Prevalence and Risk Factors for Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Colonization in Intensive Care Units

Young Ah Kim, Yoon Soo Park, Banseok Kim, Young Hee Seo, Kyungwon Lee

Research output: Contribution to journalArticle

Abstract

Active surveillance culture (ASC) can help detect hidden reservoirs, but the routine use of ASC for extended spectrum β-lactamase-producing Enterobacteriaceae is controversial in an endemic situation. We aimed to determine the prevalence and risk factors of extended spectrum β-lactamase-producing Klebsiella pneumoniae (EBSL-Kpn) colonization among intensive care unit (ICU)-admitted patients. Prospective screening of ESBL-Kpn colonization was performed for ICU-admitted patients within 48 hours for two months. A perirectal swab sample was inoculated on MacConkey agar supplemented with 2 μg/mL ceftazidime. ESBL genotype was determined by PCR-sequencing, and clonal relatedness was evaluated by pulsed-field gel electrophoresis (PFGE). The risk factors of ESBL-Kpn colonization were evaluated. The ESBL-Kpn colonization rate among the 281 patients at ICU admission was 6.4% (18/281), and blaCTX-M-15 was detected in all isolates. ESBL producers also showed resistance to fluoroquinolone (38.9%, 7/18). All isolates had the same ESBL genotype (blaCTX-M-15) and a highly clustered PFGE pattern, suggesting cross-transmission without a documented outbreak. In univariate analysis, the risk factor for ESBL-Kpn colonization over the control was the length of hospital stay (odds ratio=1.062; P=0.019). Routine use of ASC could help control endemic ESBL-Kpn for ICU patients.

Original languageEnglish
Pages (from-to)164-168
Number of pages5
JournalAnnals of laboratory medicine
Volume40
Issue number2
DOIs
Publication statusPublished - 2020 Mar 1

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Intensive care units
Klebsiella pneumoniae
Intensive Care Units
Pulsed Field Gel Electrophoresis
Electrophoresis
Length of Stay
Gels
Genotype
Ceftazidime
Fluoroquinolones
Enterobacteriaceae
Agar
Disease Outbreaks
Screening
Odds Ratio
Polymerase Chain Reaction
galantide

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

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title = "Prevalence and Risk Factors for Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Colonization in Intensive Care Units",
abstract = "Active surveillance culture (ASC) can help detect hidden reservoirs, but the routine use of ASC for extended spectrum β-lactamase-producing Enterobacteriaceae is controversial in an endemic situation. We aimed to determine the prevalence and risk factors of extended spectrum β-lactamase-producing Klebsiella pneumoniae (EBSL-Kpn) colonization among intensive care unit (ICU)-admitted patients. Prospective screening of ESBL-Kpn colonization was performed for ICU-admitted patients within 48 hours for two months. A perirectal swab sample was inoculated on MacConkey agar supplemented with 2 μg/mL ceftazidime. ESBL genotype was determined by PCR-sequencing, and clonal relatedness was evaluated by pulsed-field gel electrophoresis (PFGE). The risk factors of ESBL-Kpn colonization were evaluated. The ESBL-Kpn colonization rate among the 281 patients at ICU admission was 6.4{\%} (18/281), and blaCTX-M-15 was detected in all isolates. ESBL producers also showed resistance to fluoroquinolone (38.9{\%}, 7/18). All isolates had the same ESBL genotype (blaCTX-M-15) and a highly clustered PFGE pattern, suggesting cross-transmission without a documented outbreak. In univariate analysis, the risk factor for ESBL-Kpn colonization over the control was the length of hospital stay (odds ratio=1.062; P=0.019). Routine use of ASC could help control endemic ESBL-Kpn for ICU patients.",
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Prevalence and Risk Factors for Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Colonization in Intensive Care Units. / Kim, Young Ah; Park, Yoon Soo; Kim, Banseok; Seo, Young Hee; Lee, Kyungwon.

In: Annals of laboratory medicine, Vol. 40, No. 2, 01.03.2020, p. 164-168.

Research output: Contribution to journalArticle

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