Risk factors for fecal carriage of extended-spectrum beta-lactamase-producing and carbapenem-resistant Escherichia coli and Klebsiella pneumoniae strains among patients at hospital admission

Kızılateş, Filiz; Yakupoğulları, Yusuf; Berk, Hande; Öztoprak, Nefise; Otlu, Barış

doi:10.1016/j.ajic.2020.07.035

Cited by 16 publications

(12 citation statements)

References 34 publications

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“…This finding is consistent with other studies which found that prolonged hospitalization was an independent risk factor for intestinal ESBL E. coli colonization. 9 , 14 Further, as antibiotics are commonly used in healthcare settings, the resulting gut dysbiosis (loss of gut colonization resistance) coupled with longer exposure to a high-prevalence healthcare setting (during a prolonged hospital stay) could provide a synergistic combination for increased acquisition.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, in this meta-analysis, we explored the global prevalence of human ESBL E. coli faecal carriage in healthcare settings and compared it with the values found in the community. Furthermore, as the acquisition of intestinal ESBL E. coli carriage could rise with increasing hospital stay, 9 , 14 we compared carriage rates among patients with varying duration of hospitalization and in individuals living in nursing care facilities.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the global prevalence and trend of human intestinal carriage of ESBL-producing Escherichia coli between healthcare and community settings: a systematic review and meta-analysis

Bezabih

Dion

et al. 2022

JAC-Antimicrobial Resistance

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Objectives The widespread intestinal carriage of ESBL-producing Escherichia coli (ESBL E. coli) among both patients and healthy individuals is alarming. However, the global prevalence and trend of this MDR bacterium in healthcare settings remains undetermined. To address this knowledge gap, we performed a comparative meta-analysis of the prevalence in community and healthcare settings. Methods Our systematic review included 133 articles published between 1 January 2000 and 22 April 2021 and indexed in PubMed, EMBASE or Google Scholar. A random-effects meta-analysis was performed to obtain the global pooled prevalence (community and healthcare settings). Subgroup meta-analyses were performed by grouping studies using the WHO regions and 5 year intervals of the study period. Results We found that 21.1% (95% CI, 19.1%–23.2%) of inpatients in healthcare settings and 17.6% (95% CI, 15.3%–19.8%) of healthy individuals worldwide carried ESBL E. coli in their intestine. The global carriage rate in healthcare settings increased 3-fold from 7% (95% CI, 3.7%–10.3%) in 2001–05 to 25.7% (95% CI, 19.5%–32.0%) in 2016–20, whereas in community settings it increased 10-fold from 2.6% (95% CI, 1.2%–4.0%) to 26.4% (95% CI, 17.0%–35.9%) over the same period. Conclusions The global and regional human intestinal ESBL E. coli carriage is increasing in both community and healthcare settings. Carriage rates were generally higher in healthcare than in community settings. Key relevant health organizations should perform surveillance and implement preventive measures to address the spread of ESBL E. coli in both settings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of the global prevalence and trend of human intestinal carriage of ESBL-producing Escherichia coli between healthcare and community settings: a systematic review and meta-analysis

Bezabih

Dion

et al. 2022

JAC-Antimicrobial Resistance

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“…For instance, in the general population of hospitalized patients, the rates of MDR-Ent colonization (ESBL-Ent and CRE) ranged between 12 and 65% in different countries. However, history of antibiotic use, duration of hospital stay, nursing home residency, receiving parenteral nutrition, and previous hospital admission(s) were constantly recognized as independent factors associated with the carriage [55][56][57][58][59].…”

Section: Hospital Settingmentioning

confidence: 99%

Intestinal colonization with multidrug-resistant Enterobacterales: screening, epidemiology, clinical impact, and strategies to decolonize carriers

Campos-Madueno

Moradi

Eddoubaji

et al. 2023

Eur J Clin Microbiol Infect Dis

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The clinical impact of infections due to extended-spectrum β-lactamase (ESBL)- and/or carbapenemase-producing Enterobacterales (Ent) has reached dramatic levels worldwide. Infections due to these multidrug-resistant (MDR) pathogens—especially Escherichia coli and Klebsiella pneumoniae—may originate from a prior asymptomatic intestinal colonization that could also favor transmission to other subjects. It is therefore desirable that gut carriers are rapidly identified to try preventing both the occurrence of serious endogenous infections and potential transmission. Together with the infection prevention and control countermeasures, any strategy capable of effectively eradicating the MDR-Ent from the intestinal tract would be desirable. In this narrative review, we present a summary of the different aspects linked to the intestinal colonization due to MDR-Ent. In particular, culture- and molecular-based screening techniques to identify carriers, data on prevalence and risk factors in different populations, clinical impact, length of colonization, and contribution to transmission in various settings will be overviewed. We will also discuss the standard strategies (selective digestive decontamination, fecal microbiota transplant) and those still in development (bacteriophages, probiotics, microcins, and CRISPR-Cas-based) that might be used to decolonize MDR-Ent carriers.

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“…The description of acute kidney injury has been developed in several steps, and KDIGO has distinct AKI that meets one or more of the subsequent three criteria's: 48-hour rise in serum creatinine over 0.3 mg / dL, serum creatinine 1. 5 times higher of the baseline in 7 days, the urine output decreased to 0.5 ml / kg / h in less than six hours [7][8] . This is the newest and maximum applied AKI criterion and we appliedthis criterion to define AKI in this research.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury is A Risk Factor among Type 2 Diabetic Patients after UTI due to Extended-Spectrum Beta-Lactamase Producing Organisms

Samin¹,

Malik²,

Sadiq³

et al. 2021

PJMHS

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Background: Urinary tract infections (UTIs) are very communal, and patients with diabetics develop UTIs more frequently. Acute kidney injury (AKI) can be a complication of UTI. This study is designed to determine whether Urinary tract infections because of extended-spectrum beta-lactamase (ESBL) could be a risk factor of acute kidney injury in individuals with type-II diabetes mellitus. Methods: This case study was conducted in the Outpatient department of Diabetes Hospital Peshawar and Nishter Hospital Multan for duration of six months from August 2020 to January 2021. People of type II diabetes were assessed with culture confirmed UTI. The cases of UTI patients complicated with AKI were included in the study group, and people without AKI were taken as a control group. ESBLs positivity from isolated organisms have been assessed as risk factors for AKI. A total of 140 subjects were selected with equal distribution in two groups. The group A has UTI complicated with AKI and group B included has patients without AKI but with UTI. Results: UTI was diagnosed in 140 cases among type-II diabetic patients with 2:4 male to female ratio. The duration and mean age of diabetes mellitus were 8.60±5.35and55.80±14.10 years, correspondingly. The strongest common etiological factor was Escherichia coli (60.7%), trailed by Klebsiella pneumoniae (11.4%). In ESBL positive organism; E. coli was present in 81.4% and K. pneumoniae in 10% of individuals. Of the 140 UTI cases, AKI was observed in 70 (50%); out of which 48 (62.5%) were ESBL-positive microorganisms and 22 (22/70, 31.43%) for non-ESBL microorganisms. Conclusions: Nearly50% of the patients with type-II diabetes mellitus and UTI had ESBL-positive microorganisms as etiological mediators in this analysis. Owing to the presence of ESBL-positive microorganisms, UTI was the main cause of AKI and is a strong risk factor. Keywords: ESBL, Acute kidney injury, UTI, type 2 diabetes, risk factor.

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Risk factors for fecal carriage of extended-spectrum beta-lactamase-producing and carbapenem-resistant Escherichia coli and Klebsiella pneumoniae strains among patients at hospital admission

Cited by 16 publications

References 34 publications

Comparison of the global prevalence and trend of human intestinal carriage of ESBL-producing Escherichia coli between healthcare and community settings: a systematic review and meta-analysis

Comparison of the global prevalence and trend of human intestinal carriage of ESBL-producing Escherichia coli between healthcare and community settings: a systematic review and meta-analysis

Intestinal colonization with multidrug-resistant Enterobacterales: screening, epidemiology, clinical impact, and strategies to decolonize carriers

Acute Kidney Injury is A Risk Factor among Type 2 Diabetic Patients after UTI due to Extended-Spectrum Beta-Lactamase Producing Organisms

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