TY - JOUR
T1 - Local prevalence of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae intestinal carriers at admission and co-expression of ESBL and OXA-48 carbapenemase in Klebsiella pneumoniae
T2 - A prevalence survey in a Spanish University Hospital
AU - Cristina, Diaz Agero
AU - López-Fresneña, Nieves
AU - Rincon Carlavilla, Angela L.
AU - Hernandez Garcia, Marta
AU - Ruiz-Garbajosa, Patricia
AU - Aranaz-Andrés, Jesús María
AU - Maechler, Friederike
AU - Gastmeier, Petra
AU - Bonten, Marc J.M.
AU - Canton, Rafael
N1 - Funding Information:
Funding The project falls within the R-GNOSIS study (Resistance of Gram-Negative Organisms: Studying Intervention Strategies), within the Work Package 5 Patient isolation strategies for ESBL carriers in medical and surgical hospital wards, funded by the European Union (FP7-HEALTH-2011-SINGLE STAGE-N°282512). MH-G is supported with a contract from Instituto de Salud Carlos III of Spain (iP-FIS program, ref. IFI14/00022).
Funding Information:
The project falls within the R-GNOSIS study (Resistance of Gram-Negative Organisms: Studying Intervention Strategies) within the Work Package 5 "Patient isolation strategies for ESBL carriers in medical and surgical hospital wards", funded by the EU (FP7-HEALTH-2011-SINGLE STAGE-N°282512).
Publisher Copyright:
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - 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.
AB - 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.
KW - carbapenemase producing enterobacteriaceae
KW - extended-spectrum beta-lactamase producing enterobacteriaceae
KW - prevalence
KW - surveillance
UR - http://www.scopus.com/inward/record.url?scp=85062400666&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-024879
DO - 10.1136/bmjopen-2018-024879
M3 - Article
C2 - 30826764
AN - SCOPUS:85062400666
SN - 2044-6055
VL - 9
JO - BMJ Open
JF - BMJ Open
IS - 3
M1 - 024879
ER -