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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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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. |
format | Online Article Text |
id | pubmed-6102905 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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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