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Intestinal Colonization by Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae in Infants.
Rev Invest Clin. 2015 Sep-Oct; 67(5):313-7.RI

Abstract

BACKGROUND

Members of the Enterobacteriaceae family are common agents of nosocomial infections. Intestinal colonization by these microorganisms represents a major step in the development of systemic infection. Extended-spectrum b-lactamase-producing bacteria are usually associated with outbreaks, but endemic infections are common in intensive care units.

OBJECTIVE

To determine the frequency of intestinal colonization with extended-spectrum b-lactamase-producing Enterobacteriaceae in newborns.

PATIENTS AND METHODS

This was a descriptive cohort study. Newborns from two general hospitals (A and B) in Mexico City were included during a five-month period; those with a hospital stay > 7 days were selected. Fecal samples were obtained by rectal swab on day 7 and every week until discharge. Extended-spectrum b-lactamase production was confirmed in enterobacteria by the Etest. Clonal relatedness was established by pulsed-field gel electrophoresis.

RESULTS

102 newborns were included; 63/102 (61.7%) were colonized by extended-spectrum b-lactamase-producing Enterobacteriaceae on day 7, 17/21 (81%) on day 14, and 6/8 (75%) on day 21 of hospitalization. Klebsiella pneumoniae was recovered most frequently (75.4%). A predominant clone (95%) was found in hospital B, and a major clone (75%) in Hospital A. Other extended-spectrum b-lactamase-producing Enterobacteriaceae isolates were Enterobacter spp. (16%) and Escherichia coli (7.6%).

CONCLUSIONS

High rates of colonization and horizontal transmission of extended-spectrum b-lactamase-producing Enterobacteriaceae were found in the newborn care units of two general hospitals. Clonal relatedness was identified. Lack of adherence to standard precautions and hand hygiene were determining factors.

Authors+Show Affiliations

Department of Infectious Diseases, Hospital de Pediatría, Centro Medico Nacional Siglo XXI, IMSS, México D.F, México.Medical Research Unit in Hospital Epidemiology, Coordinación de Investigación en Salud, IMSS, México D.F, México.Coordinación de Unidades Medicas de Alta Especialidad, IMSS, México D.F, México.Department of Infectious Diseases, Hospital de Pediatría, Centro Medico Nacional Siglo XXI, IMSS, México D.F, México.Department of Infectious Diseases, Hospital de Pediatría, Centro Medico Nacional Siglo XXI, IMSS, México D.F, México.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

26696335

Citation

Huerta-García, Gloria Concepción, et al. "Intestinal Colonization By Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae in Infants." Revista De Investigacion Clinica; Organo Del Hospital De Enfermedades De La Nutricion, vol. 67, no. 5, 2015, pp. 313-7.
Huerta-García GC, Miranda-Novales G, Díaz-Ramos R, et al. Intestinal Colonization by Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae in Infants. Rev Invest Clin. 2015;67(5):313-7.
Huerta-García, G. C., Miranda-Novales, G., Díaz-Ramos, R., Vázquez-Rosales, G., & Solórzano-Santos, F. (2015). Intestinal Colonization by Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae in Infants. Revista De Investigacion Clinica; Organo Del Hospital De Enfermedades De La Nutricion, 67(5), 313-7.
Huerta-García GC, et al. Intestinal Colonization By Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae in Infants. Rev Invest Clin. 2015 Sep-Oct;67(5):313-7. PubMed PMID: 26696335.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intestinal Colonization by Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae in Infants. AU - Huerta-García,Gloria Concepción, AU - Miranda-Novales,Guadalupe, AU - Díaz-Ramos,Rita, AU - Vázquez-Rosales,Guillermo, AU - Solórzano-Santos,Fortino, PY - 2015/12/24/entrez PY - 2015/12/24/pubmed PY - 2015/12/24/medline SP - 313 EP - 7 JF - Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion JO - Rev. Invest. Clin. VL - 67 IS - 5 N2 - BACKGROUND: Members of the Enterobacteriaceae family are common agents of nosocomial infections. Intestinal colonization by these microorganisms represents a major step in the development of systemic infection. Extended-spectrum b-lactamase-producing bacteria are usually associated with outbreaks, but endemic infections are common in intensive care units. OBJECTIVE: To determine the frequency of intestinal colonization with extended-spectrum b-lactamase-producing Enterobacteriaceae in newborns. PATIENTS AND METHODS: This was a descriptive cohort study. Newborns from two general hospitals (A and B) in Mexico City were included during a five-month period; those with a hospital stay > 7 days were selected. Fecal samples were obtained by rectal swab on day 7 and every week until discharge. Extended-spectrum b-lactamase production was confirmed in enterobacteria by the Etest. Clonal relatedness was established by pulsed-field gel electrophoresis. RESULTS: 102 newborns were included; 63/102 (61.7%) were colonized by extended-spectrum b-lactamase-producing Enterobacteriaceae on day 7, 17/21 (81%) on day 14, and 6/8 (75%) on day 21 of hospitalization. Klebsiella pneumoniae was recovered most frequently (75.4%). A predominant clone (95%) was found in hospital B, and a major clone (75%) in Hospital A. Other extended-spectrum b-lactamase-producing Enterobacteriaceae isolates were Enterobacter spp. (16%) and Escherichia coli (7.6%). CONCLUSIONS: High rates of colonization and horizontal transmission of extended-spectrum b-lactamase-producing Enterobacteriaceae were found in the newborn care units of two general hospitals. Clonal relatedness was identified. Lack of adherence to standard precautions and hand hygiene were determining factors. SN - 0034-8376 UR - https://www.unboundmedicine.com/medline/citation/26696335/Intestinal_Colonization_by_Extended_Spectrum_Beta_Lactamase_Producing_Enterobacteriaceae_in_Infants_ L2 - http://clinicalandtranslationalinvestigation.com/abstract.php?id=62 DB - PRIME DP - Unbound Medicine ER -