Assessing the Effect of Contact Isolation on Nosocomial Colonization With ESBL-EC in German Hematology/Oncology Wards (CONTAIN)

University of Cologne

Status: Unknown

Conditions: Infection Due to ESBL Escherichia Coli; Oncology [See Also, Affected System]; Hematological Disease

Study type: Observational

Funder types: Other

Identifiers

NCT02456818

CONTAIN

Details and patient eligibility

About

This study aims to evaluate the impact of contact isolation on the rate of hospital-acquired transmissions of ESBL-producing Escherichia coli (ESBL-EC) and the rate of colonization and infection. On the basis of this study, it will be possible to re-evaluate the need for contact isolation for patients colonized or infected with ESBL-EC.

Full description

The study aims to evaluate the impact of contact isolation on the rate of hospital-acquired transmissions of ESBL-producing Escherichia coli and the rate of colonization and infection.

Hematological and oncological wards in hospitals with a non-outbreak setting for ESBL-EC and adhering to at least the following standard of care are eligible for study participation:

• Fecal screening for the presence of ESBL-EC of all patients within 72 hours of each admission by use of a rectal swab or stool sample
• Follow-up fecal screening once a week and within 72 hours of discharge
• Implementation of clinical standards aimed at ESBL-EC decolonization is not allowed on wards participating in this study, including in the context of clinical studies.

Sites will be grouped according to their approach regarding contact isolation (see group description).

As a control for external factors a hand hygiene program, including training and adherence assessments, will be implemented.

Enrollment: 2,264 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Wards adhering to at least the following standard of care are eligible for study participation:
• Fecal screening for the presence of ESBL-EC of all patients within 72 hours of each admission by use of a rectal swab or stool sample
• Follow-up fecal screening once a week and within 72 hours of discharge

Exclusion criteria

• none

Trial design

2,264 participants in 2 patient groups

Centers using contact isolation

Description:

* Isolation triggered by the detection of ESBL-EC at hospital admission in surveillance screening or during the hospitalization by weekly screening or clinical cultures * Contact isolation terminated, after at least two negative consecutive fecal screening cultures * Contact isolation resumed, if subsequent ESBL-EC positive cultures are identified for the same patient including readmissions Contact isolation must include: * Patient placement in single rooms * Cohorting only possible, when no single rooms available and corresponding ESBL-EC strains are phenotypically identical * Staff and visitors wearing gloves and gowns as contact precautions when entering the room, patient when leaving the room

Centers using no contact isolation

Description:

* not regularly isolating for ESBL-EC * ESBL-EC colonized or infected patients with urinary or fecal incontinence or diarrhea (\>3 loose bowel movements/day) isolated in single rooms with above described contact precautions