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A multinational study of colonization with extended spectrum β-lactamase-producing Enterobacteriaceae in healthcare personnel and family members of carrier patients hospitalized in rehabilitation centres.
Clin Microbiol Infect. 2014 Aug; 20(8):O516-23.CM

Abstract

The study aims were: (i) to define the prevalence of and risk factors for colonization by extended spectrum β-lactamase (ESBL) -producing Enterobacteriaceae (EPE) among healthcare workers (HCWs) and family members (FMs) of EPE-colonized patients in rehabilitation units and (ii) to compare EPE isolates from these three groups. The study included 286 FMs of 194 EPE-carrying patients identified in five rehabilitation units located in Israel, Italy, France and Spain. The EPE were detected in rectal swabs from 26 (9%) of 286 FMs screened. In multivariate analyses, older age of FM, greater mean number of hours spent with the patient, being a daughter or a female spouse of a patient, and chronic lung disease of the patient were significantly associated with carriage in the FM. Escherichia coli was the most common organism (76%), followed by Klebsiella pneumoniae (19%). Isolates were typed by pulsed field gel electrophoresis and multilocus sequence typing, and ESBLs were identified by PCR sequencing. A comparison of paired species isolates from FMs and their respective patient showed that 17 of 23 strains were indistinguishable. EPE were detected in 35 (3.5%, E. coli = 34) of the 1001 HCWs screened. Feeding patients was associated with EPE carriage by HCWs. Only 7 of 23 E. coli subclones cultured from HCWs were also represented among 376 patient-derived ESBL-producing E. coli isolates from the same rehabilitation units. In Spain, a higher proportion of HCWs and FMs were ESBL carriers than elsewhere (p <0.05). In conclusion, the molecular and epidemiological data suggest that FMs are at higher risk of EPE acquisition from their relative patients than HCWs.

Authors+Show Affiliations

Division of Epidemiology, Tel-Aviv Sourasky Medical Centre, Tel-Aviv, Israel.No 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 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 availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24450778

Citation

Adler, A, et al. "A Multinational Study of Colonization With Extended Spectrum Β-lactamase-producing Enterobacteriaceae in Healthcare Personnel and Family Members of Carrier Patients Hospitalized in Rehabilitation Centres." Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, vol. 20, no. 8, 2014, pp. O516-23.
Adler A, Baraniak A, Izdebski R, et al. A multinational study of colonization with extended spectrum β-lactamase-producing Enterobacteriaceae in healthcare personnel and family members of carrier patients hospitalized in rehabilitation centres. Clin Microbiol Infect. 2014;20(8):O516-23.
Adler, A., Baraniak, A., Izdebski, R., Fiett, J., Salvia, A., Samso, J. V., Lawrence, C., Solomon, J., Paul, M., Lerman, Y., Schwartzberg, Y., Mordechai, E., Rossini, A., Fierro, J., Lammens, C., Malhotra-Kumar, S., Goossens, H., Hryniewicz, W., Brun-Buisson, C., ... Carmeli, Y. (2014). A multinational study of colonization with extended spectrum β-lactamase-producing Enterobacteriaceae in healthcare personnel and family members of carrier patients hospitalized in rehabilitation centres. Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 20(8), O516-23. https://doi.org/10.1111/1469-0691.12560
Adler A, et al. A Multinational Study of Colonization With Extended Spectrum Β-lactamase-producing Enterobacteriaceae in Healthcare Personnel and Family Members of Carrier Patients Hospitalized in Rehabilitation Centres. Clin Microbiol Infect. 2014;20(8):O516-23. PubMed PMID: 24450778.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A multinational study of colonization with extended spectrum β-lactamase-producing Enterobacteriaceae in healthcare personnel and family members of carrier patients hospitalized in rehabilitation centres. AU - Adler,A, AU - Baraniak,A, AU - Izdebski,R, AU - Fiett,J, AU - Salvia,A, AU - Samso,J V, AU - Lawrence,C, AU - Solomon,J, AU - Paul,M, AU - Lerman,Y, AU - Schwartzberg,Y, AU - Mordechai,E, AU - Rossini,A, AU - Fierro,J, AU - Lammens,C, AU - Malhotra-Kumar,S, AU - Goossens,H, AU - Hryniewicz,W, AU - Brun-Buisson,C, AU - Gniadkowski,M, AU - Carmeli,Y, AU - ,, Y1 - 2014/03/05/ PY - 2013/08/28/received PY - 2013/12/05/revised PY - 2013/12/15/accepted PY - 2014/1/24/entrez PY - 2014/1/24/pubmed PY - 2015/4/23/medline KW - Carriage KW - extended spectrum β-lactamase KW - family members KW - healthcare workers KW - rehabilitation centres SP - O516 EP - 23 JF - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases JO - Clin. Microbiol. Infect. VL - 20 IS - 8 N2 - The study aims were: (i) to define the prevalence of and risk factors for colonization by extended spectrum β-lactamase (ESBL) -producing Enterobacteriaceae (EPE) among healthcare workers (HCWs) and family members (FMs) of EPE-colonized patients in rehabilitation units and (ii) to compare EPE isolates from these three groups. The study included 286 FMs of 194 EPE-carrying patients identified in five rehabilitation units located in Israel, Italy, France and Spain. The EPE were detected in rectal swabs from 26 (9%) of 286 FMs screened. In multivariate analyses, older age of FM, greater mean number of hours spent with the patient, being a daughter or a female spouse of a patient, and chronic lung disease of the patient were significantly associated with carriage in the FM. Escherichia coli was the most common organism (76%), followed by Klebsiella pneumoniae (19%). Isolates were typed by pulsed field gel electrophoresis and multilocus sequence typing, and ESBLs were identified by PCR sequencing. A comparison of paired species isolates from FMs and their respective patient showed that 17 of 23 strains were indistinguishable. EPE were detected in 35 (3.5%, E. coli = 34) of the 1001 HCWs screened. Feeding patients was associated with EPE carriage by HCWs. Only 7 of 23 E. coli subclones cultured from HCWs were also represented among 376 patient-derived ESBL-producing E. coli isolates from the same rehabilitation units. In Spain, a higher proportion of HCWs and FMs were ESBL carriers than elsewhere (p <0.05). In conclusion, the molecular and epidemiological data suggest that FMs are at higher risk of EPE acquisition from their relative patients than HCWs. SN - 1469-0691 UR - https://www.unboundmedicine.com/medline/citation/24450778/A_multinational_study_of_colonization_with_extended_spectrum_β_lactamase_producing_Enterobacteriaceae_in_healthcare_personnel_and_family_members_of_carrier_patients_hospitalized_in_rehabilitation_centres_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1198-743X(14)60354-2 DB - PRIME DP - Unbound Medicine ER -