Universität zu Köln

Rohde, Anna M., Zweigner, Janine, Wiese-Posselt, Miriam, Schwab, Frank, Behnke, Michael, Kola, Axel, Schroeder, Wiebke, Peter, Silke ORCID: 0000-0002-1355-3953, Tacconelli, Evelina, Wille, Thorsten, Feihl, Susanne, Querbach, Christiane, Gebhardt, Friedemann, Goelz, Hannah, Schneider, Christian, Mischnik, Alexander, Vehreschild, Maria J. G. T., Seifert, Harald, Kern, Winfried, V, Gastmeier, Petra and Hamprecht, Axel ORCID: 0000-0003-1449-5780 (2020). Prevalence of third-generation cephalosporin-resistant Enterobacterales colonization on hospital admission and ESBL genotype-specific risk factors: a cross-sectional study in six German university hospitals. J. Antimicrob. Chemother., 75 (6). S. 1631 - 1639. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2091

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Abstract

Objectives: To assess the admission prevalence of third-generation cephalosporin-resistant Enterobacterales (3GCREB) and to assess whether risk factors vary by beta-lactamase genotype. Methods:Adult patients were recruited within 72h of admission to general wards of six unversity hospitals in 2014 and 2015. Rectal swabs were screened for 3GCREB and isolates were analysed phenotypically and genotypically. Patients were questioned on potential risk factors. Multivariable analyses were performed to identify risk factors for 3GCREB colonization and for specific beta-lactamases. Results: Of 8753 patients screened, 828 were 3GCREB positive (9.5%). Eight hundred and thirteen isolates were available for genotyping. CTX-M-15 was the most common ESBL (38.0%), followed by CTX-M-1 (22.5%), CTX-M-14 (8.7%), CTX-M-27 (7.5%) and SHV-ESBL (4.4%). AmpC was found in 11.9%. Interestingly, 18 Escherichia coli isolates were AmpC positive, 12 of which (67%) contained AmpC on a gene of plasmid origin [CMY (n=10), DHA (n=2)]. Risk factors for 3GCREB colonization varied by genotype. Recent antibiotic exposure and prior colonization by antibiotic-resistant bacteria were risk factors for all beta-lactamases except CTX-M-14 and CTX-M-27. Travel outside Europe was a risk factor for CTX-M-15 and CTX-M-27 [adjusted OR (aOR) 3.49, 95% CI 2.88-4.24 and aOR 2.73, 95% CI 1.68-4.43]. A previous stay in a long-term care facility was associated with CTX-M-14 (aOR 3.01, 95% CI 1.98-4.59). A preceding hospital stay in Germany increased the risk of CTX-M-15 (aOR 1.27, 95% CI 1.14-1.41), while a prior hospital stay in other European countries increased the risk of SHV-ESBL colonization (aOR 3.85, 95% CI 1.67-8.92). Conclusions: The detection of different ESBL types is associated with specific risk factor sets that might represent distinct sources of colonization and ESBL-specific dissemination routes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rohde, Anna M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zweigner, Janine UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiese-Posselt, Miriam UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwab, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Behnke, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Kola, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, Wiebke UNSPECIFIED UNSPECIFIED UNSPECIFIED Peter, Silke UNSPECIFIED orcid.org/0000-0002-1355-3953 UNSPECIFIED Tacconelli, Evelina UNSPECIFIED UNSPECIFIED UNSPECIFIED Wille, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Feihl, Susanne UNSPECIFIED UNSPECIFIED UNSPECIFIED Querbach, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Gebhardt, Friedemann UNSPECIFIED UNSPECIFIED UNSPECIFIED Goelz, Hannah UNSPECIFIED UNSPECIFIED UNSPECIFIED Schneider, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Mischnik, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Maria J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Kern, Winfried, V UNSPECIFIED UNSPECIFIED UNSPECIFIED Gastmeier, Petra UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamprecht, Axel UNSPECIFIED orcid.org/0000-0003-1449-5780 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-330923
DOI:	10.1093/jac/dkaa052
Journal or Publication Title:	J. Antimicrob. Chemother.
Volume:	75
Number:	6
Page Range:	S. 1631 - 1639
Date:	2020
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2091
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SEQUENCE TYPE 131; LACTAMASE-PRODUCING ENTEROBACTERIACEAE; (ESBL)-PRODUCING ESCHERICHIA-COLI; INFECTION; TRAVELERS; C1-M27; CLADE Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33092