Background: Cancer patients are at increased risk of infection. Fecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) may increase this risk. There are few studies on the prevalence of ESBL-PE colonization and surgical site infections (SSIs).
Methods: This prospective cohort study included patients with gastrointestinal and gynecological malignancies who were admitted to the hospital for elective surgery. Rectal swab cultures were obtained on the day of admission and during the postoperative period every 5 days. Prevalence of ESBL-PE fecal colonization and risk factors for the development of SSI were assessed.
Results: We included 171 patients, 30 (17.5%) of whom were colonized with ESBL-PE at admission. This proportion increased to 21% (37 of 171) of the samples during the hospital stay. Incidence of SSI was 14.6% (n = 25). Ten of 37 (27%) patients colonized by ESBL-PE developed SSI versus 15 of 134 (11%) of the non-ESBL-PE (relative risk [RR], 2.163; 95% confidence interval [CI], 1.201-3.897; P = .016). Five patients developed a bloodstream infection, and 4 patients were colonized with ESBL-PE (RR = 4.02; 95% CI, 1.2-3.89; P = .008).
Conclusions: The rate of ESBL-PE fecal colonization in surgical patients was 17.5%. Colonization of ESBL-PE duplicated the risk of SSI by the same strain and, by a factor of 4, the risk of bloodstream infections.
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Drivers of extended spectrum β-lactamase (ESBL)-producing Enterobacterales colonization among residents of long-term health care facilities: a European multicentric prospective cohort study.
J Hosp Infect
January 2025
Infectious Diseases, Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany; Infectious Diseases, Dept of Diagnostic and Public Health, University Hospital Verona, Verona, Italy; DZIF-Clinical Research Unit, Infectious Diseases, Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany.
Article Synopsis
- ESBL-producing Enterobacterales (ESBL-PE) are common in long-term care facilities (LTCFs), prompting a study across six sites in Europe to assess how residents acquire these bacteria and the associated risk factors.
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High prevalence of colonization with extended-spectrum β-lactamase-producing and multidrug-resistant Enterobacterales in the community in Addis Ababa Ethiopia: risk factors, carbapenem resistance, and molecular characterization.
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Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Background: Globally, extended-spectrum beta-lactamase-producing and carbapenem-resistant Enterobacterales are major causes of hospital-acquired infections and there are increasing concerns about their role in community-acquired infections.
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View Article and Find Full Text PDFGut colonization and subsequent infection of neonates caused by extended-spectrum beta-lactamase-producing and .
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Laboratorio de Infectología, Microbiología e Inmunología Clínica. Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico.
The gut microbiota harbors diverse bacteria considered reservoirs for antimicrobial resistance genes. The global emergence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (ESBL-PE) significantly contributes to healthcare-associated infections (HAIs). We investigated the presence of ESBL-producing (ESBL-PEco) and ESBL-producing (ESBL-PKpn) in neonatal patients' guts.
View Article and Find Full Text PDFWithin-host genetic diversity of extended-spectrum beta-lactamase-producing Enterobacterales in long-term colonized patients.
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Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Despite recognition of the immediate impact of infections caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (ESBL-PE) on human health, essential aspects of their molecular epidemiology remain under-investigated. This includes knowledge on the potential of a particular strain to persist in a host, mutational events during colonization, and the genetic diversity in individual patients over time. To investigate long-term genetic diversity of colonizing and infecting ESBL-Klebsiella pneumoniae species complex and ESBL-Escherichia coli in individual patients over time, we performed a ten-year longitudinal retrospective study and extracted clinical and microbiological data from electronic health records.
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