Tags

Type your tag names separated by a space and hit enter

Orally administered colistin leads to colistin-resistant intestinal flora and fails to prevent faecal colonisation with extended-spectrum β-lactamase-producing enterobacteria in hospitalised newborns.
Int J Antimicrob Agents. 2011 Jan; 37(1):67-9.IJ

Abstract

Colonisation and infection with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) is an emerging problem. The aim of this study was to investigate whether colistin, which is reported to be effective against multiresistant enterobacteria, prevents ESBL-E colonisation in neonates. For prophylaxis of necrotising enterocolitis, oral gentamicin (15 mg/kg/day) is routinely used in all neonates hospitalised at the Neonatal Intensive Care Unit of University Hospital Graz (Austria). During the study period from May 2005 to September 2007, three ESBL-E outbreaks (total duration 18 months) occurred. During these outbreaks, gentamicin was immediately replaced by oral colistin (8 mg/kg/day) in all hospitalised neonates. All neonates colonised with ESBL-E during the study period were retrospectively analysed with regard to the influence of colistin on ESBL-E colonisation. Genetic relatedness of isolates was assessed by repetitive sequence-based polymerase chain reaction (rep-PCR). During the study period, 30 (4.5%) of 667 neonates were colonised with ESBL-E. Twelve of twenty-one patients colonised with Klebsiella pneumoniae (ESBL-Kp) and one of nine patients colonised with Klebsiella oxytoca (ESBL-Ko) had received oral colistin at time of colonisation with ESBL-E. Amongst ESBL-Kp, the rate of colistin resistance was significantly higher in the colistin group (P=0.0075). Four different clones of ESBL-Kp and three different clones of ESBL-Ko were isolated, indicating the occurrence of patient-to-patient transmission. Colistin-resistant as well as colistin-susceptible isolates were detected within the same clones, indicating induction of resistance. At the dosage used, oral colistin did not prevent colonisation with ESBL-E and appeared to select colistin-resistant strains or to induce colistin resistance.

Authors+Show Affiliations

Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 30, A-8036 Graz, Austria. volker.strenger@medunigraz.atNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21074372

Citation

Strenger, Volker, et al. "Orally Administered Colistin Leads to Colistin-resistant Intestinal Flora and Fails to Prevent Faecal Colonisation With Extended-spectrum Β-lactamase-producing Enterobacteria in Hospitalised Newborns." International Journal of Antimicrobial Agents, vol. 37, no. 1, 2011, pp. 67-9.
Strenger V, Gschliesser T, Grisold A, et al. Orally administered colistin leads to colistin-resistant intestinal flora and fails to prevent faecal colonisation with extended-spectrum β-lactamase-producing enterobacteria in hospitalised newborns. Int J Antimicrob Agents. 2011;37(1):67-9.
Strenger, V., Gschliesser, T., Grisold, A., Zarfel, G., Feierl, G., Masoud, L., Hoenigl, M., Resch, B., Müller, W., & Urlesberger, B. (2011). Orally administered colistin leads to colistin-resistant intestinal flora and fails to prevent faecal colonisation with extended-spectrum β-lactamase-producing enterobacteria in hospitalised newborns. International Journal of Antimicrobial Agents, 37(1), 67-9. https://doi.org/10.1016/j.ijantimicag.2010.09.010
Strenger V, et al. Orally Administered Colistin Leads to Colistin-resistant Intestinal Flora and Fails to Prevent Faecal Colonisation With Extended-spectrum Β-lactamase-producing Enterobacteria in Hospitalised Newborns. Int J Antimicrob Agents. 2011;37(1):67-9. PubMed PMID: 21074372.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Orally administered colistin leads to colistin-resistant intestinal flora and fails to prevent faecal colonisation with extended-spectrum β-lactamase-producing enterobacteria in hospitalised newborns. AU - Strenger,Volker, AU - Gschliesser,Tanja, AU - Grisold,Andrea, AU - Zarfel,Gernot, AU - Feierl,Gebhard, AU - Masoud,Lilian, AU - Hoenigl,Martin, AU - Resch,Bernhard, AU - Müller,Wilhelm, AU - Urlesberger,Berndt, Y1 - 2010/11/11/ PY - 2010/06/15/received PY - 2010/08/28/revised PY - 2010/09/17/accepted PY - 2010/11/16/entrez PY - 2010/11/16/pubmed PY - 2011/3/29/medline SP - 67 EP - 9 JF - International journal of antimicrobial agents JO - Int. J. Antimicrob. Agents VL - 37 IS - 1 N2 - Colonisation and infection with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) is an emerging problem. The aim of this study was to investigate whether colistin, which is reported to be effective against multiresistant enterobacteria, prevents ESBL-E colonisation in neonates. For prophylaxis of necrotising enterocolitis, oral gentamicin (15 mg/kg/day) is routinely used in all neonates hospitalised at the Neonatal Intensive Care Unit of University Hospital Graz (Austria). During the study period from May 2005 to September 2007, three ESBL-E outbreaks (total duration 18 months) occurred. During these outbreaks, gentamicin was immediately replaced by oral colistin (8 mg/kg/day) in all hospitalised neonates. All neonates colonised with ESBL-E during the study period were retrospectively analysed with regard to the influence of colistin on ESBL-E colonisation. Genetic relatedness of isolates was assessed by repetitive sequence-based polymerase chain reaction (rep-PCR). During the study period, 30 (4.5%) of 667 neonates were colonised with ESBL-E. Twelve of twenty-one patients colonised with Klebsiella pneumoniae (ESBL-Kp) and one of nine patients colonised with Klebsiella oxytoca (ESBL-Ko) had received oral colistin at time of colonisation with ESBL-E. Amongst ESBL-Kp, the rate of colistin resistance was significantly higher in the colistin group (P=0.0075). Four different clones of ESBL-Kp and three different clones of ESBL-Ko were isolated, indicating the occurrence of patient-to-patient transmission. Colistin-resistant as well as colistin-susceptible isolates were detected within the same clones, indicating induction of resistance. At the dosage used, oral colistin did not prevent colonisation with ESBL-E and appeared to select colistin-resistant strains or to induce colistin resistance. SN - 1872-7913 UR - https://www.unboundmedicine.com/medline/citation/21074372/Orally_administered_colistin_leads_to_colistin_resistant_intestinal_flora_and_fails_to_prevent_faecal_colonisation_with_extended_spectrum_β_lactamase_producing_enterobacteria_in_hospitalised_newborns_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0924-8579(10)00433-4 DB - PRIME DP - Unbound Medicine ER -