Abstract
BackgroundThe objective of this study was to determine whether patients infected with extended-spectrum beta-lactamase (ESBL)-producing organisms are colonized at multiple body sites.MethodsThis was a prospective cohort study at a tertiary care center in Beirut, Lebanon. Hospitalized patients with infections caused by ESBL-producing organisms were included. Cultures were obtained from the primary site of infection as well as from other sites (skin, nasopharynx, urine, rectum). Molecular analysis was performed on isolates to determine clonal relatedness.ResultsOne hundred patients were included in the study. Only 22 patients had positive cultures from sites other than the primary site of infection. The most common ESBL gene was CTX-M-15 followed by TEM-1. In 11 of 22 patients, isolates collected from the same patient were 100% genetically related, while in the remaining patients, genomic relatedness ranged from 42.9% to 97.1%.ConclusionsColonization at sites other than the primary site of infection was not common among our patient population infected with ESBL-producing organisms. The dynamics of transmission of these bacterial strains should be studied in further prospective studies to determine the value of routine active surveillance and the need for expanded precautions in infected and colonized patients.
Highlights
The objective of this study was to determine whether patients infected with extended-spectrum beta-lactamase (ESBL)-producing organisms are colonized at multiple body sites
The objective of this study is to evaluate the extent of colonization with ESBL-EC and ESBL-KP in hospitalized patients with active infections and designing recommendations
Adult patients who were hospitalized at AUBMC between July 2011 and February 2014 and who were diagnosed with an infection due to ESBL-EC or ESBL-KP were included in the study
Summary
The objective of this study was to determine whether patients infected with extended-spectrum beta-lactamase (ESBL)-producing organisms are colonized at multiple body sites. ESBL-producing organisms have evolved over the past two decades to become a phenomenon of paramount medical importance at the global level. There exists wide geographical variations in the the problem of ESBL-producing organisms is clearly more accentuated in developing countries [6], it is important to mention that the magnitude of the problem is still probably underestimated due to inadequate or ineffective detection in some clinical laboratories [7, 8]. Kanafani et al Antimicrobial Resistance and Infection Control (2017) 6:46 with growing concerns of emergence of ESBL-producing organisms in the community and hospital settings [9,10,11,12,13]. At AUBMC, the proportion of ESBL-EC and ESBL-KP has risen between 1999 and 2016 from 2.5% and 9.8% to 28.5% and 30%, respectively (data from the Clinical Microbiology Laboratory)
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