Rates of Fecal Transmission of Extended-Spectrum beta-Lactamase-Producing and Carbapenem-Resistant Enterobacteriaceae Among Patients in Intensive Care Units in Korea
Annals of Laboratory Medicine
; : 20-25, 2014.
Artículo
en Inglés
| WPRIM (Pacífico Occidental)
| ID: wpr-193133
Biblioteca responsable:
WPRO
ABSTRACT
BACKGROUND:
We investigated the rates of fecal transmission of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) and carbapenem-resistant Enterobacteriaceae (CRE) among patients admitted to intensive care units (ICUs).METHODS:
From June to August 2012, rectal cultures were acquired from all patients at ICU admission. For patients not carrying ESBL-E or CRE at admission, follow-up cultures were performed to detect acquisition. A chromogenic assay was used to screen for ESBL-E and CRE. Bacterial species identification and antibiotic susceptibility tests were performed using the Vitek 2 system (bioMerieux, France). ESBL genotypes were determined by PCR, and clonal relatedness of the isolates was assessed by pulsed-field gel electrophoresis.RESULTS:
Out of 347 ICU admissions, 98 patients were found to be carriers of ESBL-E (28.2%, 98/347). Follow-up cultures were acquired from 91 of the patients who tested negative for ESBL-E at admission; the acquisition rate in this group was 12.1% (11/91), although none was a nosocomial transmission. For CRE, the prevalence of fecal carriage was 0.3% (1/347), and the acquisition rate was 2.9% (4/140). None of the CRE isolates were carbapenemase-producers.CONCLUSIONS:
The high prevalence of ESBL-E carriage on admission (28.2%), coupled with rare nosocomial transmission and the very low carriage rate of CRE (0.3%), challenge the routine use of active surveillance in non-epidemic settings. Nevertheless, passive surveillance measures, such as rapid and accurate screening of clinical specimens, will be critical for controlling the spread of CRE.
Texto completo:
Disponible
Contexto en salud:
Enfermedades Desatendidas
Problema de salud:
Enfermedades Desatendidas
/
Zoonosis
Base de datos:
WPRIM (Pacífico Occidental)
Asunto principal:
Proteínas Bacterianas
/
Beta-Lactamasas
/
ADN Bacteriano
/
Portador Sano
/
Carbapenémicos
/
Reacción en Cadena de la Polimerasa
/
Infección Hospitalaria
/
Prevalencia
/
Electroforesis en Gel de Campo Pulsado
/
Farmacorresistencia Bacteriana
Tipo de estudio:
Estudio de prevalencia
Límite:
Humanos
País/Región como asunto:
Asia
Idioma:
Inglés
Revista:
Annals of Laboratory Medicine
Año:
2014
Tipo del documento:
Artículo