Publication
Title
A binational cohort study of intestinal colonization with extended-spectrum -lactamase-producing **Proteus mirabilis** in patients admitted to rehabilitation centres
Author
Institution/Organisation
MOSAR WP5 Study Group
MOSAR WP2 Study Group
Abstract
The aims of our study were to analyse the risk factors for colonization by Extended-spectrum -lactamases (ESBL)-producing Proteus mirabilis (ESBL-PM) in rehabilitation patients and to characterize the molecular features of these strains. The study was conducted in two rehabilitation centres located in Rome, Italy (Fondazione Santa Lucia IRCCS (FSL)), and Tel-Aviv, Israel (Tel-Aviv Sourasky Medical Center (TASMC)). Carriage of ESBL-PM was surveyed by rectal swabs. Strain typing was performed by pulsed-field gel electrophoresis (PFGE). Identification of ESBL genes was done by PCR and sequencing. Patients admitted to the same institutions without ESBL carriage were included as controls. The study group included 70 and 41 patients from FSL and TASMC, respectively. In FSL, the multivariate analysis identified severe acute brain injury (OR=15, 95% CI=3.269.5, p 0.001), decubitus ulcer (OR=3.5, 95% CI=1.29.8, p 0.018) and recent treatment with quinolones (OR=5.7, 95% CI=1.0730.1, p 0.042) as independent risk factors. ESBL-PM carriers stayed longer in the hospital on average and were less likely to be discharged home. No significant risk factor was identified in TASMC. There were no similarities in PFGE types or ESBL genes between the ESBL-PM isolates from the two institutions. In both hospitals, a variety of PFGE types existed but a single ESBL type predominated, namely TEM-92 in FSL (n=64/70; 91%) and CTX-M-2 in TASMC (n=37/41; 90%). A new TEM ESBL variant, TEM-177 was identified in FSL. The clonal diversity and the predominance of a single ESBL type suggested that horizontal gene transfer played an important role in dissemination of resistance. The development of a population analysis tool that would allow tracing deeper genetic relationships is required.
Language
English
Source (journal)
Clinical microbiology and infection / European Society of Clinical Microbiology and Infectious Diseases. - Oxford
Publication
Oxford : 2013
ISSN
1198-743X
Volume/pages
19:2(2013), p. 51-58
ISI
000314656100001
Full text (Publisher's DOI)
Full text (publisher's version - intranet only)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 30.04.2013
Last edited 07.08.2017
To cite this reference