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Comparison of rates of fecal colonization with extended-spectrum beta-lactamase-producing enterobacteria among patients in different wards, outpatients and medical students.
Microbiol Immunol. 2016 May; 60(5):285-94.MI

Abstract

Because asymptomatic carriage of extended-spectrum beta-lactamase (ESBL) producers is a risk factor for infection, data on colonization dynamics are important when planning infection control. This study investigated fecal colonization with ESBL producers among inpatients, outpatients and medical students and compares the characteristics of ESBL producers among these groups. Carriage rates were investigated in 5581 fecal samples; 4343 from inpatients (330, 1397, 619 and 1864 from adult ICUs [intensive care units], adult non-ICUs, pediatric ICUs and pediatric non-ICUs, respectively), 814 from outpatients and 424 from screening of medical students. ESBL producers were characterized by co-resistance, integrons carried, and aminoglycoside resistance and ESBL genes. Dynamic regression models were built to identify relationships between combinations of time series of monthly antibiotic consumption, prevalence of carriers and infected subjects. Inpatients, ICU patients and adults showed higher prevalence than outpatients, non-ICU patients or children (7.4%, 9.3% and 12.0% vs. 3.1%, 6.1% and 4.1%, respectively). Klebsiella pneumoniae was more frequent in ICU patients; dominance of CTX-M-15 producers was more marked in adult than in pediatric inpatients. ESBL carriage was shown to be a consequence of infection in adults in the time-series analysis; antibiotic consumption had little effect. The epidemiology of colonization with ESBL producers differed between pediatric ICU, adult ICU and adult non-ICU patients. In adults, carriage of ESBL producers seems to be the consequence of infection, especially in ICU patients; the main source of colonization is nosocomial acquisition. In contrast, children are less likely to acquire colonizer strains in hospitals; importation of ESBL producers by colonized children seems to be significant.

Authors+Show Affiliations

Department of Medical Microbiology, University of Debrecen.Department of Medical Microbiology, University of Debrecen.Department of Medical Microbiology, University of Debrecen.Department of Medical Microbiology, University of Debrecen. Clinical Pharmacy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen Nagyerdei krt.98, Hungary.Department of Medical Microbiology, University of Debrecen. Clinical Pharmacy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen Nagyerdei krt.98, Hungary.Department of Medical Microbiology, University of Debrecen.Department of Medical Microbiology, University of Debrecen.Department of Medical Microbiology, University of Debrecen.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26959958

Citation

Ebrahimi, Fatemeh, et al. "Comparison of Rates of Fecal Colonization With Extended-spectrum Beta-lactamase-producing Enterobacteria Among Patients in Different Wards, Outpatients and Medical Students." Microbiology and Immunology, vol. 60, no. 5, 2016, pp. 285-94.
Ebrahimi F, Mózes J, Monostori J, et al. Comparison of rates of fecal colonization with extended-spectrum beta-lactamase-producing enterobacteria among patients in different wards, outpatients and medical students. Microbiol Immunol. 2016;60(5):285-94.
Ebrahimi, F., Mózes, J., Monostori, J., Gorácz, O., Fésűs, A., Majoros, L., Szarka, K., & Kardos, G. (2016). Comparison of rates of fecal colonization with extended-spectrum beta-lactamase-producing enterobacteria among patients in different wards, outpatients and medical students. Microbiology and Immunology, 60(5), 285-94. https://doi.org/10.1111/1348-0421.12373
Ebrahimi F, et al. Comparison of Rates of Fecal Colonization With Extended-spectrum Beta-lactamase-producing Enterobacteria Among Patients in Different Wards, Outpatients and Medical Students. Microbiol Immunol. 2016;60(5):285-94. PubMed PMID: 26959958.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of rates of fecal colonization with extended-spectrum beta-lactamase-producing enterobacteria among patients in different wards, outpatients and medical students. AU - Ebrahimi,Fatemeh, AU - Mózes,Julianna, AU - Monostori,Júlia, AU - Gorácz,Orsolya, AU - Fésűs,Adina, AU - Majoros,László, AU - Szarka,Krisztina, AU - Kardos,Gábor, PY - 2015/11/13/received PY - 2016/02/22/revised PY - 2016/03/06/accepted PY - 2016/3/10/entrez PY - 2016/3/10/pubmed PY - 2017/3/21/medline KW - antibiotic consumption KW - asymptomatic carriage KW - extended-spectrum beta-lactamase-producing Escherichia coli KW - extended-spectrum beta-lactamase-producing Klebsiella pneumoniae SP - 285 EP - 94 JF - Microbiology and immunology JO - Microbiol. Immunol. VL - 60 IS - 5 N2 - Because asymptomatic carriage of extended-spectrum beta-lactamase (ESBL) producers is a risk factor for infection, data on colonization dynamics are important when planning infection control. This study investigated fecal colonization with ESBL producers among inpatients, outpatients and medical students and compares the characteristics of ESBL producers among these groups. Carriage rates were investigated in 5581 fecal samples; 4343 from inpatients (330, 1397, 619 and 1864 from adult ICUs [intensive care units], adult non-ICUs, pediatric ICUs and pediatric non-ICUs, respectively), 814 from outpatients and 424 from screening of medical students. ESBL producers were characterized by co-resistance, integrons carried, and aminoglycoside resistance and ESBL genes. Dynamic regression models were built to identify relationships between combinations of time series of monthly antibiotic consumption, prevalence of carriers and infected subjects. Inpatients, ICU patients and adults showed higher prevalence than outpatients, non-ICU patients or children (7.4%, 9.3% and 12.0% vs. 3.1%, 6.1% and 4.1%, respectively). Klebsiella pneumoniae was more frequent in ICU patients; dominance of CTX-M-15 producers was more marked in adult than in pediatric inpatients. ESBL carriage was shown to be a consequence of infection in adults in the time-series analysis; antibiotic consumption had little effect. The epidemiology of colonization with ESBL producers differed between pediatric ICU, adult ICU and adult non-ICU patients. In adults, carriage of ESBL producers seems to be the consequence of infection, especially in ICU patients; the main source of colonization is nosocomial acquisition. In contrast, children are less likely to acquire colonizer strains in hospitals; importation of ESBL producers by colonized children seems to be significant. SN - 1348-0421 UR - https://www.unboundmedicine.com/medline/citation/26959958/Comparison_of_rates_of_fecal_colonization_with_extended_spectrum_beta_lactamase_producing_enterobacteria_among_patients_in_different_wards_outpatients_and_medical_students_ L2 - https://doi.org/10.1111/1348-0421.12373 DB - PRIME DP - Unbound Medicine ER -