scholarly journals Relating knowledge, attitude and practice of antibiotic use to extended-spectrum beta-lactamase-producing Enterobacteriaceae carriage: results of a cross-sectional community survey

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e023859 ◽  
Author(s):  
Yin Mo ◽  
Ivan Seah ◽  
Pei Shi Priscillia Lye ◽  
Xiang Lee Jamie Kee ◽  
Kien Yee Michael Wong ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Community Dwelling ◽  
Molecular Characteristics ◽  
Beta Lactamase ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Modifiable Factors ◽  
Rectal Swabs ◽  
Stool Samples

ObjectivesTo study the correlation between knowledge, attitude and practices (KAP) of antibiotic consumption with epidemiology and molecular characteristics of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) carriage, in order to identify modifiable factors and public health interventions to reduce prevalence of multidrug-resistant organism colonisation in the community.DesignCross-sectional questionnaire of KAP towards antibiotic use and collection of stool samples or rectal swabs. ESBL-PE isolates obtained underwent whole genome sequencing to identify resistance genes.SettingA densely populated community in Singapore.ParticipantsThere were 693 healthy community-dwelling questionnaire respondents. Out of which, 305 provided stool samples or rectal swabs.ResultsThe overall knowledge of antibiotic use was poor (mean score 4.6/10, IQR 3.0–6.0). 80 participants (80/305, 26.2%) carried at least one ESBL-PE isolate. The most common ESBL-PE was Escherichia coli sequence type 131 carrying CTX-M type beta-lactamases (11/71, 15.5%). Living overseas for >1 year (OR 3.3, 95% CI 1.6 to 6.9) but not short-term travel, recent hospitalisation or antibiotic intake was associated with ESBL-PE carriage. Interestingly, higher knowledge scores (OR 2.0, 95% CI 1.03 to 3.9) and having no leftover antibiotics (OR 2.4, 95% CI 1.2 to 4.9) were independent factors associated with ESBL-PE carriage in the multivariate logistic regression model.ConclusionsWhile the role of trans-border transmission of antimicrobial resistance is well known, we may have to examine the current recommendation that all antibiotics courses have to be completed. Clinical trials to determine the optimum duration of treatment for common infections are critically important.

scholarly journals The Effect of Infection Precautions on Colonization of Nursing Staff with Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae in Three Beirut Hospitals

2020 ◽  
Author(s):  
Nicholas Haddad ◽  
Joanna Abi Ghosn
Keyword(s):  
Nursing Staff ◽  
Work Experience ◽  
Randomized Study ◽  
Antibiotic Use ◽  
Contact Precaution ◽  
Beta Lactamase ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
The Impact

Abstract Background: ESBL-PE are emerging worldwide. This study assesses the effect of contact precaution (CP) on ESBL-PE-colonization rates among nurses in 3 hospitals in Beirut, where ESBL is endemic, to define risk factors for colonization, and evaluate the ongoing use of CP to prevent ESBL-PE transmission to healthy nurses. Methods: Cross-sectional, non-randomized study completed in three hospitals. Hospital 1 required CP, Hospital 2 recently stopped CP, and Hospital 3 had stopped it 3 years previously. Questionnaires and stool-collection containers were distributed to all patient care nurses in those 3 hospitals. Returned samples were tested using agar dilution technique. Results: 269 of 733 nurses volunteered; 140 met inclusion criteria (no recent hospitalization, antibiotic use, known ESBL-PE colonization). 15% were ESBL-positive. Compared to nurses from Hospital 3, nurses from Hospital 1 were 59% less likely to be colonized, while nurses from Hospital 2 were 62% more likely to be colonized. Discussion: In hospitals where CP is ongoing for ESBL-positive patients, transmission to nursing staff was reduced. Additionally, a work experience of 2-4 years increased the odds of ESBL-PE colonization in comparison with longer nursing experience. HIGHLIGHTS : • We examined the impact of contact precautions (CP) for Extended spectrum beta-lactamase- producing Enterobacteriaceae (ESBL-PE) colonized patients on rates of ESBL-PE colonization in nursing staff. • We found significantly decreased rates of colonization in nurses from a hospital utilizing CP, and significantly increased rates of colonization among nurses from a hospital that recently • discontinued CP, compared with nurses from a hospital that had discontinued CP 3 years previously. • Findings suggest that contact precaution may be required to prevent ESBL-PE transmission from patients to nursing staff.

scholarly journals Infection of Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae and Its Association with Antibiotic Use in Patients of Central ICU "Rumah Sakit Cipto Mangunkusumo" in 2011

2014 ◽  
Author(s):  
Arini Purwono ◽  
Yulia Rosa Saharman
Keyword(s):  
Secondary Data ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Beta Lactamase ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Laboratory Test Results

Background Irrational use of antibiotics could increase the incidence of infection caused by the extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae. Prevalence of ESBL-producing Enterobacteriaceae varies among hospitals, and its resistance could complicate the treatment, extend the hospital length of stay, and increase the mortality. The aim of this study is to determine the prevalence of ESBL-producing Enterobacteriaceae and its association with antibiotic use. Methods This study was a cross sectional study, involving 111 secondary data derived from ESBL resistance test of culture examinations which used the standardized method according to The Clinical and Laboratory Standards Institute (CLSI) and patients medical records in Central ICU RSCM in 2011. Results Laboratory test results showed that 8 from 111 samples (7,2%) were infected with Enterobacteriaceae producing ESBL. Data were analyzed using chi-square test, p=0,05. Statistical analysis results were RP>1 with the value of significance p=1.000 and 95% CI 1.039; 1.179. Conclusion It is concluded that there is no association between antibiotic use and ESBL-producing Enterobacteriaceae infection in Central ICU RSCM in 2011.

scholarly journals Colonisation with extended spectrum beta-lactamase-producing and carbapenem-resistant Enterobacterales in children admitted to a paediatric referral hospital in South Africa

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241776
Author(s):  
Babatunde O. Ogunbosi ◽  
Clinton Moodley ◽  
Preneshni Naicker ◽  
James Nuttall ◽  
Colleen Bamford ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Sub Saharan Africa ◽  
Infection Prevention And Control ◽  
Invasive Infection ◽  
Beta Lactamase ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
Carbapenem Resistant ◽  
Extended Spectrum

Introduction There are few studies describing colonisation with extended spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) and carbapenem-resistant Enterobacterales (CRE) among children in sub-Saharan Africa. Colonisation often precedes infection and multi-drug-resistant Enterobacterales are important causes of invasive infection. Methods In this prospective cross-sectional study, conducted between April and June 2017, 200 children in a tertiary academic hospital were screened by rectal swab for EBSL-PE and CRE. The resistance-conferring genes were identified using polymerase chain reaction technology. Risk factors for colonisation were also evaluated. Results Overall, 48% (96/200) of the children were colonised with at least one ESBL-PE, 8.3% (8/96) of these with 2 ESBL-PE, and one other child was colonised with a CRE (0.5% (1/200)). Common colonising ESBL-PE were Klebsiella pneumoniae (62.5%, 65/104) and Escherichia coli (34.6%, 36/104). The most frequent ESBL-conferring gene was blaCTX-M in 95% (76/80) of the isolates. No resistance- conferring gene was identified in the CRE isolate (Enterobacter cloacae). Most of the Klebsiella pneumoniae isolates were susceptible to piperacillin/tazobactam (86.2%) and amikacin (63.9%). Similarly, 94.4% and 97.2% of the Escherichia coli isolates were susceptible to piperacillin/tazobactam and amikacin, respectively. Hospitalisation for more than 7 days before study enrolment was associated with ESBL-PE colonisation. Conclusion Approximately half of the hospitalised children in this study were colonised with ESBL-PE. This highlights the need for improved infection prevention and control practices to limit the dissemination of these microorganisms.

scholarly journals Extended Spectrum Beta-Lactamase Production in Uropathogens Isolated from Hospitalized Patients with Chronic Pyelonephritis

2015 ◽  
Vol 8 (1) ◽  
pp. 71-75 ◽  
Author(s):  
Olga I Chub ◽  
Aleksandr V Bilchenko ◽  
Igor Khalin
Keyword(s):  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Chronic Pyelonephritis ◽  
Diffusion Method ◽  
Beta Lactamase ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Tract Infections

Background : Increased multidrug resistance of extended-spectrum beta-lactamases (ESBLs) compromises the efficacy of treatment of urinary tract infections. Objective : The objective of this study is to determine the prevalence of ESBL-producing uropathogens from hospitalized patients with chronic pyelonephritis and to identify the presence of genes involved in the resistance. Methods : A cross-sectional study of 105 patients with chronic pyelonephritis, treated in Kharkiv City Clinical Emergency Hospital, Ukraine was carried. Bacterial isolates were collected, antimicrobial susceptibility of isolates was determined by the Kirby Bauer disk diffusion method and screening for the presence of blaSHV, blaTEM, blaCTX-M ESBL genes was performed by polymerase chain reaction. Results : 84 (80%) patients had positive urine cultures. Eschеrichia coli wаs the most common microorganism isolated. Among them, 29 (25.2%) were found to be ESBL producers. Out of 53 E. coli isolates, 10 (18.9%), 4 (7.5%) and 6 (11.3%) were identified to carry bla(TEM), bla(SHV) and bla(CTX-M) beta-lactamase genes, respectively. The highest resistance was observed against ampicillin (75.9%), ciprofloxacin (48.3%), levofloxacin (41.4%) and gentamicin (41.4%). Beside this, only meropenem (96.6% susceptibility), nitroxolinum (86.2%) and fosfomycin (72.4%) exhibited a good enough activity against ESBLs-producing urinary strains. Conclusion : Isоlation and detеction of ESBL-prоducing strаins are еssential fоr the sеlection оf the mоst effеctive antibiоtic for the empiric trеatment.

scholarly journals Prevalence of Extended Spectrum Beta Lactamase Producing and Carbapenems Resistance Isolates from Hands of Health Care Workers in a Health Care Setting of Nepal

2020 ◽  
Vol 13 (1) ◽  
pp. 23-31
Author(s):  
Binita Koirala Sharma
Keyword(s):  
Health Care ◽  
Antibiotic Susceptibility ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Resistant Bacteria ◽  
Beta Lactamase ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

Background: Hands of healthcare workers (HCWs) could be colonized by potential drug resistant bacteria like Extended Spectrum Beta Lactamase producers (ESBLs) and Carbapenems-resistant (CR) isolates and could become vectors of nosocomial pathogens in healthcare facilities that are associated with an increase of morbidity, mortality and healthcare costs. This study aimed to investigate the prevalence of ESBLs and CR isolates from hands of HCWs with their antibiotic susceptibility pattern. Materials and methods: This was a cross-sectional study that included a total of 150 hand swabs collected from March, 2018 to September, 2018 in Gandaki Medical College and Teaching Hospital. Isolation, identification and antimicrobial susceptibility tests were done using standard microbiological procedures. Results: Among the total isolates of 219 obtained from growth positive samples 92/219(42.01%) were Gram negative bacteria (GNB) and the most common were Klebsiella spp 32(34.78%) followed by Escherichia coli 17(18.48%), Pseudomonas aeruginosa12 (13.04%), Acenetobacter spp 11(11.96%), Proteus spp 9(9.78%), Citrobacter spp 7(7.61%) and Enterobacter spp 4(4.35%). The prevalence of ESBLs, CR and ESBLs with Co-resistant to Carbapenems were 19.56%,14.13% and 9.78%, respectively. The most effective drugs for isolates were Nitrofurantoin followed by Amikacin, Tetracycline and Gentamycin. Distribution pattern of the ESBLs and CR isolates among doctors, nurses, laboratory technicians, helpers and basic science faculties were not significant (p>0.05). Conclusions: This report revealed the emerging and moderately high prevalence of ESBLs, CR and ESBLs with Co-resistant to Carbapenems GNB with their antibiotic susceptibility patterns found on hands of HCWs in Nepal. Thus, this study could be helpful in developing proper guidelines on hand hygiene and implementation of infection control measures including contact precautions against the spread of infections by such pathogens in healthcare settings.  

scholarly journals Quantifying antibiotic impact on within-host dynamics of extended-spectrum beta-lactamase resistance in hospitalized patients

2019 ◽  
Author(s):  
Rene Niehus ◽  
Esther van Kleef ◽  
Mo Yin ◽  
Agata Turlej-Rogacka ◽  
Christine Lammens ◽  
...  
Keyword(s):  
Drug Resistance ◽  
16S Rrna ◽  
Gene Family ◽  
Antibiotic Use ◽  
Beta Lactamase ◽  
Prospective Longitudinal Study ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Variable Nature ◽  
Prospective Longitudinal

AbstractAntibiotic exposure can perturb the human gut microbiome and cause changes in the within-host abundance of the genetic determinants of drug-resistance in bacteria. Such within-host dynamics are expected to play an important role in mediating the relationship between antibiotic use and persistence of drug-resistance within a host and its prevalence within a population. Developing a quantitative representation of these within-host dynamics is an important step towards a detailed mechanistic understanding of the population-level processes by which antibiotics select for resistance. Here we study extended-spectrum beta-lactamase (ESBL) producing organisms of the Enterobacteriaceae bacterial family. These have been identified as a global public health priority and are resistant to most first-line antibiotics for treatment of Enterobacteriaceae infections.We analyse data from 833 rectal swabs from a prospective longitudinal study in three European countries including 133 ESBL-positive hospitalised patients. Quantitative polymerase chain reaction was used to quantify the abundance of the CTX-M gene family – the most wide-spread ESBL gene family – and the 16S rRNA gene as a proxy for bacterial load. We find strong dynamic heterogeneity in CTX-M abundance that is largely explained by the variable nature of the swab sampling. Using information on time-varying antibiotic treatments, we develop a dynamic Bayesian model to decompose the serial data into observational variation and ecological signal and to quantify the potentially causal antibiotic effects.We find an association of treatment with cefuroxime or ceftriaxone with increased CTX-M abundance (approximately 21% and 10% daily increase, respectively), while treatment with meropenem or piperacillin-tazobactam is associated with decreased CTX-M (approximately 8% daily decrease for both). Despite a potential risk for indirect selection, oral ciprofloxacin is also associated with decreasing CTX-M (approximately 8% decrease per day). Using our dynamic model to make forward stochastic simulations of CTX-M dynamics, we generate testable predictions about antibiotic impacts on duration of carriage. We find that a typical course of cefuroxime or ceftriaxone is expected to more than double a patient’s carriage duration of CTX-M. A typical course of piperacillin-tazobactam or of meropenem – both options to treat hospital acquired infections (HAI) like pneumonia – would reduce CTX-M carriage time relative to ceftriaxone plus amikacin (also an option to treat HAIs) by about 70%. While most antibiotics showed little association with changes in total bacterial abundance, meropenem and piperacillin-tazobactam were associated with decrease in 16S rRNA abundance (3% and 4% daily decrease, respectively).Our study quantifies antibiotic impacts on within-host resistance abundance and resistance carriage, and informs our understanding of how changes in patterns of antibiotic use will affect the prevalence of resistance. This work also provides an analytical framework that can be used more generally to quantify the antibiotic treatment effects on within-host dynamics of determinants of antibiotic resistance using clinical data.

scholarly journals Molecular Detection of Extended Spectrum Beta-lactamase Resistance in Escherichia coli from Poultry Droppings in Karu, Nasarawa State, Nigeria

2021 ◽  
pp. 31-42
Author(s):  
S. C. Tama ◽  
Y. B. Ngwai ◽  
G. R. I. Pennap ◽  
I. H. Nkene ◽  
R. H. Abimiku
Keyword(s):  
Escherichia Coli ◽  
Molecular Detection ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Microbiological Methods ◽  
Poultry Droppings

Aims: This study investigates and reports the production of extended spectrum beta-lactamase in Escherichia coli isolates in poultry droppings sourced from selected poultry farms in Karu, Nigeria Study Design:  Cross sectional study Place and Duration of Study: Department of Microbiology, Nasarawa State University, Keffi, between August 2019 and February 2020. Methodology: Escherichia coli was isolated from the samples using standard cultural and microbiological methods. Antibiotic susceptibility testing and minimum inhibitory concentrations were evaluated as described by the Clinical and Laboratory Standards Institute (CLSI). The detection of ESBL production in E. coli isolates was carried out using double disc synergy test.  In addition, molecular detection of ESBL genes was carried out using Polymerase Chain Reaction (PCR) method. Results: All (100%) samples collected had E. coli. Antibiotic resistances in the isolates in decreasing order were as follows: ampicillin (96.7%), streptomycin (94.4%), sulphamethoxazole /trimethoprim (87.8%), amoxicillin/ clavulanic acid (61.1%), gentamicin (52.2%), ciprofloxacin (40.0%), ceftazidime (35.6%), cefotaxime (31.1%), imipenems (22.2%), cefoxitin (13.3%). The commonest antibiotic resistant phenotype was AMP-SXT-S-CTX-CN (8.8%). Multiple antibiotic resistance (MAR) was observed in 92.2% (83/90) of the isolates with the common MAR indices being 0.5 (26.5%), 0.6 (19.2%), 0.4 (13.2%) and 0.9 (10.8%). Fifty nine of the eighty beta-lactam resistant isolates (73.7%) were confirmed ESBL producers. 55 of the 59 ESBL positive isolates (93.2%) carried bla genes as follows:   blaSHV (50/55, 90.9%), blaTEM (31/55, 56.3%) and blaCTX-M (46/55, 83.6%). Thirty six (65.5%) of the 55 isolates carried two bla genes (blaSHV and blaTEM, blaTEM and blaCTX-M, and blaCTX-M and blaSHV). Conclusion: The E. coli isolates showed lower resistances to cefoxitin, imipenem, cefotaxime, ceftazidime, and ciprofloxacin and most isolates were MAR, with resistance to 5 antibiotics being the most predominant. In addition, blaSHV gene was the most common ESBL gene detected in the confirmed ESBL-producing E. coli isolates.

Sign in / Sign up

Export Citation Format

Share Document