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

Authors
 Young Ah Kim  ;  Yoon Soo Park  ;  Banseok Kim  ;  Young Hee Seo  ;  Kyungwon Lee 
Citation
 ANNALS OF LABORATORY MEDICINE, Vol.40(2) : 164-168, 2020 
Journal Title
 ANNALS OF LABORATORY MEDICINE 
ISSN
 2234-3806 
Issue Date
2020
MeSH
Aged ; Aged, 80 and over ; Anti-Bacterial Agents/pharmacology ; Drug Resistance, Bacterial/genetics ; Electrophoresis, Gel, Pulsed-Field ; Female ; Fluoroquinolones/pharmacology ; Genotype ; Humans ; Intensive Care Units ; Klebsiella Infections/epidemiology ; Klebsiella Infections/microbiology ; Klebsiella Infections/pathology* ; Klebsiella pneumoniae/enzymology* ; Klebsiella pneumoniae/genetics ; Klebsiella pneumoniae/isolation & purification ; Length of Stay ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; beta-Lactamases/genetics*
Keywords
Colonization ; Extended spectrum β-lactamase ; Klebsiella pneumoniae ; Prevalence ; Risk factor
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.
Files in This Item:
T202001074.pdf Download
DOI
10.3343/alm.2020.40.2.164
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175649
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