title: Risk Factors for Colonization With Multidrug-Resistant Bacteria Among Patients Admitted to the Intensive Care Unit After Returning From Abroad.
abstract: BACKGROUND
  Few national recommendations exist on management of patients returning from abroad and all focus on hospitalized patients. Our purpose was to compare, in an intensive care unit (ICU), the admission prevalence and acquisition of multidrug-resistant (MDR) bacteria carriage in patients with ("Abroad") or without ("Local") a recent stay abroad, and then identify the risk factors in "Abroad" patients.
  
  
  METHODS
  In this retrospective study, we reviewed charts of all the patients hospitalized in the ICU unit from January 2011 through July 2013 with hygiene samplings performed. We identified all patients who had stayed abroad ("Abroad") within 6 months prior to ICU admission.
  
  
  RESULTS
  Of 1,842 ICU patients, 129 (7%) "Abroad" patients were reported. In the "Abroad" group, the rate of MDR strain carriage was higher at admission (33% vs 6.7%, p < 0.001) and also more often diagnosed during the ICU stay (acquisition rate: 17% vs 5.2%, p < 0.001) than in "Local" patients. Risk factors associated with MDR bacteria carriage at admission in "Abroad" patients were diabetes mellitus [odds ratio (OR) 5.1 (1.7-14.8), p = 0.003] and "hospitalization abroad with antibiotic treatment" [OR 10.7 (4.2-27.3), p < 0.001]. Hospitalization abroad without antibiotic treatment was not identified as a risk factor.
  
  
  CONCLUSIONS
  The main factor associated with MDR bacteria carriage after a stay abroad seems to be a hospitalization abroad only in case of antibiotic treatment abroad. Screening and isolation of "Abroad" patients should be recommended, even in case of a first negative screening.
authors.affiliation: Intensive Care Unit, CHU Félix Guyon, Saint-Denis, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Angue
authors.affiliation: Intensive Care Unit, CHU Félix Guyon, Saint-Denis, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Allou
authors.affiliation: Bacteriology Laboratory, CHU Félix Guyon, Saint-Denis, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Belmonte
authors.affiliation: Intensive Care Unit, CHU Félix Guyon, Saint-Denis, France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Lefort
authors.affiliation: Infection Control Unit, CHU Félix Guyon, Saint-Denis, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Lugagne
authors.affiliation: Intensive Care Unit, CHU Félix Guyon, Saint-Denis, France.
authors.forename: David
authors.initials: D
authors.lastname: Vandroux
authors.affiliation: Département Anesthésie Réanimation, AP-HP, Hop Bichat-Claude Bernard, Paris, France.|Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Montravers
authors.affiliation: Intensive Care Unit, CHU Félix Guyon, Saint-Denis, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Allyn
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy*; D015169:Colony Count, Microbial; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005602:France; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014195:Travel / Q000706:statistics & numerical data*
chemical_list: D000900:Anti-Bacterial Agents