Intra-hospital patient transfers and acquisition of ESBL-E Eight out of 108 (7.4%) transferred patients acquired an ESBL-E, compared to 12 out of 489 (2.3%) patients that were not transferred (OR 3.18, 95%CI 1.27-7.98). Five out of 32 (15.6%) patients that were transferred twice or more acquired an ESBL-E, compared to 15 out of 565 (2.7%) patients who were once or not transferred (OR 6.79, 95%CI 2.29-20.06). Patients who were transferred once did not have significantly higher odds for ESBL-E acquisition (OR 1.22, 95%CI 0.35-4.26). Having a hospitalization period of six to ten days was associated with higher odds on having intra-hospital patient transfers, compared to patients admitted two or three days (OR 3.01, 95%CI 1.53-5.91), as well as patients hospitalized ten days or longer (OR 3.75, 95%CI 1.97-7.14). Patients whom acquired an ESBL-E during hospitalization had a median length of stay of nine days (2-146), patients who did not acquire an ESBL-E had a median length of stay of 6 days (2-72). No significant association was identified between length of hospitalization and acquisition of ESBL-E. Table 2. Number of patients who were positive for ESBL-producing Enterobacterales at admission, at discharge, and the number of patients who acquired an ESBL-producing Enterobacterales. Old hospital building (n=225) New hospital building (n=372) Admission (%) Discharge (%) Acquisition (%)4 Admission (%) Discharge (%) Acquisition (%) No ESBL-E 215 (95.6) 214 (95.1) NA 348 (93.5) 344 (92.5) NA ESBL-E1,2 10 (4.4) 11 (4.9) 7 (3.1) 24 (6.4) 28 (7.5) 13 (3.2) Escherichia coli3 6 (2.7) 8 (3.5) 5 (2.2) 19 (5.1) 22 (5.9) 8 (2.2) Klebsiella pneumoniae 1 (0.4) 3 (1.3) 2 (0.9) 2 (0.5) 5 (1.3) 3 (0.8) Citrobacter freundii 2 (0.9) 0 (-) NA 0 (-) 1 (0.3) 1 (0.3) Proteus spp. 1 (0.4) 0 (-) NA 2 (0.5) 0 (-) NA Enterobacter cloacae complex 0 (-) 0 (-) NA 1 (0.3) 0 (-) NA Morganella morganii 0 (-) 1 (0.4) 1 (0.4) 0 (-) 0 (-) NA Klebsiella aerogenes 0 (-) 0 (-) NA 1 (0.3) 2 (0.5) 1 (0.3) ESBL extended-spectrum beta-lactamase, ESBL-E extended-spectrum beta-lactamase producing Enterobacterales, NA not applicable 1 Five patients in the old building, and seven patients in the new building were ESBL-E positive at admission and ESBL-E negative at discharge. 2 Non-significant difference between the old hospital setting and the new hospital setting for admission (P=0.305), for discharge (P=0.206), and for acquisition (P=0.801). 3 Non-significant difference between the old hospital setting and the new hospital setting for admission (P=0.149), for discharge (P=0.156), and for acquisition (P=0.901). 4 One patient was positive at admission but acquired a different ESBL-E during hospitalization and one patient acquired two ESBL-E in the old building. Consequently, there are seven patients who acquired an ESBL-E during hospitalization in the old building, but eight different ESBL-E. 5 One Proteus faecis, one Proteus terrae, and one unknown Proteus spp. 34 Chapter 2.1
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