Colonization by high-level aminoglycoside-resistant enterococci in intensive care unit patients: epidemiology and clinical relevance
A cohort study was performed to investigate the risk factors for colonization with high-level aminoglycoside-resistant enterococci (HLARE) in intensive care unit (ICU) patients. Colonization was investigated by performing surveillance samples during ICU stay. Clonal relatedness of the isolates was a...
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| Veröffentlicht in: | The Journal of hospital infection 2005-08, Vol.60 (4), p.353-359 |
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| creator | Rodríguez-Baño, J. Ramírez, E. Muniain, M.A. Santos, J. Joyanes, P. González, F. García-Sánchez, M. Martínez-Martínez, L. |
| description | A cohort study was performed to investigate the risk factors for colonization with high-level aminoglycoside-resistant enterococci (HLARE) in intensive care unit (ICU) patients. Colonization was investigated by performing surveillance samples during ICU stay. Clonal relatedness of the isolates was assessed by pulsed-field gel electrophoresis. Eighty-six patients with an ICU stay of >48
h were included; two were colonized with HLARE at admission, and 24 (28.5%) acquired HLARE during their stay in the ICU. HLARE were initially isolated from rectal swabs alone. Thirty-five percent of
Enterococcus faecalis and 57% of
E. faecium showed high-level resistance to gentamicin or streptomycin. Most isolates were clonally unrelated. Using multi-variate analysis, the only variable associated with HLARE colonization was previous antimicrobial use. Five patients had HLARE isolated from clinical samples, three of them with infection; in all of these, colonization with the same clone had been detected previously by surveillance samples. We conclude that most infections due to HLARE in the ICU are preceded by previous colonization, and that antimicrobial use is the main risk factor for colonization. |
| doi_str_mv | 10.1016/j.jhin.2004.12.024 |
| format | Article |
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h were included; two were colonized with HLARE at admission, and 24 (28.5%) acquired HLARE during their stay in the ICU. HLARE were initially isolated from rectal swabs alone. Thirty-five percent of
Enterococcus faecalis and 57% of
E. faecium showed high-level resistance to gentamicin or streptomycin. Most isolates were clonally unrelated. Using multi-variate analysis, the only variable associated with HLARE colonization was previous antimicrobial use. Five patients had HLARE isolated from clinical samples, three of them with infection; in all of these, colonization with the same clone had been detected previously by surveillance samples. We conclude that most infections due to HLARE in the ICU are preceded by previous colonization, and that antimicrobial use is the main risk factor for colonization.</description><identifier>ISSN: 0195-6701</identifier><identifier>EISSN: 1532-2939</identifier><identifier>DOI: 10.1016/j.jhin.2004.12.024</identifier><identifier>PMID: 15893852</identifier><language>eng</language><publisher>Kent: Elsevier Ltd</publisher><subject>Aminoglycosides - pharmacology ; Anti-Bacterial Agents - pharmacology ; Antibacterial agents ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Biological and medical sciences ; Cohort Studies ; Cross Infection - epidemiology ; Cross Infection - microbiology ; DNA Fingerprinting ; DNA, Bacterial - genetics ; Drug Resistance, Bacterial ; Electrophoresis, Gel, Pulsed-Field ; Enterococcus ; Enterococcus - drug effects ; Enterococcus - isolation & purification ; Enterococcus faecalis ; Enterococcus faecalis - drug effects ; Enterococcus faecium - drug effects ; Female ; General aspects ; Genotype ; Gentamicins - pharmacology ; Gram-Positive Bacterial Infections - epidemiology ; Gram-Positive Bacterial Infections - microbiology ; High-level aminoglycoside resistance ; Hospital-acquired infections ; Human infectious diseases. Experimental studies and models ; Humans ; Infectious diseases ; Intensive care unit ; Intensive Care Units - statistics & numerical data ; Male ; Medical sciences ; Molecular Epidemiology ; Pharmacology. Drug treatments ; Risk Factors ; Spain - epidemiology ; Streptomycin - pharmacology</subject><ispartof>The Journal of hospital infection, 2005-08, Vol.60 (4), p.353-359</ispartof><rights>2005 The Hospital Infection Society</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-d9de931ef45ebf123dba80ccde6e311a2056417f36c4d78a9d78adfbcf687b4c3</citedby><cites>FETCH-LOGICAL-c415t-d9de931ef45ebf123dba80ccde6e311a2056417f36c4d78a9d78adfbcf687b4c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jhin.2004.12.024$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16948493$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15893852$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rodríguez-Baño, J.</creatorcontrib><creatorcontrib>Ramírez, E.</creatorcontrib><creatorcontrib>Muniain, M.A.</creatorcontrib><creatorcontrib>Santos, J.</creatorcontrib><creatorcontrib>Joyanes, P.</creatorcontrib><creatorcontrib>González, F.</creatorcontrib><creatorcontrib>García-Sánchez, M.</creatorcontrib><creatorcontrib>Martínez-Martínez, L.</creatorcontrib><title>Colonization by high-level aminoglycoside-resistant enterococci in intensive care unit patients: epidemiology and clinical relevance</title><title>The Journal of hospital infection</title><addtitle>J Hosp Infect</addtitle><description>A cohort study was performed to investigate the risk factors for colonization with high-level aminoglycoside-resistant enterococci (HLARE) in intensive care unit (ICU) patients. Colonization was investigated by performing surveillance samples during ICU stay. Clonal relatedness of the isolates was assessed by pulsed-field gel electrophoresis. Eighty-six patients with an ICU stay of >48
h were included; two were colonized with HLARE at admission, and 24 (28.5%) acquired HLARE during their stay in the ICU. HLARE were initially isolated from rectal swabs alone. Thirty-five percent of
Enterococcus faecalis and 57% of
E. faecium showed high-level resistance to gentamicin or streptomycin. Most isolates were clonally unrelated. Using multi-variate analysis, the only variable associated with HLARE colonization was previous antimicrobial use. Five patients had HLARE isolated from clinical samples, three of them with infection; in all of these, colonization with the same clone had been detected previously by surveillance samples. We conclude that most infections due to HLARE in the ICU are preceded by previous colonization, and that antimicrobial use is the main risk factor for colonization.</description><subject>Aminoglycosides - pharmacology</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Antibacterial agents</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - microbiology</subject><subject>DNA Fingerprinting</subject><subject>DNA, Bacterial - genetics</subject><subject>Drug Resistance, Bacterial</subject><subject>Electrophoresis, Gel, Pulsed-Field</subject><subject>Enterococcus</subject><subject>Enterococcus - drug effects</subject><subject>Enterococcus - isolation & purification</subject><subject>Enterococcus faecalis</subject><subject>Enterococcus faecalis - drug effects</subject><subject>Enterococcus faecium - drug effects</subject><subject>Female</subject><subject>General aspects</subject><subject>Genotype</subject><subject>Gentamicins - pharmacology</subject><subject>Gram-Positive Bacterial Infections - epidemiology</subject><subject>Gram-Positive Bacterial Infections - microbiology</subject><subject>High-level aminoglycoside resistance</subject><subject>Hospital-acquired infections</subject><subject>Human infectious diseases. Experimental studies and models</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Intensive care unit</subject><subject>Intensive Care Units - statistics & numerical data</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Molecular Epidemiology</subject><subject>Pharmacology. Drug treatments</subject><subject>Risk Factors</subject><subject>Spain - epidemiology</subject><subject>Streptomycin - pharmacology</subject><issn>0195-6701</issn><issn>1532-2939</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc2K2zAUhUVp6WSmfYEuijbtzq4kS45VuhnC_BQGumnXQpaukxtsKZWcQLrug1chgdl1QEggvnPu5RxCPnBWc8bbL9t6u8FQC8ZkzUXNhHxFFlw1ohK60a_JgnGtqnbJ-BW5znnLGCv_6i254qrTTafEgvxdxTEG_GNnjIH2R7rB9aYa4QAjtROGuB6PLmb0UCXImGcbZgphhhRddA4phnJmCBkPQJ1NQPcBZ7orhgXLXynsinjCMmZ9pDZ46kYM6OxIE5Q5Njh4R94Mdszw_vLekF_3dz9Xj9XTj4fvq9unykmu5sprD7rhMEgF_cBF43vbMec8tNBwbgVTreTLoWmd9MvO6tPlh94NbbfspWtuyOez7y7F33vIs5kwOxhHGyDus2k7xjrF1IugYJxJ1uoCijPoUsw5wWB2CSebjoYzcyrJbM2pJHMqyXBhSklF9PHivu8n8M-SSysF-HQBbC5BDamEhPmZa7XspG4K9-3MQQntgJBMdiV1Bx4TuNn4iP_b4x9hw7RM</recordid><startdate>20050801</startdate><enddate>20050801</enddate><creator>Rodríguez-Baño, J.</creator><creator>Ramírez, E.</creator><creator>Muniain, M.A.</creator><creator>Santos, J.</creator><creator>Joyanes, P.</creator><creator>González, F.</creator><creator>García-Sánchez, M.</creator><creator>Martínez-Martínez, L.</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20050801</creationdate><title>Colonization by high-level aminoglycoside-resistant enterococci in intensive care unit patients: epidemiology and clinical relevance</title><author>Rodríguez-Baño, J. ; Ramírez, E. ; Muniain, M.A. ; Santos, J. ; Joyanes, P. ; González, F. ; García-Sánchez, M. ; Martínez-Martínez, L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-d9de931ef45ebf123dba80ccde6e311a2056417f36c4d78a9d78adfbcf687b4c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aminoglycosides - pharmacology</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Antibacterial agents</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Cross Infection - epidemiology</topic><topic>Cross Infection - microbiology</topic><topic>DNA Fingerprinting</topic><topic>DNA, Bacterial - genetics</topic><topic>Drug Resistance, Bacterial</topic><topic>Electrophoresis, Gel, Pulsed-Field</topic><topic>Enterococcus</topic><topic>Enterococcus - drug effects</topic><topic>Enterococcus - isolation & purification</topic><topic>Enterococcus faecalis</topic><topic>Enterococcus faecalis - drug effects</topic><topic>Enterococcus faecium - drug effects</topic><topic>Female</topic><topic>General aspects</topic><topic>Genotype</topic><topic>Gentamicins - pharmacology</topic><topic>Gram-Positive Bacterial Infections - epidemiology</topic><topic>Gram-Positive Bacterial Infections - microbiology</topic><topic>High-level aminoglycoside resistance</topic><topic>Hospital-acquired infections</topic><topic>Human infectious diseases. 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Drug treatments</topic><topic>Risk Factors</topic><topic>Spain - epidemiology</topic><topic>Streptomycin - pharmacology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rodríguez-Baño, J.</creatorcontrib><creatorcontrib>Ramírez, E.</creatorcontrib><creatorcontrib>Muniain, M.A.</creatorcontrib><creatorcontrib>Santos, J.</creatorcontrib><creatorcontrib>Joyanes, P.</creatorcontrib><creatorcontrib>González, F.</creatorcontrib><creatorcontrib>García-Sánchez, M.</creatorcontrib><creatorcontrib>Martínez-Martínez, L.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of hospital infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rodríguez-Baño, J.</au><au>Ramírez, E.</au><au>Muniain, M.A.</au><au>Santos, J.</au><au>Joyanes, P.</au><au>González, F.</au><au>García-Sánchez, M.</au><au>Martínez-Martínez, L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Colonization by high-level aminoglycoside-resistant enterococci in intensive care unit patients: epidemiology and clinical relevance</atitle><jtitle>The Journal of hospital infection</jtitle><addtitle>J Hosp Infect</addtitle><date>2005-08-01</date><risdate>2005</risdate><volume>60</volume><issue>4</issue><spage>353</spage><epage>359</epage><pages>353-359</pages><issn>0195-6701</issn><eissn>1532-2939</eissn><abstract>A cohort study was performed to investigate the risk factors for colonization with high-level aminoglycoside-resistant enterococci (HLARE) in intensive care unit (ICU) patients. Colonization was investigated by performing surveillance samples during ICU stay. Clonal relatedness of the isolates was assessed by pulsed-field gel electrophoresis. Eighty-six patients with an ICU stay of >48
h were included; two were colonized with HLARE at admission, and 24 (28.5%) acquired HLARE during their stay in the ICU. HLARE were initially isolated from rectal swabs alone. Thirty-five percent of
Enterococcus faecalis and 57% of
E. faecium showed high-level resistance to gentamicin or streptomycin. Most isolates were clonally unrelated. Using multi-variate analysis, the only variable associated with HLARE colonization was previous antimicrobial use. Five patients had HLARE isolated from clinical samples, three of them with infection; in all of these, colonization with the same clone had been detected previously by surveillance samples. We conclude that most infections due to HLARE in the ICU are preceded by previous colonization, and that antimicrobial use is the main risk factor for colonization.</abstract><cop>Kent</cop><pub>Elsevier Ltd</pub><pmid>15893852</pmid><doi>10.1016/j.jhin.2004.12.024</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0195-6701 |
| ispartof | The Journal of hospital infection, 2005-08, Vol.60 (4), p.353-359 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Aminoglycosides - pharmacology Anti-Bacterial Agents - pharmacology Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Biological and medical sciences Cohort Studies Cross Infection - epidemiology Cross Infection - microbiology DNA Fingerprinting DNA, Bacterial - genetics Drug Resistance, Bacterial Electrophoresis, Gel, Pulsed-Field Enterococcus Enterococcus - drug effects Enterococcus - isolation & purification Enterococcus faecalis Enterococcus faecalis - drug effects Enterococcus faecium - drug effects Female General aspects Genotype Gentamicins - pharmacology Gram-Positive Bacterial Infections - epidemiology Gram-Positive Bacterial Infections - microbiology High-level aminoglycoside resistance Hospital-acquired infections Human infectious diseases. Experimental studies and models Humans Infectious diseases Intensive care unit Intensive Care Units - statistics & numerical data Male Medical sciences Molecular Epidemiology Pharmacology. Drug treatments Risk Factors Spain - epidemiology Streptomycin - pharmacology |
| title | Colonization by high-level aminoglycoside-resistant enterococci in intensive care unit patients: epidemiology and clinical relevance |
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