scholarly journals Extended-spectrum beta-lactamase (ESBL) producing Enterobacterales in stool surveillance cultures of preterm infants are no risk factor for necrotizing enterocolitis: a retrospective case–control study over 12 years

Infection ◽  
2020 ◽  
Vol 48 (6) ◽  
pp. 853-860
Author(s):  
Martin Eberhart ◽  
Andrea Grisold ◽  
Michela Lavorato ◽  
Elisabeth Resch ◽  
Andreas Trobisch ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Gestational Age ◽  
Klebsiella Oxytoca ◽  
Case Group ◽  
Beta Lactamase ◽  
Retrospective Case ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Surveillance Cultures

Abstract Purpose Microbial dysbiosis has been found preceding necrotizing enterocolitis (NEC) in preterm infants; thus, we aimed to investigate whether there is evidence that neonates with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) positive stool cultures are at higher risk for NEC at the NICU. Methods We included very preterm inborn infants of ≤ 32 weeks of gestational age being fecal carriers of ESBL-E and compared them with 1:1 matched (gestational age, birth weight, gender and year) controls tested negative for ESBL-E in the stool between 2005 and 2016. An association with NEC was defined as the first detection of ESBL-E before or at the time of definite diagnosis of NEC. Results During the study period, we diagnosed 217 infants with a total of 270 ESBL-E. We identified ten different species with ESBL-producing Klebsiella oxytoca being the most common one (46%) followed by Klebsiella pneumoniae (19%), and Citrobacter freundii (17%). Ten out of 217 infants had any kind of NEC in the case group compared to two of the controls (p < 0.01), but only four cases with predefined criteria were associated with NEC ≥ stage IIa (1.8 vs. 0.5%, p = 0.089, OR 4.1, CI95% 0.45–36.6). NEC mortality rate was 2/8 (25%). Conclusions We observed a threefold increase of ESBL-E in stool surveillance cultures during study time and germs were dominated by ESBL-producing Klebsiella spp. There was no evidence that preterm infants colonized with ESBL-E in the stool were at higher risk for definite NEC.

scholarly journals Whole-Genome Multilocus Sequence Typing of Extended-Spectrum-Beta-Lactamase-Producing Enterobacteriaceae

2016 ◽  
Vol 54 (12) ◽  
pp. 2919-2927 ◽  
Author(s):  
Marjolein F. Q. Kluytmans-van den Bergh ◽  
John W. A. Rossen ◽  
Patricia C. J. Bruijning-Verhagen ◽  
Marc J. M. Bonten ◽  
Alexander W. Friedrich ◽  
...  
Keyword(s):  
Multilocus Sequence Typing ◽  
Klebsiella Oxytoca ◽  
Whole Genome ◽  
Beta Lactamase ◽  
Typing Method ◽  
Content Type ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Species Specific

Molecular typing has become indispensable in the detection of nosocomial transmission of bacterial pathogens and the identification of sources and routes of transmission in outbreak settings, but current methods are labor-intensive, are difficult to standardize, or have limited resolution. Whole-genome multilocus sequence typing (wgMLST) has emerged as a whole-genome sequencing (WGS)-based gene-by-gene typing method that may overcome these limitations and has been applied successfully for several species in outbreak settings. In this study, genus-, genetic-complex-, and species-specific wgMLST schemes were developed forCitrobacterspp., theEnterobacter cloacaecomplex,Escherichia coli,Klebsiella oxytoca, andKlebsiella pneumoniaeand used to type a national collection of 1,798 extended-spectrum-beta-lactamase-producingEnterobacteriaceae(ESBL-E) isolates obtained from patients in Dutch hospitals. Genus-, genetic-complex-, and species-specific thresholds for genetic distance that accurately distinguish between epidemiologically related and unrelated isolates were defined forCitrobacterspp., theE. cloacaecomplex,E. coli, andK. pneumoniae. wgMLST was shown to have higher discriminatory power and typeability thanin silicoMLST. In conclusion, the wgMLST schemes developed in this study facilitate high-resolution WGS-based typing of the most prevalent ESBL-producing species in clinical practice and may contribute to further elucidation of the complex epidemiology of antimicrobial-resistantEnterobacteriaceae. wgMLST opens up possibilities for the creation of a Web-accessible database for the global surveillance of ESBL-producing bacterial clones.

scholarly journals Molecular characterization of extended-spectrum beta-lactamases in Enterobacteriaceae from patients of two hospitals in Saxony, Germany

2007 ◽  
Vol 56 (2) ◽  
pp. 241-249 ◽  
Author(s):  
Joachim Schmitt ◽  
Enno Jacobs ◽  
Herbert Schmidt
Keyword(s):  
Plasmid Dna ◽  
Klebsiella Oxytoca ◽  
Rflp Analysis ◽  
Beta Lactamase ◽  
M Gene ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Genes Encoding ◽  
Extended Spectrum Beta Lactamases

Between January and September 2003, 39 isolates of the family Enterobacteriaceae with phenotypically positive Vitek 1 extended-spectrum beta-lactamase (ESBL) test results were collected, originating from patients of two hospitals in Saxony, Germany. Plasmid DNA was isolated and screened by PCR for the presence of genes encoding beta-lactamases of SHV, TEM and CTX-M types. To differentiate ESBL and non-ESBL among SHV and TEM genes, detailed analysis of PCR products was performed. Twenty-four strains carried SHV-2, SHV-5 or SHV-12 genes. In a further 11 strains a CTX-M gene was detected. The CTX-M genes could be affiliated to the CTX-M-1 and CTX-M-9 cluster by RFLP analysis. In the case of four Klebsiella oxytoca isolates, hyperproduction of the chromosomal beta-lactamase K1 was inferred, because genes of the above-mentioned types were not detected. The strains contained plasmid DNA between 45 and 160 kb in size. Common plasmid restriction patterns among SHV-5 producers provided evidence of horizontal spread. Twenty strains had a MIC for cefotaxime of ⩽4 mg l−1, 18 strains had the same MIC for ceftazidime, and nine strains had this MIC of >4 mg l−1 for both antibiotics. The ESBL phenotypes often coincided with ciprofloxacin or gentamicin resistance.

Molecular Epidemiology of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Isolated From Environmental and Clinical Specimens in a Cardiac Surgery Intensive Care Unit

2004 ◽  
Vol 25 (10) ◽  
pp. 852-855 ◽  
Author(s):  
Guillaume Kac ◽  
Isabelle Podglajen ◽  
Sabine Vaupré ◽  
Nathalie Colardelle ◽  
Annie Buu-Hoï ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Molecular Analysis ◽  
Klebsiella Oxytoca ◽  
University Teaching ◽  
Beta Lactamase ◽  
Clinical Strains ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

AbstractObjectives:To investigate environmental contamination by extended-spectrum beta-lactamase-producing Enterobacteriaceae and to perform a comparative molecular analysis of clinical and environmental strains.Setting:A 17-bed cardiac surgery intensive care unit of a 480-bed university teaching hospital.Methods:Following an outbreak of extended-spectrum beta-lactamase-producing Enterobacteriaceae, an environmental survey revealed extensive contamination of the environment (particularly faucets, sink drains, and the joints of the countertops) by extended-spectrum beta-lactamase-producing Enterobacteriaceae. Environmental strains were compared with clinical strains by pulsed-field gel electrophoresis and randomly amplified polymorphic DNA.Results:A total of 62 environmental strains belonging to 4 species of extended-spectrum beta-lactamase-producing Enterobacteriaceae were analyzed and compared with 43 clinical strains obtained from 34 patients. Comparative molecular analysis revealed 4 identical or closely related patterns (3 fromKlebsiella oxytocaand 1 fromEnterobacter cloacae)between environmental and clinical strains.Conclusions:Moist surfaces may serve as sources of multiply resistant Enterobacteriaceae in the intensive care unit. Identification and disinfection of such sources may therefore be helpful in prevention and control of outbreaks.

Co-Carriage Rates of Vancomycin-ResistantEnterococcusand Extended-Spectrum Beta-Lactamase-Producing Bacteria Among a Cohort of Intensive Care Unit Patients: Implications for an Active Surveillance Program

2004 ◽  
Vol 25 (2) ◽  
pp. 105-108 ◽  
Author(s):  
Anthony D. Harris ◽  
Lucia Nemoy ◽  
Judith A. Johnson ◽  
Amy Martin-Carnahan ◽  
David L. Smith ◽  
...  
Keyword(s):  
Intensive Care ◽  
Active Surveillance ◽  
Predictive Value ◽  
Resistant Bacteria ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Surveillance Cultures ◽  
Colonization Rates

AbstractObjective:To assess the co-colonization rates of extended-spectrum beta-lactamase (ESBL)-producing bacteria and vancomycin-resistantEnterococcus(VRE) obtained on active surveillance cultures.Design:Prospective cohort study.Setting:Medical and surgical intensive care units (ICUs) of a tertiary-care hospital.Patients:Patients admitted between September 2001 and November 2002 to the medical and surgical ICUs at the University of Maryland Medical System had active surveillance perirectal cultures performed. Samples were concurrently processed for VRE and ESBL-producing bacteria.Results:Of 1,362 patients who had active surveillance cultures on admission, 136 (10%) were colonized with VRE. Among these, 15 (positive predictive value, 11%) were co-colonized with ESBL. Among the 1,226 who were VRE negative, 1,209 were also ESBL negative (negative predictive value, 99%). Among the 1,362 who had active surveillance cultures on admission, 32 (2%) were colonized with ESBL. Among these, 15 (47%) were co-colonized with VRE. Of the 32 patients colonized with ESBL, 10 (31%) had positive clinical cultures for ESBL on the same hospital admission. For these 10 patients, the surveillance cultures were positive an average of 2.7 days earlier than the clinical cultures.Conclusions:Patients who are colonized with VRE can also be co-colonized with other antibiotic-resistant bacteria such as ESBL-producing bacteria. Our study is the first to measure co-colonization rates of VRE and ESBL-producing bacteria. Isolating VRE-colonized patients would isolate 47% of the ESBL-colonized patients without the need for further testing. Hence, active surveillance for VRE should also theoretically diminish the amount of patient-to-patient transmission of ESBL-producing bacteria.

scholarly journals Enrichment Broth and Detection of Extended-Spectrum-Beta-Lactamase-Producing Bacteria in Throat and Rectal Surveillance Cultures of Intensive Care Unit Patients

2009 ◽  
Vol 47 (9) ◽  
pp. 3066-3067 ◽  
Author(s):  
B. M. W. Diederen ◽  
S. M. Euser ◽  
J.-L. A. N. Murk ◽  
D. L. J. Hess ◽  
C. M. J. E. Vandenbroucke-Grauls ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Beta Lactamase ◽  
Enrichment Broth ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Surveillance Cultures
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