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BMJ Open ; 9(3): e024879, 2019 03 01.
Article in English | MEDLINE | ID: mdl-30826764

ABSTRACT

OBJECTIVE: To assess the prevalence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) faecal carriers at admission in a University Hospital in Spain. DESIGN: Prevalence survey. SETTING: Pneumology, gastroenterology, urology and neurosurgery units at a university tertiary hospital in Madrid (Spain). PARTICIPANTS: A total of 10 643 patients aged 18 and older admitted from March 2014 to April 2016 with a rectal swab taken at admission or as soon as possible within the first 48 hours. PRIMARY AND SECONDARY OUTCOME MEASURES: Prevalence of ESBL-E faecal carriers and prevalence of ESBL-E infections at admission. RESULTS: The prevalance of ESBL-E carriers at admission was 7.69% (CI 95% 7.18 to 8.19). Most of the isolates were Escherichia coli (77.51%), followed by Klebsiella pneumoniae (20.71%). Eighty-eight (10.41%) of ESBL-E were simultaneous ESBL and carbapenemase (CP) producers, 1.83% in the case of E. coli and 42.86% among K. pneumoniae isolates. Of the ESBL typed, 52.15% belonged to the cefotaximases (CTX-M-15) type and 91.38% of the CP were oxacillinase (OXA-48) type. Only 0.43% patients presented an active infection by ESBL-E at admission. CONCLUSIONS: The prevalence found in our study is very similar to that found in literature. However, we found a high percentage of simultaneous ESBL and CP producers, particularly in K. pneumoniae. Despite the high prevalence of colonised patients, the ESBL-infection rate at admission was very low.


Subject(s)
Bacterial Proteins/isolation & purification , Enterobacteriaceae Infections , Enterobacteriaceae , Klebsiella pneumoniae , beta-Lactamases/isolation & purification , Asymptomatic Diseases/epidemiology , Diagnostic Tests, Routine/methods , Diagnostic Tests, Routine/statistics & numerical data , Drug Resistance, Multiple, Bacterial , Enterobacteriaceae/isolation & purification , Enterobacteriaceae/physiology , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/epidemiology , Enterobacteriaceae Infections/microbiology , Female , Hospitals, University/statistics & numerical data , Humans , Intestines/microbiology , Klebsiella pneumoniae/isolation & purification , Klebsiella pneumoniae/physiology , Male , Microbial Sensitivity Tests/methods , Microbial Sensitivity Tests/statistics & numerical data , Middle Aged , Prevalence , Spain/epidemiology , Surveys and Questionnaires
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