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Risk factors for extended-spectrum beta-lactamase-producing Serratia marcescens and Klebsiella pneumoniae acquisition in a neonatal intensive care unit.
J Hosp Infect. 2007 Oct; 67(2):135-41.JH

Abstract

We investigated the molecular epidemiology of gentamicin-resistant, extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae and Serratia marcescens, and risk factors associated with their acquisition in a neonatal intensive care unit (NICU) of a university hospital in Italy. During the study period (April-November 2004), S. marcescens was responsible for six infections and 31 colonisations, while K. pneumoniae was responsible for six infections and 103 colonisations. Concurrent isolation of both organisms occurred in 24 neonates. Molecular typing identified one major pulsed-field gel electrophoresis pattern each for S. marcescens and K. pneumoniae strains isolated during the study period. An 80 kb plasmid containing bla(SHV-12), bla(TEM-1) and aac(6')-Ib genes, isolated from both S. marcescens and K. pneumoniae strains, and showing identical restriction profiles, transferred resistance to third-generation cephalosporins to a previously susceptible Escherichia coli host. Birthweight, gestational age and use of invasive devices were significantly associated with S. marcescens and K. pneumoniae acquisition on univariate analysis, while empiric antimicrobial treatment with ampicillin and gentamicin, and duration of hospital stay, proved to be the only independent risk factors. In conclusion, conjugal plasmid transfer and empiric antimicrobial therapy with ampicillin and gentamicin might have contributed to the selection and spread of gentamicin-resistant ESBL-producing Enterobacteriaceae in the NICU.

Authors+Show Affiliations

Department of Preventive Medical Sciences, Hygiene Section, University Federico II, Naples, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17884248

Citation

Crivaro, V, et al. "Risk Factors for Extended-spectrum Beta-lactamase-producing Serratia Marcescens and Klebsiella Pneumoniae Acquisition in a Neonatal Intensive Care Unit." The Journal of Hospital Infection, vol. 67, no. 2, 2007, pp. 135-41.
Crivaro V, Bagattini M, Salza MF, et al. Risk factors for extended-spectrum beta-lactamase-producing Serratia marcescens and Klebsiella pneumoniae acquisition in a neonatal intensive care unit. J Hosp Infect. 2007;67(2):135-41.
Crivaro, V., Bagattini, M., Salza, M. F., Raimondi, F., Rossano, F., Triassi, M., & Zarrilli, R. (2007). Risk factors for extended-spectrum beta-lactamase-producing Serratia marcescens and Klebsiella pneumoniae acquisition in a neonatal intensive care unit. The Journal of Hospital Infection, 67(2), 135-41.
Crivaro V, et al. Risk Factors for Extended-spectrum Beta-lactamase-producing Serratia Marcescens and Klebsiella Pneumoniae Acquisition in a Neonatal Intensive Care Unit. J Hosp Infect. 2007;67(2):135-41. PubMed PMID: 17884248.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for extended-spectrum beta-lactamase-producing Serratia marcescens and Klebsiella pneumoniae acquisition in a neonatal intensive care unit. AU - Crivaro,V, AU - Bagattini,M, AU - Salza,M F, AU - Raimondi,F, AU - Rossano,F, AU - Triassi,M, AU - Zarrilli,R, Y1 - 2007/09/19/ PY - 2007/05/31/received PY - 2007/07/26/accepted PY - 2007/9/22/pubmed PY - 2008/1/16/medline PY - 2007/9/22/entrez SP - 135 EP - 41 JF - The Journal of hospital infection JO - J. Hosp. Infect. VL - 67 IS - 2 N2 - We investigated the molecular epidemiology of gentamicin-resistant, extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae and Serratia marcescens, and risk factors associated with their acquisition in a neonatal intensive care unit (NICU) of a university hospital in Italy. During the study period (April-November 2004), S. marcescens was responsible for six infections and 31 colonisations, while K. pneumoniae was responsible for six infections and 103 colonisations. Concurrent isolation of both organisms occurred in 24 neonates. Molecular typing identified one major pulsed-field gel electrophoresis pattern each for S. marcescens and K. pneumoniae strains isolated during the study period. An 80 kb plasmid containing bla(SHV-12), bla(TEM-1) and aac(6')-Ib genes, isolated from both S. marcescens and K. pneumoniae strains, and showing identical restriction profiles, transferred resistance to third-generation cephalosporins to a previously susceptible Escherichia coli host. Birthweight, gestational age and use of invasive devices were significantly associated with S. marcescens and K. pneumoniae acquisition on univariate analysis, while empiric antimicrobial treatment with ampicillin and gentamicin, and duration of hospital stay, proved to be the only independent risk factors. In conclusion, conjugal plasmid transfer and empiric antimicrobial therapy with ampicillin and gentamicin might have contributed to the selection and spread of gentamicin-resistant ESBL-producing Enterobacteriaceae in the NICU. SN - 0195-6701 UR - https://www.unboundmedicine.com/medline/citation/17884248/Risk_factors_for_extended_spectrum_beta_lactamase_producing_Serratia_marcescens_and_Klebsiella_pneumoniae_acquisition_in_a_neonatal_intensive_care_unit_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0195-6701(07)00265-4 DB - PRIME DP - Unbound Medicine ER -