Presence of Clostridioides difficile and multidrug-resistant healthcare-associated pathogens in stool specimens from hospitalized patients in the USA
| Autor: | Julie Anderson, Amanda T. Harrington, Caitlin M. dela Cruz, Matthew J. Bankowski, Rose Overcast, J. Stacey Klutts, Anne E. Obradovich, Violeta J. Rekasius, Terrie Koyamatsu, Isabella A. Tickler, Niaz Banaei, Jamie Lynne Dill, Albert Rojtman, Mary Ann Henthorne, Scott Dewell, Richard V. Goering, Victoria M. Le, Fred C. Tenover |
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| Rok vydání: | 2020 |
| Předmět: |
Methicillin-Resistant Staphylococcus aureus
Microbiology (medical) medicine.disease_cause Vancomycin-Resistant Enterococci law.invention Microbiology Feces law Drug Resistance Multiple Bacterial Humans Medicine Pathogen Genotyping Polymerase chain reaction Cross Infection Gastrointestinal tract Clostridioides difficile business.industry Enterobacteriaceae Infections General Medicine United States Gastrointestinal Tract Hospitalization Multiple drug resistance Infectious Diseases Carriage Staphylococcus aureus Clostridium Infections business Clostridioides |
| Zdroj: | Journal of Hospital Infection. 106:179-185 |
| ISSN: | 0195-6701 |
| Popis: | Summary Background Healthcare-associated infections (HCAIs) continue to be a major cause of morbidity and mortality. Many HCAI pathogens, including multidrug-resistant organisms (MDROs), colonize the gastrointestinal tract. Aim To determine the frequency of MDRO carriage in patients who do and do not harbour toxigenic Clostridioides difficile in their stools. Methods Stool specimens received from nine US laboratories were cultured using media selective for C. difficile, Staphylococcus aureus, vancomycin-resistant enterococci (VRE), and carbapenem-resistant Gram-negative organisms (CROs). Specimens and isolates were also tested by polymerase chain reaction (PCR). Bacterial isolates underwent susceptibility testing and genotyping. Findings Among 363 specimens, 175 yielded toxigenic C. difficile isolates spanning 27 PCR ribotypes. C. difficile (TCD+) stools harboured an additional 28 organisms, including six CROs (3.4%), of which two (1.1%) were carbapenemase-producing organisms (CPOs), 19 VRE (10.9%), and three meticillin-resistant S. aureus isolates (MRSA, 1.7 %). Stools that were culture negative for toxigenic C. difficile (TCD–) yielded 26 organisms, including four CROs (2.1%), 20 VRE (10.6), and two MRSA (1.1%). Excluding C. difficile, no significant differences were seen in the rates of the MDROs between TCD+ and TCD– specimens. Conclusion Overall, 15.4% of the TCD+ stools and 11.2% of the TCD– stools carried at least one non-C. difficile MDRO pathogen, indicating that multiple MDROs may be present in the gastrointestinal tracts of patients, including those that harbour C. difficile. |
| Databáze: | OpenAIRE |
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