Tags

Type your tag names separated by a space and hit enter

Long-term faecal carriage in infants and intra-household transmission of CTX-M-15-producing Klebsiella pneumoniae following a nosocomial outbreak.
J Antimicrob Chemother. 2013 May; 68(5):1043-8.JA

Abstract

OBJECTIVES

To investigate the duration of faecal carriage of CTX-M-15-producing Klebsiella pneumoniae in infants colonized during a nosocomial neonatal intensive care unit (NICU) outbreak after discharge from hospital, possible risk factors for long-term colonization and transmission to household contacts (HCs).

METHODS

Fifty-one infants colonized with two unrelated clones of CTX-M-15 K. pneumoniae [sequence type (ST) 17 and ST485] during an NICU outbreak and 60 HCs provided faecal and rectal samples, respectively, every 1-3 months after hospital discharge. Extended-spectrum β-lactamase (ESBL)-producing strains of K. pneumoniae were identified on Chrom ID ESBL agar and examined by antimicrobial susceptibility testing. blaCTX-M-15 was detected by PCR and DNA sequencing. Clonal relationship was examined by PFGE.

RESULTS

The median carriage time in infants after discharge was 12.5 months (IQR 9.5-17.5). Stable antimicrobial susceptibility patterns in PFGE-related strains confirmed the intestinal persistence of both outbreak strains. Risk factors for prolonged faecal carriage in infants were delivery by caesarean section [hazard ratio (HR) 2.4, 95% CI 1.1-5.5, P = 0.029] and treatment with antibiotics during hospitalization (HR 4.5, 95% CI 1.6-12.6, P = 0.004). Transmission of CTX-M-15 K. pneumoniae was observed in 9/28 (32%) households. Median carriage length in parents was 2.5 months (IQR 1.0-5.0) (P < 0.001 compared with infants).

CONCLUSIONS

Infants may be long-term faecal carriers of ESBL-producing K. pneumoniae after colonization during hospitalization in the neonatal period. Delivery by caesarean section and antibiotic treatment during hospitalization are possible risk factors for prolonged carriage. Faecal ESBL carriage in infants represents a reservoir for intra-household spread of ESBL-producing K. pneumoniae.

Authors+Show Affiliations

Department of Medical Microbiology, Stavanger University Hospital, Stavanger, Norway. iren.hoyland.lohr@sus.noNo 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

23288401

Citation

Löhr, Iren Høyland, et al. "Long-term Faecal Carriage in Infants and Intra-household Transmission of CTX-M-15-producing Klebsiella Pneumoniae Following a Nosocomial Outbreak." The Journal of Antimicrobial Chemotherapy, vol. 68, no. 5, 2013, pp. 1043-8.
Löhr IH, Rettedal S, Natås OB, et al. Long-term faecal carriage in infants and intra-household transmission of CTX-M-15-producing Klebsiella pneumoniae following a nosocomial outbreak. J Antimicrob Chemother. 2013;68(5):1043-8.
Löhr, I. H., Rettedal, S., Natås, O. B., Naseer, U., Oymar, K., & Sundsfjord, A. (2013). Long-term faecal carriage in infants and intra-household transmission of CTX-M-15-producing Klebsiella pneumoniae following a nosocomial outbreak. The Journal of Antimicrobial Chemotherapy, 68(5), 1043-8. https://doi.org/10.1093/jac/dks502
Löhr IH, et al. Long-term Faecal Carriage in Infants and Intra-household Transmission of CTX-M-15-producing Klebsiella Pneumoniae Following a Nosocomial Outbreak. J Antimicrob Chemother. 2013;68(5):1043-8. PubMed PMID: 23288401.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term faecal carriage in infants and intra-household transmission of CTX-M-15-producing Klebsiella pneumoniae following a nosocomial outbreak. AU - Löhr,Iren Høyland, AU - Rettedal,Siren, AU - Natås,Olav B, AU - Naseer,Umaer, AU - Oymar,Knut, AU - Sundsfjord,Arnfinn, Y1 - 2013/01/03/ PY - 2013/1/5/entrez PY - 2013/1/5/pubmed PY - 2013/9/28/medline SP - 1043 EP - 8 JF - The Journal of antimicrobial chemotherapy JO - J. Antimicrob. Chemother. VL - 68 IS - 5 N2 - OBJECTIVES: To investigate the duration of faecal carriage of CTX-M-15-producing Klebsiella pneumoniae in infants colonized during a nosocomial neonatal intensive care unit (NICU) outbreak after discharge from hospital, possible risk factors for long-term colonization and transmission to household contacts (HCs). METHODS: Fifty-one infants colonized with two unrelated clones of CTX-M-15 K. pneumoniae [sequence type (ST) 17 and ST485] during an NICU outbreak and 60 HCs provided faecal and rectal samples, respectively, every 1-3 months after hospital discharge. Extended-spectrum β-lactamase (ESBL)-producing strains of K. pneumoniae were identified on Chrom ID ESBL agar and examined by antimicrobial susceptibility testing. blaCTX-M-15 was detected by PCR and DNA sequencing. Clonal relationship was examined by PFGE. RESULTS: The median carriage time in infants after discharge was 12.5 months (IQR 9.5-17.5). Stable antimicrobial susceptibility patterns in PFGE-related strains confirmed the intestinal persistence of both outbreak strains. Risk factors for prolonged faecal carriage in infants were delivery by caesarean section [hazard ratio (HR) 2.4, 95% CI 1.1-5.5, P = 0.029] and treatment with antibiotics during hospitalization (HR 4.5, 95% CI 1.6-12.6, P = 0.004). Transmission of CTX-M-15 K. pneumoniae was observed in 9/28 (32%) households. Median carriage length in parents was 2.5 months (IQR 1.0-5.0) (P < 0.001 compared with infants). CONCLUSIONS: Infants may be long-term faecal carriers of ESBL-producing K. pneumoniae after colonization during hospitalization in the neonatal period. Delivery by caesarean section and antibiotic treatment during hospitalization are possible risk factors for prolonged carriage. Faecal ESBL carriage in infants represents a reservoir for intra-household spread of ESBL-producing K. pneumoniae. SN - 1460-2091 UR - https://www.unboundmedicine.com/medline/citation/23288401/Long_term_faecal_carriage_in_infants_and_intra_household_transmission_of_CTX_M_15_producing_Klebsiella_pneumoniae_following_a_nosocomial_outbreak_ L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dks502 DB - PRIME DP - Unbound Medicine ER -