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Title
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Transmission dynamics of ESBL-producing **Escherichia coli** clones in rehabilitation wards at a tertiary care centre
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Author
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Institution/Organisation
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MOSAR WP5 Study Group
MOSAR WP2 Study Group
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Abstract
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| Increasing resistance due to the production of ESBL in Escherichia coli (ESBL-E. coli) has become a major threat to public health. Our aims were to study the incidence of ESBL-E. coli acquisition during hospitalization and the transmission rates of different ESBL-E. coli clones. This was a prospective casecontrol study, conducted in two geriatric rehabilitation wards in Tel-Aviv. Serial rectal cultures were collected from admission till discharge. All patient-unique ESBL-E. coli isolates were subjected to molecular typing by PFGE, MLST and determination of ESBL genes. An acquisition of ESBL-E. coli was defined as traceable when a patient with the same ST, PFGE type and ESBL gene was hospitalized in the same ward in parallel to the acquisition case. ESBL-E. colis were recovered from 125 patients out of 492 enrolled: 52 were recovered upon admission, 59 acquired ESBL-E. coli during their stay, and there was undetermined status in 14 patients. A low Nortons score was associated with acquisition (O.R. 1.14 for each point, 95% C.I. 1.011.29, p < 0.05). ESBL-E. coli infections (n = 9) had occurred only in ESBL-E. coli carriers. The pandemic ST131 clone was the most common (48/125). The majority of the isolates (101/125) produced CTX-M-type ESBL. Of the 59 acquisition cases, 32 were traced to another patient. In-hospital dissemination was highest in the CTX-M-27-producing ST131 and the SHV-5-producing ST372 sub-clones (acquisition/admission ratios of 17/11 and 9/3, respectively), with almost all cases traced to other patients. In conclusion, most ESBL-E. coli acquisition cases were traceable to other patients. The transmission potential varied significantly between ESBL-E. coli clones. |
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Language
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English
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Source (journal)
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Clinical microbiology and infection / European Society of Clinical Microbiology and Infectious Diseases. - Oxford
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Publication
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Oxford
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2012
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ISSN
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1198-743X
[print]
1469-0691
[online]
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DOI
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10.1111/J.1469-0691.2012.03999.X
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Volume/pages
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18
:12
(2012)
, p. E497-E505
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ISI
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000311109100003
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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