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Fecal carriage and intrafamilial spread of extended-spectrum β-lactamase-producing enterobacteriaceae following colonization at the neonatal ICU.
Pediatr Crit Care Med. 2013 Feb; 14(2):157-63.PC

Abstract

OBJECTIVE

Fecal carriage of extended-spectrum β-lactamase-producing enterobacteriaceae may contribute to the spread of extended-spectrum β-lactamase-producing enterobacteriaceae into the community. The objective of this study was to assess the duration of fecal carriage after discharge and the occurrence of intrafamilial transmission.

DESIGN

Case series.

SETTING

Quaternary care children's hospital.

PATIENTS

Patients colonized with extended-spectrum β-lactamase-producing enterobacteriaceae at the neonatal ICU and the respective household members.

INTERVENTIONS

Screening for intestinal extended-spectrum β-lactamase-producing enterobacteriaceae colonization was done at 1, 2, 4, 6, 9, and 12 months after discharge. Genetic relatedness of isolated extended-spectrum β-lactamase-producing enterobacteriaceae strains was determined using automated rep-PCR.

RESULTS

Twenty-five neonates (case-patients) colonized with extended-spectrum β-lactamase-producing enterobacteriaceae (one extended-spectrum β-lactamase-Escherichia coli; six extended-spectrum β-lactamase-Klebsiella pneumoniae; 11 extended-spectrum β-lactamase-Klebsiella oxytoca; and seven extended-spectrum β-lactamase-Serratia marcescens) were included. Duration of fecal carriage was longer (up to 1 yr) in case-patients colonized with Klebsiella species than in case-patients colonized with Serratia marcescens (<4 months). During follow-up, strains and species of extended-spectrum β-lactamase-producing enterobacteriaceae different from the primary strain were found in four and three case-patients, respectively. In nine of 49 (18.4%) included household members, extended-spectrum β-lactamase-producing enterobacteriaceae were found during the follow-up period. In two of nine colonized household members, the isolated extended-spectrum β-lactamase-producing enterobacteriaceae was identical to the primary strains of the respective case-patients.

CONCLUSIONS

After intestinal colonization with extended-spectrum β-lactamase-producing enterobacteriaceae at the neonatal ICU, infants potentially remain carriers during the first year after discharge. Intrafamilial spread has been proven.

Authors+Show Affiliations

Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 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 availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23254982

Citation

Strenger, Volker, et al. "Fecal Carriage and Intrafamilial Spread of Extended-spectrum Β-lactamase-producing Enterobacteriaceae Following Colonization at the Neonatal ICU." Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, vol. 14, no. 2, 2013, pp. 157-63.
Strenger V, Feierl G, Resch B, et al. Fecal carriage and intrafamilial spread of extended-spectrum β-lactamase-producing enterobacteriaceae following colonization at the neonatal ICU. Pediatr Crit Care Med. 2013;14(2):157-63.
Strenger, V., Feierl, G., Resch, B., Zarfel, G., Grisold, A., Masoud-Landgraf, L., Dosch, V., Riedl, R., Zenz, W., Müller, W., & Urlesberger, B. (2013). Fecal carriage and intrafamilial spread of extended-spectrum β-lactamase-producing enterobacteriaceae following colonization at the neonatal ICU. Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 14(2), 157-63. https://doi.org/10.1097/PCC.0b013e31824ea2a2
Strenger V, et al. Fecal Carriage and Intrafamilial Spread of Extended-spectrum Β-lactamase-producing Enterobacteriaceae Following Colonization at the Neonatal ICU. Pediatr Crit Care Med. 2013;14(2):157-63. PubMed PMID: 23254982.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fecal carriage and intrafamilial spread of extended-spectrum β-lactamase-producing enterobacteriaceae following colonization at the neonatal ICU. AU - Strenger,Volker, AU - Feierl,Gebhard, AU - Resch,Bernhard, AU - Zarfel,Gernot, AU - Grisold,Andrea, AU - Masoud-Landgraf,Lilian, AU - Dosch,Verena, AU - Riedl,Regina, AU - Zenz,Werner, AU - Müller,Wilhelm, AU - Urlesberger,Berndt, PY - 2012/12/21/entrez PY - 2012/12/21/pubmed PY - 2013/9/17/medline SP - 157 EP - 63 JF - Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies JO - Pediatr Crit Care Med VL - 14 IS - 2 N2 - OBJECTIVE: Fecal carriage of extended-spectrum β-lactamase-producing enterobacteriaceae may contribute to the spread of extended-spectrum β-lactamase-producing enterobacteriaceae into the community. The objective of this study was to assess the duration of fecal carriage after discharge and the occurrence of intrafamilial transmission. DESIGN: Case series. SETTING: Quaternary care children's hospital. PATIENTS: Patients colonized with extended-spectrum β-lactamase-producing enterobacteriaceae at the neonatal ICU and the respective household members. INTERVENTIONS: Screening for intestinal extended-spectrum β-lactamase-producing enterobacteriaceae colonization was done at 1, 2, 4, 6, 9, and 12 months after discharge. Genetic relatedness of isolated extended-spectrum β-lactamase-producing enterobacteriaceae strains was determined using automated rep-PCR. RESULTS: Twenty-five neonates (case-patients) colonized with extended-spectrum β-lactamase-producing enterobacteriaceae (one extended-spectrum β-lactamase-Escherichia coli; six extended-spectrum β-lactamase-Klebsiella pneumoniae; 11 extended-spectrum β-lactamase-Klebsiella oxytoca; and seven extended-spectrum β-lactamase-Serratia marcescens) were included. Duration of fecal carriage was longer (up to 1 yr) in case-patients colonized with Klebsiella species than in case-patients colonized with Serratia marcescens (<4 months). During follow-up, strains and species of extended-spectrum β-lactamase-producing enterobacteriaceae different from the primary strain were found in four and three case-patients, respectively. In nine of 49 (18.4%) included household members, extended-spectrum β-lactamase-producing enterobacteriaceae were found during the follow-up period. In two of nine colonized household members, the isolated extended-spectrum β-lactamase-producing enterobacteriaceae was identical to the primary strains of the respective case-patients. CONCLUSIONS: After intestinal colonization with extended-spectrum β-lactamase-producing enterobacteriaceae at the neonatal ICU, infants potentially remain carriers during the first year after discharge. Intrafamilial spread has been proven. SN - 1529-7535 UR - https://www.unboundmedicine.com/medline/citation/23254982/Fecal_carriage_and_intrafamilial_spread_of_extended_spectrum_β_lactamase_producing_enterobacteriaceae_following_colonization_at_the_neonatal_ICU_ L2 - http://dx.doi.org/10.1097/PCC.0b013e31824ea2a2 DB - PRIME DP - Unbound Medicine ER -