Dataset Information

Local prevalence of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae intestinal carriers at admission and co-expression of ESBL and OXA-48 carbapenemase in Klebsiella pneumoniae: a prevalence survey in a Spanish University Hospital.

ABSTRACT: OBJECTIVE:To assess the prevalence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) faecal carriers at admission in a University Hospital in Spain. DESIGN:Prevalence survey. SETTING:Pneumology, gastroenterology, urology and neurosurgery units at a university tertiary hospital in Madrid (Spain). PARTICIPANTS:A total of 10 643 patients aged 18 and older admitted from March 2014 to April 2016 with a rectal swab taken at admission or as soon as possible within the first 48 hours. PRIMARY AND SECONDARY OUTCOME MEASURES:Prevalence of ESBL-E faecal carriers and prevalence of ESBL-E infections at admission. RESULTS:The prevalance of ESBL-E carriers at admission was 7.69% (CI 95% 7.18 to 8.19). Most of the isolates were Escherichia coli (77.51%), followed by Klebsiella pneumoniae (20.71%). Eighty-eight (10.41%) of ESBL-E were simultaneous ESBL and carbapenemase (CP) producers, 1.83% in the case of E. coli and 42.86% among K. pneumoniae isolates. Of the ESBL typed, 52.15% belonged to the cefotaximases (CTX-M-15) type and 91.38% of the CP were oxacillinase (OXA-48) type. Only 0.43% patients presented an active infection by ESBL-E at admission. CONCLUSIONS:The prevalence found in our study is very similar to that found in literature. However, we found a high percentage of simultaneous ESBL and CP producers, particularly in K. pneumoniae. Despite the high prevalence of colonised patients, the ESBL-infection rate at admission was very low.

SUBMITTER: Diaz-Agero Perez C

PROVIDER: S-EPMC6429960 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Local prevalence of extended-spectrum beta-lactamase (ESBL) producing <i>Enterobacteriaceae</i> intestinal carriers at admission and co-expression of ESBL and OXA-48 carbapenemase in <i>Klebsiella pneumoniae</i>: a prevalence survey in a Spanish University Hospital.

Díaz-Agero Pérez Cristina C López-Fresneña Nieves N Rincon Carlavilla Angela L AL Hernandez Garcia Marta M Ruiz-Garbajosa Patricia P Aranaz-Andrés Jesús María JM Maechler Friederike F Gastmeier Petra P Bonten Marc J M MJM Canton Rafael R

BMJ open 20190301 3

<h4>Objective</h4>To assess the prevalence of extended-spectrum beta-lactamase (ESBL)-producing <i>Enterobacteriaceae</i> (ESBL-E) faecal carriers at admission in a University Hospital in Spain.<h4>Design</h4>Prevalence survey.<h4>Setting</h4>Pneumology, gastroenterology, urology and neurosurgery units at a university tertiary hospital in Madrid (Spain).<h4>Participants</h4>A total of 10 643 patients aged 18 and older admitted from March 2014 to April 2016 with a rectal swab taken at admission o ...[more]

PMID: 30826764

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Project description:The increasing spread of carbapenemase-producing Enterobacteriaceae (CPE) poses a serious threat to public health. Recent studies suggested animals as a putative source of such bacteria. We investigated 19,025 Escherichia coli, 1607 Klebsiella spp. and 570 Enterobacter spp. isolated from livestock, companion animal, horse, and pet samples between 2009 and 2016 in our routine diagnostic laboratory for reduced susceptibility to carbapenems (CP) by using meropenem-containing media. Actively screened CP non-susceptible strains as well as 367 archived ESBL/AmpC-β-lactamase-producing Enterobacteriaceae were then tested for the presence of CP genes by PCRs. Among 21,569 isolates, OXA-48 could be identified as the sole carbapenemase type in 137 (0.64%) strains. The blaOXA-48 gene was located on an ∼60-kb IncL plasmid and sequence analysis revealed high similarity to reference plasmid pOXA-48a, which has been involved in the global spread of the blaOXA-48 gene in humans for many years. Klebsiella pneumoniae was the predominant OXA-48 producer (n = 86; 6.6% of all K. pneumoniae isolates), followed by E. cloacae (n = 28; 5.0%), Klebsiella oxytoca (n = 1; 0.3%), and E. coli (n = 22, 0.1%). OXA-48 was not found in livestock, but in dogs (120/3182; 3.8%), cats (13/792; 1.6%), guinea pig (1/43; 2.3%), rat (1/23; 4.3%), mouse (1/180; 0.6%), and one rabbit (1/144; 0.7%). Genotyping identified few major clones among the different enterobacteria species, including sequence types ST11 and ST15 for K. pneumoniae, ST1196 for E. coli, and ST506 and ST78 for E. cloacae, most of which were previously involved in the dissemination of multidrug-resistant strains in humans. The majority of OXA-48 isolates (n = 112) originated from a university veterinary clinic (UVC), while animals from further 16 veterinary institutions were positive. Clonal analyses suggested nosocomial events related to different species and STs in two veterinary clinics and horizontal transfer of the pOXA-48-like plasmid between bacterial species and animals. A systematic monitoring is urgently needed to assess the dissemination of CPE not only in livestock but also in companion animals and veterinary clinics.

Dataset Information

Local prevalence of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae intestinal carriers at admission and co-expression of ESBL and OXA-48 carbapenemase in Klebsiella pneumoniae: a prevalence survey in a Spanish University Hospital.

Publications

Local prevalence of extended-spectrum beta-lactamase (ESBL) producing <i>Enterobacteriaceae</i> intestinal carriers at admission and co-expression of ESBL and OXA-48 carbapenemase in <i>Klebsiella pneumoniae</i>: a prevalence survey in a Spanish University Hospital.

Similar Datasets

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