Prevalence and Risk Factors for Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Colonization in Intensive Care Units
Annals of Laboratory Medicine
;
: 164-168, 2020.
Article
in English
| WPRIM
| ID: wpr-762470
ABSTRACT
Active surveillance culture (ASC) can help detect hidden reservoirs, but the routine use of ASC for extended spectrum β-lactamase-producing Enterobacteriaceae is controversial in an endemic situation. We aimed to determine the prevalence and risk factors of extended spectrum β-lactamase-producing Klebsiella pneumoniae (EBSL-Kpn) colonization among intensive care unit (ICU)-admitted patients. Prospective screening of ESBL-Kpn colonization was performed for ICU-admitted patients within 48 hours for two months. A perirectal swab sample was inoculated on MacConkey agar supplemented with 2 µg/mL ceftazidime. ESBL genotype was determined by PCR-sequencing, and clonal relatedness was evaluated by pulsed-field gel electrophoresis (PFGE). The risk factors of ESBL-Kpn colonization were evaluated. The ESBL-Kpn colonization rate among the 281 patients at ICU admission was 6.4% (18/281), and bla(CTX-M-15) was detected in all isolates. ESBL producers also showed resistance to fluoroquinolone (38.9%, 7/18). All isolates had the same ESBL genotype (bla(CTX-M-15)) and a highly clustered PFGE pattern, suggesting cross-transmission without a documented outbreak. In univariate analysis, the risk factor for ESBL-Kpn colonization over the control was the length of hospital stay (odds ratio=1.062; P=0.019). Routine use of ASC could help control endemic ESBL–Kpn for ICU patients.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Ceftazidime
/
Mass Screening
/
Prevalence
/
Prospective Studies
/
Risk Factors
/
Electrophoresis, Gel, Pulsed-Field
/
Colon
/
Critical Care
/
Agar
/
Enterobacteriaceae
Type of study:
Etiology study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
/
Screening study
Limits:
Humans
Language:
English
Journal:
Annals of Laboratory Medicine
Year:
2020
Type:
Article
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