Researchers at Amphia Hospital, an 850-bed teaching facility in the Netherlands, completed two prevalence studies (November 2014 and 2015) on all adult patients who had stayed for no more than two days. The cross-section study just published in Clinical Infectious Diseases (free full text) linked rectal carriage of extended spectrum beta-lactamase–producing Enterobacteriaceae to pre-admission use of PPI and H2-antagonists, among other factors.
Rectal cultures were available from 570 patients and 259 (45%) had a history of proton pump inhibitor use, while very few used H2-blockers or antacids. I have included the univariable and multivariable analyses below. More than concurrent antibiotic use or prior hospital admission, proton pump inhibitor swere associated with four times the risk of extended spectrum beta-lactamase rectal carriage. (OR 3.89; 95% CI, 1.65 to 9.19). This is a very nicely completed study and provides more evidence supporting the inclusion of proton pump inhibitors targets in our “antimicrobial” stewardship programs.
