Cargando…
Association between rectal colonization with Highly Resistant Gram-negative Rods (HR-GNRs) and subsequent infection with HR-GNRs in clinical patients: A one year historical cohort study
OBJECTIVE: Rectal colonization with Highly Resistant Gram-negative Rods (HR-GNRs) probably precedes infection. We aimed to assess the association between rectal HR-GNR colonization and subsequent HR-GNR infection in clinical patients during a follow-up period of one year in a historical cohort study...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347189/ https://www.ncbi.nlm.nih.gov/pubmed/30682095 http://dx.doi.org/10.1371/journal.pone.0211016 |
_version_ | 1783389893947293696 |
---|---|
author | Souverein, Dennis Euser, Sjoerd M. Herpers, Bjorn L. Kluytmans, Jan Rossen, John W. A. Den Boer, Jeroen W. |
author_facet | Souverein, Dennis Euser, Sjoerd M. Herpers, Bjorn L. Kluytmans, Jan Rossen, John W. A. Den Boer, Jeroen W. |
author_sort | Souverein, Dennis |
collection | PubMed |
description | OBJECTIVE: Rectal colonization with Highly Resistant Gram-negative Rods (HR-GNRs) probably precedes infection. We aimed to assess the association between rectal HR-GNR colonization and subsequent HR-GNR infection in clinical patients during a follow-up period of one year in a historical cohort study design. METHODS: Rectal HR-GNR colonization was assessed by culturing. Subsequent development of infection was determined by assessing all clinical microbiological culture results extracted from the laboratory information system including clinical data regarding HR-GNR infections. A multivariable logistic regression model was constructed with HR-GNR rectal colonization as independent variable and HR-GNR infection as dependent variable. Gender, age, antibiotic use, historic clinical admission and previous (HR-GNR) infections were included as possible confounders. RESULTS: 1133 patients were included of whom 68 patients (6.1%) were colonized with a HR-GNR. In total 22 patients with HR-GNR infections were detected. Urinary tract infections were most common (n = 14, 63.6%), followed by bloodstream infections (n = 5, 22.7%) and other infections (n = 8, 36.4%). Eight out of 68 HR-GNR colonized patients (11.8%) developed a subsequent HR-GNR infection compared to 14 out of 1065 HR-GNR negative patients (1.3%), resulting in an odds ratio (95% CI) of 7.1 (2.8–18.1) in the multivariable logistic regression analyses. CONCLUSIONS: Rectal colonization with a HR-GNR was a significant risk factor for a subsequent HR-GNR infection. This implies that historical colonization culture results should be considered in the choice of empirical antibiotic therapy to include coverage of the cultured HR-GNR, at least in critically ill patients. |
format | Online Article Text |
id | pubmed-6347189 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-63471892019-02-02 Association between rectal colonization with Highly Resistant Gram-negative Rods (HR-GNRs) and subsequent infection with HR-GNRs in clinical patients: A one year historical cohort study Souverein, Dennis Euser, Sjoerd M. Herpers, Bjorn L. Kluytmans, Jan Rossen, John W. A. Den Boer, Jeroen W. PLoS One Research Article OBJECTIVE: Rectal colonization with Highly Resistant Gram-negative Rods (HR-GNRs) probably precedes infection. We aimed to assess the association between rectal HR-GNR colonization and subsequent HR-GNR infection in clinical patients during a follow-up period of one year in a historical cohort study design. METHODS: Rectal HR-GNR colonization was assessed by culturing. Subsequent development of infection was determined by assessing all clinical microbiological culture results extracted from the laboratory information system including clinical data regarding HR-GNR infections. A multivariable logistic regression model was constructed with HR-GNR rectal colonization as independent variable and HR-GNR infection as dependent variable. Gender, age, antibiotic use, historic clinical admission and previous (HR-GNR) infections were included as possible confounders. RESULTS: 1133 patients were included of whom 68 patients (6.1%) were colonized with a HR-GNR. In total 22 patients with HR-GNR infections were detected. Urinary tract infections were most common (n = 14, 63.6%), followed by bloodstream infections (n = 5, 22.7%) and other infections (n = 8, 36.4%). Eight out of 68 HR-GNR colonized patients (11.8%) developed a subsequent HR-GNR infection compared to 14 out of 1065 HR-GNR negative patients (1.3%), resulting in an odds ratio (95% CI) of 7.1 (2.8–18.1) in the multivariable logistic regression analyses. CONCLUSIONS: Rectal colonization with a HR-GNR was a significant risk factor for a subsequent HR-GNR infection. This implies that historical colonization culture results should be considered in the choice of empirical antibiotic therapy to include coverage of the cultured HR-GNR, at least in critically ill patients. Public Library of Science 2019-01-25 /pmc/articles/PMC6347189/ /pubmed/30682095 http://dx.doi.org/10.1371/journal.pone.0211016 Text en © 2019 Souverein et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Souverein, Dennis Euser, Sjoerd M. Herpers, Bjorn L. Kluytmans, Jan Rossen, John W. A. Den Boer, Jeroen W. Association between rectal colonization with Highly Resistant Gram-negative Rods (HR-GNRs) and subsequent infection with HR-GNRs in clinical patients: A one year historical cohort study |
title | Association between rectal colonization with Highly Resistant Gram-negative Rods (HR-GNRs) and subsequent infection with HR-GNRs in clinical patients: A one year historical cohort study |
title_full | Association between rectal colonization with Highly Resistant Gram-negative Rods (HR-GNRs) and subsequent infection with HR-GNRs in clinical patients: A one year historical cohort study |
title_fullStr | Association between rectal colonization with Highly Resistant Gram-negative Rods (HR-GNRs) and subsequent infection with HR-GNRs in clinical patients: A one year historical cohort study |
title_full_unstemmed | Association between rectal colonization with Highly Resistant Gram-negative Rods (HR-GNRs) and subsequent infection with HR-GNRs in clinical patients: A one year historical cohort study |
title_short | Association between rectal colonization with Highly Resistant Gram-negative Rods (HR-GNRs) and subsequent infection with HR-GNRs in clinical patients: A one year historical cohort study |
title_sort | association between rectal colonization with highly resistant gram-negative rods (hr-gnrs) and subsequent infection with hr-gnrs in clinical patients: a one year historical cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347189/ https://www.ncbi.nlm.nih.gov/pubmed/30682095 http://dx.doi.org/10.1371/journal.pone.0211016 |
work_keys_str_mv | AT souvereindennis associationbetweenrectalcolonizationwithhighlyresistantgramnegativerodshrgnrsandsubsequentinfectionwithhrgnrsinclinicalpatientsaoneyearhistoricalcohortstudy AT eusersjoerdm associationbetweenrectalcolonizationwithhighlyresistantgramnegativerodshrgnrsandsubsequentinfectionwithhrgnrsinclinicalpatientsaoneyearhistoricalcohortstudy AT herpersbjornl associationbetweenrectalcolonizationwithhighlyresistantgramnegativerodshrgnrsandsubsequentinfectionwithhrgnrsinclinicalpatientsaoneyearhistoricalcohortstudy AT kluytmansjan associationbetweenrectalcolonizationwithhighlyresistantgramnegativerodshrgnrsandsubsequentinfectionwithhrgnrsinclinicalpatientsaoneyearhistoricalcohortstudy AT rossenjohnwa associationbetweenrectalcolonizationwithhighlyresistantgramnegativerodshrgnrsandsubsequentinfectionwithhrgnrsinclinicalpatientsaoneyearhistoricalcohortstudy AT denboerjeroenw associationbetweenrectalcolonizationwithhighlyresistantgramnegativerodshrgnrsandsubsequentinfectionwithhrgnrsinclinicalpatientsaoneyearhistoricalcohortstudy |