-0889
ER  -