Risk factors for fecal carriage of carbapenemase producing Enterobacteriaceae among intensive care unit patients from a tertiary care center in India
| Autor: | Gajanand Mittal, Prashant Verma, Rajni Gaind, Gaurav Kaushik, Deepak Kumar, Monorama Deb, Kunj Bihari Gupta |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Microbiology (medical) DNA Bacterial Imipenem 030106 microbiology India Carbapenem-resistant enterobacteriaceae Tigecycline Microbial Sensitivity Tests Gut colonization Biology Microbiology Meropenem beta-Lactamases law.invention Tertiary Care Centers 03 medical and health sciences Feces Bacterial Proteins Enterobacteriaceae law Risk Factors Carbapenem resistant Enterobacteriaceae Drug Resistance Bacterial medicine Humans Colonization AmpC Intensive care unit Infection Control Enterobacteriaceae Infections biochemical phenomena metabolism and nutrition Anti-Bacterial Agents Gastrointestinal Microbiome Intensive Care Units Carriage Carbapenemase producing Enterobacteriaceae ESBL Colistin Risk factor medicine.drug Research Article |
| Zdroj: | BMC Microbiology |
| ISSN: | 1471-2180 |
| Popis: | Background Resistance amongst the commensal flora is a serious threat because a very highly populated ecosystem like the gut, may at a later stage, be a source of extra intestinal infections, resistant strains may spread to other host or transfer genetic resistance element to other members of micro-biota including pathogens. This study was carried out to assess fecal colonization by carbapenemase producing Enterobacteriaceae (CPE) and associated risk factors among 100 patients admitted to intensive care unit (ICU). The phenotypic and molecular characterizations of CPE were also included. Results Colonization with CPE was observed in 6.6 % (8/122) controls. Among ICU patients, fecal carriage of CPE was significantly higher on day 4 (D4) (22 %) as compared to day 1 (D1) (11 %) (p value 0.002). The carbapenemase genes detected included OXA- 48, 181, KPC and NDM-1 with NDM-1 being the predominant carbapenemase in both ICU D1 and D4. Among the 50 CPE isolates, 8 (16 %) were susceptible to meropenem and imipenem (Minimum inhibitory concentration; MIC ≤ 1 mg/L) and all were susceptible to colistin (MIC range 0.125 - 1 mg/L) and tigecycline (MIC range 0.06- 1.5 mg/L). The risk factors associated with CPE carriage were duration of ICU stay, use of ventilator and aminoglycosides. Conclusions Prior colonization with CPE could result in their influx and spread in ICU, challenging infection control measures. Exposure to ICU further increases risk of colonization with diverse carbapenemase-producing Enterobacteriaceae. Gut colonization with these strains may be a source of endogenous infection and horizontal transfer of these genes in future. Electronic supplementary material The online version of this article (doi:10.1186/s12866-016-0763-y) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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