Association between rectal colonization with Highly Resistant Gram-negative Rods (HR-GNRs) and subsequent infection with HR-GNRs in clinical patients: A one year historical cohort study
| Autor: | Sjoerd M. Euser, Jeroen W. Den Boer, John W. A. Rossen, Bjorn L. Herpers, Jan Kluytmans, Dennis Souverein |
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| Přispěvatelé: | Microbes in Health and Disease (MHD) |
| Rok vydání: | 2019 |
| Předmět: |
Bacterial Diseases
Male 0301 basic medicine Microbiological culture Medical Doctors Health Care Providers Logistic regression Cohort Studies 0302 clinical medicine Antibiotics Medicine and Health Sciences Gram-negative rods Colonization Medical Personnel 030212 general & internal medicine Aged 80 and over Multidisciplinary biology Antimicrobials Confounding Drugs Hematology Middle Aged Professions Infectious Diseases Enterobacter Infections Urinary Tract Infections Medicine Female Anatomy Historical Cohort Research Article Cohort study Adult medicine.medical_specialty Gram-negative bacteria Science Urology Urinary system 030106 microbiology Microbiology 03 medical and health sciences Microbial Control Physicians Internal medicine Gram-Negative Bacteria medicine Humans Gram Negative Bacteria Aged Pharmacology business.industry Rectum Biology and Life Sciences Bloodstream Infections Bacteriology Odds ratio biology.organism_classification Gastrointestinal Tract Health Care Clinical trial Antibiotic Resistance People and Places Population Groupings Antimicrobial Resistance Gram-Negative Bacterial Infections business Digestive System Follow-Up Studies |
| Zdroj: | PLoS ONE, Vol 14, Iss 1, p e0211016 (2019) PLoS ONE, 14(1):e0211016. PUBLIC LIBRARY SCIENCE PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | OBJECTIVE: Rectal colonization with Highly Resistant Gram-negative Rods (HR-GNRs) probably precedes infection. We aimed to assess the association between rectal HR-GNR colonization and subsequent HR-GNR infection in clinical patients during a follow-up period of one year in a historical cohort study design.METHODS: Rectal HR-GNR colonization was assessed by culturing. Subsequent development of infection was determined by assessing all clinical microbiological culture results extracted from the laboratory information system including clinical data regarding HR-GNR infections. A multivariable logistic regression model was constructed with HR-GNR rectal colonization as independent variable and HR-GNR infection as dependent variable. Gender, age, antibiotic use, historic clinical admission and previous (HR-GNR) infections were included as possible confounders.RESULTS: 1133 patients were included of whom 68 patients (6.1%) were colonized with a HR-GNR. In total 22 patients with HR-GNR infections were detected. Urinary tract infections were most common (n = 14, 63.6%), followed by bloodstream infections (n = 5, 22.7%) and other infections (n = 8, 36.4%). Eight out of 68 HR-GNR colonized patients (11.8%) developed a subsequent HR-GNR infection compared to 14 out of 1065 HR-GNR negative patients (1.3%), resulting in an odds ratio (95% CI) of 7.1 (2.8-18.1) in the multivariable logistic regression analyses.CONCLUSIONS: Rectal colonization with a HR-GNR was a significant risk factor for a subsequent HR-GNR infection. This implies that historical colonization culture results should be considered in the choice of empirical antibiotic therapy to include coverage of the cultured HR-GNR, at least in critically ill patients. |
| Databáze: | OpenAIRE |
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