Universität zu Köln

Hamprecht, A., Rohde, A. M., Behnke, M., Feihl, S., Gastmeier, P., Gebhardt, F., Kern, W. V., Knobloch, J. K., Mischnik, A., Obermann, B., Querbach, C., Peter, S., Schneider, C., Schroeder, W., Schwab, F., Tacconelli, E., Wiese-Posselt, M., Wille, T., Willmann, M., Seifert, H. and Zweigner, J. (2016). Colonization with third-generation cephalosporin-resistant Enterobacteriaceae on hospital admission: prevalence and risk factors. J. Antimicrob. Chemother., 71 (10). S. 2957 - 2964. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2091

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Abstract

The objectives of this study were to prospectively assess the rectal carriage rate of third-generation cephalosporin-resistant Enterobacteriaceae (3GCREB) in non-ICU patients on hospital admission and to investigate resistance mechanisms and risk factors for carriage. Adult patients were screened for 3GCREB carriage at six German tertiary care hospitals in 2014 using rectal swabs or stool samples. 3GCREB isolates were characterized by phenotypic and molecular methods. Each patient answered a questionnaire about potential risk factors for colonization with MDR organisms (MDROs). Univariable and multivariable risk factor analyses were performed to identify factors associated with 3GCREB carriage. Of 4376 patients, 416 (9.5%) were 3GCREB carriers. Escherichia coli was the predominant species (79.1%). ESBLs of the CTX-M-1 group (67.3%) and the CTX-M-9 group (16.8%) were the most frequent beta-lactamases. Five patients (0.11%) were colonized with carbapenemase-producing Enterobacteriaceae. The following risk factors were significantly associated with 3GCREB colonization in the multivariable analysis (P<0.05): centre; previous MDRO colonization (OR=2.12); antibiotic use within the previous 6 months (OR=2.09); travel outside Europe (OR=2.24); stay in a long-term care facility (OR=1.33); and treatment of gastroesophageal reflux disease (GERD) (OR=1.22). To our knowledge, this is the largest admission prevalence study of 3GCREB in Europe. The observed prevalence of 9.5% 3GCREB carriage was higher than previously reported and differed significantly among centres. In addition to previously identified risk factors, the treatment of GERD proved to be an independent risk factor for 3GCREB colonization.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hamprecht, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rohde, A. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Behnke, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Feihl, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gastmeier, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gebhardt, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kern, W. V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Knobloch, J. K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mischnik, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Obermann, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Querbach, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Peter, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schneider, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwab, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tacconelli, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiese-Posselt, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wille, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Willmann, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zweigner, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-261589
DOI:	10.1093/jac/dkw216
Journal or Publication Title:	J. Antimicrob. Chemother.
Volume:	71
Number:	10
Page Range:	S. 2957 - 2964
Date:	2016
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2091
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LACTAMASE-PRODUCING ENTEROBACTERIACEAE; CARBAPENEMASE-PRODUCING ENTEROBACTERIACEAE; SPECTRUM BETA-LACTAMASES; INTENSIVE-CARE-UNIT; ESCHERICHIA-COLI; CTX-M; FECAL CARRIAGE; MULTIPLEX PCR; COMMUNITY; BACTERIA Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26158