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Rates of Fecal Transmission of Extended-Spectrum β-Lactamase-Producing and Carbapenem-Resistant Enterobacteriaceae Among Patients in Intensive Care Units in Korea

BACKGROUND: We investigated the rates of fecal transmission of extended-spectrum β-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...

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Autores principales: Kim, Jayoung, Lee, Ji Young, Kim, Sang Il, Song, Wonkeun, Kim, Jae-Seok, Jung, Seungwon, Yu, Jin Kyung, Park, Kang Gyun, Park, Yeon-Joon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Laboratory Medicine 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3885768/
https://www.ncbi.nlm.nih.gov/pubmed/24422191
http://dx.doi.org/10.3343/alm.2014.34.1.20
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author Kim, Jayoung
Lee, Ji Young
Kim, Sang Il
Song, Wonkeun
Kim, Jae-Seok
Jung, Seungwon
Yu, Jin Kyung
Park, Kang Gyun
Park, Yeon-Joon
author_facet Kim, Jayoung
Lee, Ji Young
Kim, Sang Il
Song, Wonkeun
Kim, Jae-Seok
Jung, Seungwon
Yu, Jin Kyung
Park, Kang Gyun
Park, Yeon-Joon
author_sort Kim, Jayoung
collection PubMed
description BACKGROUND: We investigated the rates of fecal transmission of extended-spectrum β-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 (bioMérieux, 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.
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spelling pubmed-38857682014-01-13 Rates of Fecal Transmission of Extended-Spectrum β-Lactamase-Producing and Carbapenem-Resistant Enterobacteriaceae Among Patients in Intensive Care Units in Korea Kim, Jayoung Lee, Ji Young Kim, Sang Il Song, Wonkeun Kim, Jae-Seok Jung, Seungwon Yu, Jin Kyung Park, Kang Gyun Park, Yeon-Joon Ann Lab Med Original Article BACKGROUND: We investigated the rates of fecal transmission of extended-spectrum β-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 (bioMérieux, 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. The Korean Society for Laboratory Medicine 2014-01 2013-12-06 /pmc/articles/PMC3885768/ /pubmed/24422191 http://dx.doi.org/10.3343/alm.2014.34.1.20 Text en © The Korean Society for Laboratory Medicine. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Jayoung
Lee, Ji Young
Kim, Sang Il
Song, Wonkeun
Kim, Jae-Seok
Jung, Seungwon
Yu, Jin Kyung
Park, Kang Gyun
Park, Yeon-Joon
Rates of Fecal Transmission of Extended-Spectrum β-Lactamase-Producing and Carbapenem-Resistant Enterobacteriaceae Among Patients in Intensive Care Units in Korea
title Rates of Fecal Transmission of Extended-Spectrum β-Lactamase-Producing and Carbapenem-Resistant Enterobacteriaceae Among Patients in Intensive Care Units in Korea
title_full Rates of Fecal Transmission of Extended-Spectrum β-Lactamase-Producing and Carbapenem-Resistant Enterobacteriaceae Among Patients in Intensive Care Units in Korea
title_fullStr Rates of Fecal Transmission of Extended-Spectrum β-Lactamase-Producing and Carbapenem-Resistant Enterobacteriaceae Among Patients in Intensive Care Units in Korea
title_full_unstemmed Rates of Fecal Transmission of Extended-Spectrum β-Lactamase-Producing and Carbapenem-Resistant Enterobacteriaceae Among Patients in Intensive Care Units in Korea
title_short Rates of Fecal Transmission of Extended-Spectrum β-Lactamase-Producing and Carbapenem-Resistant Enterobacteriaceae Among Patients in Intensive Care Units in Korea
title_sort rates of fecal transmission of extended-spectrum β-lactamase-producing and carbapenem-resistant enterobacteriaceae among patients in intensive care units in korea
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3885768/
https://www.ncbi.nlm.nih.gov/pubmed/24422191
http://dx.doi.org/10.3343/alm.2014.34.1.20
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