| Autor: |
Hayakawa, Kayoko, Gattu, Sureka, Marchaim, Dror, Bhargava, Ashish, Palla, Mohan, Alshabani, Khaled, Gudur, Uma Mahesh, Pulluru, Harish, Bathina, Pradeep, Sundaragiri, Pranathi Rao, Sarkar, Moumita, Kakarlapudi, Hari, Ramasamy, Balaji, Nanjireddy, Priyanka, Mohin, Shah, Dasagi, Meenakshi, Datla, Satya, Kuchipudi, Vamsi, Reddy, Swetha, Shahani, Shobha, Upputuri, Vijaya, Marrey, Satya, Gannamani, Vedavyas, Madhanagopal, Nandhini, Annangi, Srinadh, Sudha, Busani, Muppavarapu, Kalyan Srinivas, Moshos, Judy A., Lephart, Paul R., Pogue, Jason M., Bush, Karen, Kaye, Keith S. |
| Zdroj: |
Antimicrobial Agents and Chemotherapy; May 2013, Vol. 57 Issue: 8 p4010-4018, 9p |
| Abstrakt: |
ABSTRACTA case-case-control study was conducted to identify independent risk factors for recovery of Escherichia colistrains producing CTX-M-type extended-spectrum β-lactamases (CTX-M E. coli) within a large Southeastern Michigan medical center. Unique cases with isolation of ESBL-producing E. colifrom February 2010 through July 2011 were analyzed by PCR for blaCTX-M, blaTEM, and blaSHVgenes. Patients with CTX-M E. coliwere compared to patients with E. colistrains not producing CTX-M-type ESBLs (non-CTX-M E. coli) and uninfected controls. Of 575 patients with ESBL-producing E. coli, 491 (85.4%) isolates contained a CTX-M ESBL gene. A total of 319 (84.6%) patients with CTX-M E. coli(282 [74.8%] CTX-M-15 type) were compared to 58 (15.4%) non-CTX-M E. colipatients and to uninfected controls. Independent risk factors for CTX-M E. coliisolation compared to non-CTX-M E. coliincluded male gender, impaired consciousness, H2 blocker use, immunosuppression, and exposure to penicillins and/or trimethoprim-sulfamethoxazole. Compared to uninfected controls, independent risk factors for isolation of CTX-M E. coliincluded presence of a urinary catheter, previous urinary tract infection, exposure to oxyimino-cephalosporins, dependent functional status, non-home residence, and multiple comorbid conditions. Within 48 h of admission, community-acquired CTX-M E. coli(n= 51 [16%]) and non-CTX-M E coli(n= 11 [19%]) strains were isolated from patients with no recent health care contacts. CTX-M E. colistrains were more resistant to multiple antibiotics than non-CTX-M E. colistrains. CTX-M-encoding genes, especially blaCTX-M-15type, represented the most common ESBL determinants from ESBL-producing E. coli, the majority of which were present upon admission. Septic patients with risk factors for isolation of CTX-M E. colishould be empirically treated with appropriate agents. Regional infection control efforts and judicious antibiotic use are needed to control the spread of these organisms. |
| Databáze: |
Supplemental Index |
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