期刊
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
卷 68, 期 5, 页码 1043-1048出版社
OXFORD UNIV PRESS
DOI: 10.1093/jac/dks502
关键词
extended-spectrum -lactamases; ESBLs; Enterobacteriaceae; children; risk factors
资金
- Norwegian Reference Center for Detection of Antimicrobial Resistance, University Hospital of North Norway
- Stavanger University Hospital
- NORM (Usage of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Norway) [09_15]
- Western Norway Regional Health Authority [911640]
To investigate the duration of faecal carriage of CTX-M-15-producing Klebsiella pneumoniae in infants colonized during a nosocomial neonatal intensive care unit (NICU) outbreak after discharge from hospital, possible risk factors for long-term colonization and transmission to household contacts (HCs). Fifty-one infants colonized with two unrelated clones of CTX-M-15 K. pneumoniae [sequence type (ST) 17 and ST485] during an NICU outbreak and 60 HCs provided faecal and rectal samples, respectively, every 13 months after hospital discharge. Extended-spectrum -lactamase (ESBL)-producing strains of K. pneumoniae were identified on Chrom ID ESBL agar and examined by antimicrobial susceptibility testing. bla(CTX-M-15) was detected by PCR and DNA sequencing. Clonal relationship was examined by PFGE. The median carriage time in infants after discharge was 12.5 months (IQR 9.517.5). Stable antimicrobial susceptibility patterns in PFGE-related strains confirmed the intestinal persistence of both outbreak strains. Risk factors for prolonged faecal carriage in infants were delivery by caesarean section [hazard ratio (HR) 2.4, 95 CI 1.15.5, P0.029] and treatment with antibiotics during hospitalization (HR 4.5, 95 CI 1.612.6, P0.004). Transmission of CTX-M-15 K. pneumoniae was observed in 9/28 (32) households. Median carriage length in parents was 2.5 months (IQR 1.05.0) (P0.001 compared with infants). Infants may be long-term faecal carriers of ESBL-producing K. pneumoniae after colonization during hospitalization in the neonatal period. Delivery by caesarean section and antibiotic treatment during hospitalization are possible risk factors for prolonged carriage. Faecal ESBL carriage in infants represents a reservoir for intra-household spread of ESBL-producing K. pneumoniae.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据