Two-year prospective evaluation of colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae: time course and risk factors

Papst, Lea; Beović, Bojana; Seme, Katja; Pirš, Mateja

doi:10.3109/23744235.2015.1033003

Cited by 13 publications

(25 citation statements)

References 26 publications

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“…In accordance with the carriage studies mentioned above (112,113), we did not find antimicrobial consumption to be correlated with prolonged colonisation. However, there are several studies observing association between previous antimicrobial use and infection with ESBL-E (98,114), and a recent study from the Netherlands also found such a correlation in ESBL-E carriers recruited from a primary health care setting (115).…”

Section: Duration Of Faecal Esbl-e Carriage and Risk Factors For Prolsupporting

confidence: 92%

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High prevalence of faecal carriage of ESBL-producing Enterobacteriaceae in Norwegian patients with gastroenteritis

Jørgensen

Samuelsen

Sundsfjord

et al. 2014

Scandinavian Journal of Infectious Diseases

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We conducted a cross-sectional study to examine the prevalence of faecal carriage of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in patients with gastroenteritis. During April 2011, all faecal samples submitted to our hospital laboratory were examined for ESBL-producing Enterobacteriaceae. Isolates expressing an ESBL phenotype were investigated for the presence of genes encoding broad-spectrum beta-lactamases, ESBLs, carbapenemases, and plasmid-mediated AmpC. Information on age, gender, and travel history was extracted from the laboratory records. In total 273 faecal samples were included. The overall carrier rate in the study population was 15.8%. The ESBL carrier rate among patients with no history of recent travel, or where this information was missing, was 10.3%. In contrast, the carrier rate was 56.3% (odds ratio 16.3, p < 0.001) among patients with a record of travel to Asia. Two ESBL-producing isolates were identified as enteropathogenic Escherichia coli. Co-resistance between third-generation cephalosporins, trimethoprim-sulfamethoxazole, and fluoroquinolones was seen in 49% of isolates. No carbapenemase-producers were found.

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Section: Duration Of Faecal Esbl-e Carriage and Risk Factors For Prolsupporting

confidence: 92%

“…The carriage clearance rates we observed were comparable to studies from Sweden (112) and Slovenia (113). We also confirmed the findings from the Swedish study that phylogroup B2, and in our case also phylogroup D, were associated with prolonged carriage.…”

Section: Duration Of Faecal Esbl-e Carriage and Risk Factors For Prolsupporting

confidence: 92%

High prevalence of faecal carriage of ESBL-producing Enterobacteriaceae in Norwegian patients with gastroenteritis

Jørgensen

Samuelsen

Sundsfjord

et al. 2014

Scandinavian Journal of Infectious Diseases

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“…Our major contributors to phylogroups B2/D are ST131 (n = 33) and ST38 (n = 13). In a previous study, ST131 has been associated with prolonged carriage in a cohort of long term health care facility residents [18], while other studies, like the present, do not find this correlation [15,17]. Our observation support the notion that also other strains than ST131 have potential to colonise the human intestine for a long time.…”

Section: Discussionsupporting

confidence: 82%

“…However, they identify different risk factors for prolonged carriage, such as urinary catheter use [16], immobility [17], infection with E . coli strains belonging to phylogroup B2 (which includes ST131) [15,18] and CTX-M group 1 enzymes [15].…”

Section: Introductionmentioning

confidence: 99%

Fecal carriage of extended spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae after urinary tract infection – A three year prospective cohort study

et al. 2017

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We have performed a prospective cohort study to investigate the duration of and risk factors for prolonged fecal carriage of ESBL-producing Escherichia coli or Klebsiella pneumoniae in patients with community acquired urinary tract infection caused by these bacteria. From 2009 to 2011, 101 Norwegian patients were recruited. Stool swabs and questionnaires were collected every three months for one year and at the end of the study in 2012. Information on antibiotic prescriptions was collected from the Norwegian Prescription Database. Stool samples were cultured directly on ChromID ESBL agar as well as in an enrichment broth, and culture positive isolates were examined by blaCTX-M multiplex PCR. Isolates without blaCTX-M were investigated for alternative ESBL-determinants with a commercial microarray system. Time to fecal clearance of ESBL producing Enterobacteriaceae was also analysed using Kaplan-Meier estimates. Uni- and multivariate logistic regression was used to compare groups according to previously described risk factors. The ESBL point prevalence of fecal carriage were 61% at 4 months, 56% at 7 months, 48% at 10 months, 39% at 13 months, 19% after two years, and 15% after three years or more. We found no correlation between duration of carriage, comorbidity, antibiotic use or travel to ESBL high-prevalence countries. Prolonged carriage was associated with E. coli isolates of phylogroup B2 or D. Importantly, comparative MLST and MLVA analyses of individual paired urine and fecal E. coli isolates revealed that ESBL production commonly occurred in diverse strains within the same host. When investigating cross-transmission of ESBL producing bacteria in health care institutions, this notion should be taken into account.

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“…It is commonly regarded that in addition to the aforementioned risk factors, outcomes such as length of hospital stay, cost, and death are all adversely affected by MDRO infections, particularly when empiric therapy is not appropriate for pathogen susceptibility. Identified risk factors for MDRO infections include colonization, states of immune compromise (e.g., hemodialysis and transplant recipients), previous antibiotic exposure ranging from three to six months pre-infection, previous hospitalization, and admission from long-term-care facilities [10][11][12][13][14]. The epidemiology behind MDRO infections in both combat-and noncombat-related trauma is poorly understood, given the challenges behind patient enrollment and study design.…”

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confidence: 99%

Multi-Drug–Resistant Gram-Negative Infections in Deployment-Related Trauma Patients

Campbell

Whitman

et al. 2017

Surgical Infections

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Two-year prospective evaluation of colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae: time course and risk factors

Abstract: We found that prolonged colonization with EPE was common, especially in bedridden patients. Transient negative samples were often observed during the course of colonization. In some patients, urine can be the only positive site from which EPE are isolated.

Cited by 13 publications

References 26 publications

High prevalence of faecal carriage of ESBL-producing Enterobacteriaceae in Norwegian patients with gastroenteritis

High prevalence of faecal carriage of ESBL-producing Enterobacteriaceae in Norwegian patients with gastroenteritis

Fecal carriage of extended spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae after urinary tract infection – A three year prospective cohort study

Multi-Drug–Resistant Gram-Negative Infections in Deployment-Related Trauma Patients

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