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Title
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A multinational study of colonization with extended spectrum -lactamase-producing **Enterobacteriaceae** in healthcare personnel and family members of carrier patients hospitalized in rehabilitation centres
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Author
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Abstract
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| The study aims were: (i) to define the prevalence of and risk factors for colonization by extended spectrum β-lactamase (ESBL) -producing Enterobacteriaceae (EPE) among healthcare workers (HCWs) and family members (FMs) of EPE-colonized patients in rehabilitation units and (ii) to compare EPE isolates from these three groups. The study included 286 FMs of 194 EPE-carrying patients identified in five rehabilitation units located in Israel, Italy, France and Spain. The EPE were detected in rectal swabs from 26 (9%) of 286 FMs screened. In multivariate analyses, older age of FM, greater mean number of hours spent with the patient, being a daughter or a female spouse of a patient, and chronic lung disease of the patient were significantly associated with carriage in the FM. Escherichia coli was the most common organism (76%), followed by Klebsiella pneumoniae (19%). Isolates were typed by pulsed field gel electrophoresis and multilocus sequence typing, and ESBLs were identified by PCR sequencing. A comparison of paired species isolates from FMs and their respective patient showed that 17 of 23 strains were indistinguishable. EPE were detected in 35 (3.5%, E. coli = 34) of the 1001 HCWs screened. Feeding patients was associated with EPE carriage by HCWs. Only 7 of 23 E. coli subclones cultured from HCWs were also represented among 376 patient-derived ESBL-producing E. coli isolates from the same rehabilitation units. In Spain, a higher proportion of HCWs and FMs were ESBL carriers than elsewhere (p <0.05). In conclusion, the molecular and epidemiological data suggest that FMs are at higher risk of EPE acquisition from their relative patients than HCWs. |
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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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2014
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ISSN
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1198-743X
[print]
1469-0691
[online]
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DOI
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10.1111/1469-0691.12560
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Volume/pages
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20
:8
(2014)
, p. O516-O523
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ISI
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000341516600010
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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