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A prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a Thai University Hospital

BACKGROUND: Colonization with multidrug-resistant (MDR) bacteria is a major risk factor for developing subsequent MDR infections. METHODS: We performed a prospective surveillance study in hospitalized patients at Siriraj Hospital. Nasal cavity, throat, inguinal area and rectal swabs were obtained wi...

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Autores principales: Rattanaumpawan, Pinyo, Choorat, Chatiros, Takonkitsakul, Kanchanaporn, Tangkoskul, Teerawit, Seenama, Chakrapong, Thamlikitkul, Visanu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6102905/
https://www.ncbi.nlm.nih.gov/pubmed/30167108
http://dx.doi.org/10.1186/s13756-018-0393-2
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author Rattanaumpawan, Pinyo
Choorat, Chatiros
Takonkitsakul, Kanchanaporn
Tangkoskul, Teerawit
Seenama, Chakrapong
Thamlikitkul, Visanu
author_facet Rattanaumpawan, Pinyo
Choorat, Chatiros
Takonkitsakul, Kanchanaporn
Tangkoskul, Teerawit
Seenama, Chakrapong
Thamlikitkul, Visanu
author_sort Rattanaumpawan, Pinyo
collection PubMed
description BACKGROUND: Colonization with multidrug-resistant (MDR) bacteria is a major risk factor for developing subsequent MDR infections. METHODS: We performed a prospective surveillance study in hospitalized patients at Siriraj Hospital. Nasal cavity, throat, inguinal area and rectal swabs were obtained within the first 48-h after admission, on day-5 after hospitalization and then every 7 days until discharge. Target bacteria included extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL), carbapenem-resistant-P.aeruginosa (CR-PA), carbapenem-resistant-A.baumannii (CR-AB) and methicillin-resistant S.aureus (MRSA). RESULTS: From January 2013–December 2014, 487 patients were enrolled. The baseline prevalence of colonization by ESBL, CR-PA, CR-AB and MRSA at any site was 52.2%, 6.8%, 4.7% and 7.2%, respectively. After 3-week of hospitalization, the prevalence of colonization by ESBL, CR-PA, CR-AB and MRSA increased to 71.7%, 47.2%, 18.9% and 18.9%, respectively. Multivariable analysis revealed that diabetes mellitus and recent cephalosporin exposure were the independent risk factors for baseline colonization by ESBL. The independent risk factors for CR-AB and/or CR-PA colonization were cerebrovascular diseases, previous hospitalization, transfer from another hospital/a LTCF and previous nasogastric tube use, whereas those for MRSA colonization were previous fluoroquinolone exposure and previous nasogastric tube use. CONCLUSIONS: The baseline prevalence of colonization by ESBL was relatively high, whereas the baseline prevalence of colonization by CR-PA, CR-AB and MRSA was comparable to previous studies. There was an increasing trend in MDR bacteria colonization after hospitalization.
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spelling pubmed-61029052018-08-30 A prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a Thai University Hospital Rattanaumpawan, Pinyo Choorat, Chatiros Takonkitsakul, Kanchanaporn Tangkoskul, Teerawit Seenama, Chakrapong Thamlikitkul, Visanu Antimicrob Resist Infect Control Research BACKGROUND: Colonization with multidrug-resistant (MDR) bacteria is a major risk factor for developing subsequent MDR infections. METHODS: We performed a prospective surveillance study in hospitalized patients at Siriraj Hospital. Nasal cavity, throat, inguinal area and rectal swabs were obtained within the first 48-h after admission, on day-5 after hospitalization and then every 7 days until discharge. Target bacteria included extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL), carbapenem-resistant-P.aeruginosa (CR-PA), carbapenem-resistant-A.baumannii (CR-AB) and methicillin-resistant S.aureus (MRSA). RESULTS: From January 2013–December 2014, 487 patients were enrolled. The baseline prevalence of colonization by ESBL, CR-PA, CR-AB and MRSA at any site was 52.2%, 6.8%, 4.7% and 7.2%, respectively. After 3-week of hospitalization, the prevalence of colonization by ESBL, CR-PA, CR-AB and MRSA increased to 71.7%, 47.2%, 18.9% and 18.9%, respectively. Multivariable analysis revealed that diabetes mellitus and recent cephalosporin exposure were the independent risk factors for baseline colonization by ESBL. The independent risk factors for CR-AB and/or CR-PA colonization were cerebrovascular diseases, previous hospitalization, transfer from another hospital/a LTCF and previous nasogastric tube use, whereas those for MRSA colonization were previous fluoroquinolone exposure and previous nasogastric tube use. CONCLUSIONS: The baseline prevalence of colonization by ESBL was relatively high, whereas the baseline prevalence of colonization by CR-PA, CR-AB and MRSA was comparable to previous studies. There was an increasing trend in MDR bacteria colonization after hospitalization. BioMed Central 2018-08-20 /pmc/articles/PMC6102905/ /pubmed/30167108 http://dx.doi.org/10.1186/s13756-018-0393-2 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Rattanaumpawan, Pinyo
Choorat, Chatiros
Takonkitsakul, Kanchanaporn
Tangkoskul, Teerawit
Seenama, Chakrapong
Thamlikitkul, Visanu
A prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a Thai University Hospital
title A prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a Thai University Hospital
title_full A prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a Thai University Hospital
title_fullStr A prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a Thai University Hospital
title_full_unstemmed A prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a Thai University Hospital
title_short A prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a Thai University Hospital
title_sort prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a thai university hospital
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6102905/
https://www.ncbi.nlm.nih.gov/pubmed/30167108
http://dx.doi.org/10.1186/s13756-018-0393-2
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