TY - JOUR
T1 - Prevalence and risk factors for carriage of carbapenem-resistant Acinetobacter baumannii in post-acute care hospitals, Israel, 2021
AU - Israel PACH CRAB Working Group
AU - Schechner, Vered
AU - Masarwa, Samira
AU - Levi, Gabrielle D.
AU - Cohen, Adi
AU - Assi, Fadi
AU - Bechor, Moshe
AU - Temkin, Elizabeth
AU - Keren-Paz, Alona
AU - Schwaber, Mitchell J.
AU - Carmeli, Yehuda
AU - Haviv, Jacob
AU - Marcus, Esther Lee
AU - Yosef, Hana
AU - Lauden, Ari
AU - Ben-David, Debby
AU - Shimonov, Angela
AU - Stessman, Jochanan
AU - Hamo, Esther Ben
AU - Atun, Moria
AU - Gazit, Maya Shkolnik
AU - Tirosh, Oshra
AU - Vishnevski, Yana
AU - Uzlianer, Irena
AU - Kagansky, Nadya
AU - Levy, Yochai
AU - Bogoslavsky, Tanya
AU - Eluk, Orna
AU - Sasson, Ayala Gisele
AU - Matanis, Riham Matar
AU - Shimol, Margalit Ben
AU - Nassar, Mohamed
AU - Nagulevich, Tatiana
AU - Kimchi, Osnat
AU - Svirsky, Boris
AU - Habiballa, Mariana
AU - Ramlawe, Rabea
AU - Saffuri, Ibrahim
AU - Azzam, Subhi
AU - Hutzistov, Tatiana
AU - Ciobotaro, Pnina
AU - Gur, Pasha
AU - Or, Ilana
AU - Aroya, Nurit Ben
AU - Vipritski, Yulia
AU - Druker, Olga
AU - Zafrany, Inna Kaganovich
AU - Shugaev, Inna
AU - Zalyesov, Eduard
AU - Zheleznyak, Svetlana
AU - Paz, Alona
N1 - Publisher Copyright:
© 2025 European Centre for Disease Prevention and Control (ECDC). All rights reserved.
PY - 2025/4/17
Y1 - 2025/4/17
N2 - Background: Post-acute care hospitals (PACH) may act as regional reservoirs for multidrug-resistant organisms. Aim: We aimed to investigate the prevalence of carbapenem-resistant Acinetobacter baumannii (CRAB) carriers and identify risk factors for CRAB carriage in PACH. Merthods: We conducted a point prevalence survey in 18 PACH in Israel from June to December 2021. We screened patients in 55 wards of four types (mechanical ventilation, skilled nursing, sub-acute and rehabilitation) for CRAB carriage from skin, rectum and tracheostomy secretions (if applicable). We collected data on patient characteristics (including prior CRAB carriage) and ward and institution characteristics. We calculated the prevalence of CRAB carriers, the percentage of newly detected carriers, and assessed predictors of CRAB carriage using a mixed-effects logistic regression model. Results: We screened 1, 725 patients, with 385 (22%) testing positive for CRAB. The median prevalence of CRAB carriers was 48% (interquartile range (IQR): 33-70) in ventilation wards, 28% (IQR: 18-46) in skilled nursing wards, 8% (IQR: 6-13) in sub-acute wards and 0% (IQR: 0-3) in rehabilitation wards. Only 31% (118/385) had a known history of CRAB carriage. Individual risk factors for CRAB positivity included known CRAB carriage, bedsores and presence of a feeding tube. Modifiable ward-level risk factors included poor availability of alcohol-based hand rub (adjusted odds ratio (aOR) = 3.22; 95% confidence interval (CI): 1.52-6.81) and suctioning in common areas (aOR = 2.23; 95% CI: 1.30-3.85). Conclusion: The hidden reservoir of CRAB carriers in Israeli ventilation and skilled nursing wards is large. We identified modifiable risk factors at ward level, highlighting areas for targeted intervention.
AB - Background: Post-acute care hospitals (PACH) may act as regional reservoirs for multidrug-resistant organisms. Aim: We aimed to investigate the prevalence of carbapenem-resistant Acinetobacter baumannii (CRAB) carriers and identify risk factors for CRAB carriage in PACH. Merthods: We conducted a point prevalence survey in 18 PACH in Israel from June to December 2021. We screened patients in 55 wards of four types (mechanical ventilation, skilled nursing, sub-acute and rehabilitation) for CRAB carriage from skin, rectum and tracheostomy secretions (if applicable). We collected data on patient characteristics (including prior CRAB carriage) and ward and institution characteristics. We calculated the prevalence of CRAB carriers, the percentage of newly detected carriers, and assessed predictors of CRAB carriage using a mixed-effects logistic regression model. Results: We screened 1, 725 patients, with 385 (22%) testing positive for CRAB. The median prevalence of CRAB carriers was 48% (interquartile range (IQR): 33-70) in ventilation wards, 28% (IQR: 18-46) in skilled nursing wards, 8% (IQR: 6-13) in sub-acute wards and 0% (IQR: 0-3) in rehabilitation wards. Only 31% (118/385) had a known history of CRAB carriage. Individual risk factors for CRAB positivity included known CRAB carriage, bedsores and presence of a feeding tube. Modifiable ward-level risk factors included poor availability of alcohol-based hand rub (adjusted odds ratio (aOR) = 3.22; 95% confidence interval (CI): 1.52-6.81) and suctioning in common areas (aOR = 2.23; 95% CI: 1.30-3.85). Conclusion: The hidden reservoir of CRAB carriers in Israeli ventilation and skilled nursing wards is large. We identified modifiable risk factors at ward level, highlighting areas for targeted intervention.
UR - http://www.scopus.com/inward/record.url?scp=105003033767&partnerID=8YFLogxK
U2 - 10.2807/1560-7917.ES.2025.30.15.2400563
DO - 10.2807/1560-7917.ES.2025.30.15.2400563
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C2 - 40248891
AN - SCOPUS:105003033767
SN - 1025-496X
VL - 30
JO - Eurosurveillance
JF - Eurosurveillance
IS - 15
M1 - 2400563
ER -