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Prevalence and Risk Factors for Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Colonization in Intensive Care Units
Annals of Laboratory Medicine ; : 164-168, 2020.
Artículo en Inglés | 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.
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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Ceftazidima / Tamizaje Masivo / Prevalencia / Estudios Prospectivos / Factores de Riesgo / Electroforesis en Gel de Campo Pulsado / Colon / Cuidados Críticos / Agar / Enterobacteriaceae Tipo de estudio: Estudio de etiología / Estudio observacional / Estudio de prevalencia / Estudio pronóstico / Factores de riesgo / Estudio de tamizaje Límite: Humanos Idioma: Inglés Revista: Annals of Laboratory Medicine Año: 2020 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Ceftazidima / Tamizaje Masivo / Prevalencia / Estudios Prospectivos / Factores de Riesgo / Electroforesis en Gel de Campo Pulsado / Colon / Cuidados Críticos / Agar / Enterobacteriaceae Tipo de estudio: Estudio de etiología / Estudio observacional / Estudio de prevalencia / Estudio pronóstico / Factores de riesgo / Estudio de tamizaje Límite: Humanos Idioma: Inglés Revista: Annals of Laboratory Medicine Año: 2020 Tipo del documento: Artículo