He acquired carriage and horse and found stable and lodgings in a mews on Gloucester Road.
ESBL imported carriage was defined as a first screening positive for ESBL whereas ESBL acquired carriage as a negative first screening at admission followed by at least one positive rectal swan.
Microbiological data concerning ESBL-PE imported and acquired carriage were monitored by rectal swabs collected at admission and once weekly every Monday for the whole duration of the ICU stay.
In this prospective observational study in 470 consecutive patients admitted to a 12-bed medical and surgical ICU with no single rooms, the prevalence of imported ESBL carriage was 13.2% and the incidence of acquired carriage was 4.1%, mostly with E. coli.
In multivariate analysis, the severity (SAPS II) at admission was the only factor identified to be associated with the acquired carriage of ESBL, while some authors have reported that the duration of exposure to an ESBL carrier is independently associated with ESBL acquisition [13, 20].
Family studies allow assessment of differences in susceptibility to acquiring carriage by controlling exposure to pneumococci and have revealed higher susceptibility to acquiring carriage in young children [ 11- 13].
But, Syrjänen et al. have shown in their study on the temporal association between pneumococcal carriage and otitis media that not preceding pneumococcal carriage state, but newly acquired carriage is associated with otitis media [ 10].
Carriage at ICU admission (imported carriage) and acquisition during hospitalization in the unit (acquired carriage) were defined as isolation of A. baumannii from at least one screening sample obtained within or later than the first 48 hours of admission, respectively.
The actual prevalence might be better estimated by the proportion of patients in the study who were ever detected to have S.aureus carriage (74/733; 10.1%; 95%CI 7.2-12.3) – though some of these patients probably acquired carriage during admission.
The factor Time, either as hospital days before ICU admission, or as antibiotic treatment-days and duration of mechanical ventilation during the ICU stay, was recognized as an independent risk factor for imported and acquired carriage, respectively.
