Tags

Type your tag names separated by a space and hit enter

Detection and characterization of extended-spectrum beta-lactamase-producing Enterobacteriaceae in high-risk patients in an Irish tertiary care hospital.
J Hosp Infect. 2015 Jun; 90(2):102-7.JH

Abstract

BACKGROUND

Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) are Gram-negative, multi-drug-resistant organisms that are of major clinical significance among immunocompromised patients in high-risk areas in hospital settings. In Ireland, the number of ESBL-E bloodstream infections is increasing.

AIMS

To conduct a prevalence study of ESBL-E among immunocompromised patients in high-risk areas [intensive care unit (ICU), liver transplantation and haematology/oncology wards], characterize any ESBL genes detected by polymerase chain reaction (PCR), and perform epidemiological typing using pulsed-field gel electrophoresis (PFGE).

METHODS

In total, 317 non-duplicate rectal swabs from patients in high-risk wards were screened anonymously for ESBL-E carriage. Positive isolates were characterized using PCR to detect blaCTX-M, blaTEM, blaOXA-1 and blaSHV ESBL-E genes. Clonal relationships of these isolates were investigated using PFGE.

FINDINGS

Fifty (15.8%) high-risk patients were found to harbour ESBL-E. Prevalence rates of 21.9% (N = 28), 14.3% (N = 15) and 8.3% (N = 7) of ESBL-E were isolated from patients on the liver transplantation, ICU and haematology/oncology wards, respectively. Seventy percent of ESBL-E isolates carried more than one resistance gene. Of the 25 ESBL-producing Escherichia coli isolates typed by PFGE, two pairs of two isolates demonstrated >80% homology, and four of the five ESBL-producing Enterobacter cloacae isolates typed by PFGE demonstrated >80% homology, suggesting clonal relatedness and potential cross-transmission from individual patients.

CONCLUSION

A significant proportion of the patients screened were found to be colonized with ESBL-E. Typing revealed three incidents of potential cross-infection. Therefore, timely detection of ESBL-E among patients in high-risk wards is critical for treatment and infection control.

Authors+Show Affiliations

Department of Microbiology, St. Vincent's University Hospital and School of Medicine and Medical Science, University College Dublin, Dublin, Ireland. Electronic address: n.o'connell@svuh.ie.Department of Microbiology, St. Vincent's University Hospital and School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.Department of Microbiology, St. Vincent's University Hospital and School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.Department of Microbiology, St. Vincent's University Hospital and School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.

Pub Type(s)

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

Language

eng

PubMed ID

25799484

Citation

O'Connell, N, et al. "Detection and Characterization of Extended-spectrum Beta-lactamase-producing Enterobacteriaceae in High-risk Patients in an Irish Tertiary Care Hospital." The Journal of Hospital Infection, vol. 90, no. 2, 2015, pp. 102-7.
O'Connell N, Keating D, Kavanagh J, et al. Detection and characterization of extended-spectrum beta-lactamase-producing Enterobacteriaceae in high-risk patients in an Irish tertiary care hospital. J Hosp Infect. 2015;90(2):102-7.
O'Connell, N., Keating, D., Kavanagh, J., & Schaffer, K. (2015). Detection and characterization of extended-spectrum beta-lactamase-producing Enterobacteriaceae in high-risk patients in an Irish tertiary care hospital. The Journal of Hospital Infection, 90(2), 102-7. https://doi.org/10.1016/j.jhin.2015.01.018
O'Connell N, et al. Detection and Characterization of Extended-spectrum Beta-lactamase-producing Enterobacteriaceae in High-risk Patients in an Irish Tertiary Care Hospital. J Hosp Infect. 2015;90(2):102-7. PubMed PMID: 25799484.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detection and characterization of extended-spectrum beta-lactamase-producing Enterobacteriaceae in high-risk patients in an Irish tertiary care hospital. AU - O'Connell,N, AU - Keating,D, AU - Kavanagh,J, AU - Schaffer,K, Y1 - 2015/02/21/ PY - 2014/09/12/received PY - 2015/01/12/accepted PY - 2015/3/24/entrez PY - 2015/3/24/pubmed PY - 2016/3/5/medline KW - Bacteria KW - ESBL KW - Hospital KW - ICU KW - Resistance SP - 102 EP - 7 JF - The Journal of hospital infection JO - J. Hosp. Infect. VL - 90 IS - 2 N2 - BACKGROUND: Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) are Gram-negative, multi-drug-resistant organisms that are of major clinical significance among immunocompromised patients in high-risk areas in hospital settings. In Ireland, the number of ESBL-E bloodstream infections is increasing. AIMS: To conduct a prevalence study of ESBL-E among immunocompromised patients in high-risk areas [intensive care unit (ICU), liver transplantation and haematology/oncology wards], characterize any ESBL genes detected by polymerase chain reaction (PCR), and perform epidemiological typing using pulsed-field gel electrophoresis (PFGE). METHODS: In total, 317 non-duplicate rectal swabs from patients in high-risk wards were screened anonymously for ESBL-E carriage. Positive isolates were characterized using PCR to detect blaCTX-M, blaTEM, blaOXA-1 and blaSHV ESBL-E genes. Clonal relationships of these isolates were investigated using PFGE. FINDINGS: Fifty (15.8%) high-risk patients were found to harbour ESBL-E. Prevalence rates of 21.9% (N = 28), 14.3% (N = 15) and 8.3% (N = 7) of ESBL-E were isolated from patients on the liver transplantation, ICU and haematology/oncology wards, respectively. Seventy percent of ESBL-E isolates carried more than one resistance gene. Of the 25 ESBL-producing Escherichia coli isolates typed by PFGE, two pairs of two isolates demonstrated >80% homology, and four of the five ESBL-producing Enterobacter cloacae isolates typed by PFGE demonstrated >80% homology, suggesting clonal relatedness and potential cross-transmission from individual patients. CONCLUSION: A significant proportion of the patients screened were found to be colonized with ESBL-E. Typing revealed three incidents of potential cross-infection. Therefore, timely detection of ESBL-E among patients in high-risk wards is critical for treatment and infection control. SN - 1532-2939 UR - https://www.unboundmedicine.com/medline/citation/25799484/Detection_and_characterization_of_extended_spectrum_beta_lactamase_producing_Enterobacteriaceae_in_high_risk_patients_in_an_Irish_tertiary_care_hospital_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0195-6701(15)00070-5 DB - PRIME DP - Unbound Medicine ER -