Colonization with Carbapenem-Resistant Enterobacteriaceae Contributes to Unfavorable Outcomes in End-Stage Liver Disease Patients

Zeng, Guofen; Pang, Yingxin; Zheng, Jiaxin; Zhuo, Chuyue; Guo, Yingyi; Liu, Jiayin; Li, Xiaojie; Lei, Ziying; Zhu, Jianyun; Xu, Lejia; Gao, Zhiliang; Zhuo, Chao; Liu, Jing

doi:10.3390/antibiotics11111667

Cited by 1 publication

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“…The family Enterobacteriales naturally colonizes in the gastrointestinal tract, which is the most important reservoir for CRE strains. Previous studies reported that the prevalence of CRE colonization rates was less than or ∼5%, but it would be higher in critical patients in the intensive care unit (4)(5)(6)(7). Furthermore, fecal carriage of CRE isolates is regarded as a risk factor for developing CRE infections.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of intestinal colonization and nosocomial infection with carbapenem-resistant Enterobacteriales in children: a retrospective study

Pan,

Chen,

Duan

et al. 2023

Front. Public Health

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ObjectiveWe investigated the epidemiological surveillance of the intestinal colonization and nosocomial infection of carbapenem-resistant Enterobacteriales (CRE) isolates from inpatients, which can provide the basis for developing effective prevention.MethodsA total of 96 CRE strains were collected from 1,487 fecal samples of hospitalized children between January 2016 and June 2017, which were defined as the “CRE colonization” group. In total, 70 CRE clinical isolates were also randomly selected for the comparison analysis and defined as the “CRE infection” group. The antimicrobial susceptibility of all strains was determined by the microdilution broth method. Polymerase chain reaction (PCR) was used to analyze carbapenemase genes, plasmid typing, and integrons. Multilocus sequence typing was further used to determine clonal relatedness.ResultsIn the “CRE colonization” group, Klebsiella pneumoniae was mostly detected with a rate of 42.7% (41/96), followed by Escherichia coli (34.4%, 33/96) and Enterobacter cloacae (15.6%, 15/96). The ST11 KPC-2 producer, ST8 NDM-5 producer, and ST45 NDM-1 producer were commonly present in carbapenem-resistant K. pneumoniae (CRKPN), carbapenem-resistant E. coli (CRECO), and carbapenem-resistant E. cloacae (CRECL) isolates, respectively. In the “CRE infection” group, 70% (49/70) of strains were K. pneumoniae, with 21.4% E. cloacae (15/70) and 5.7% E. coli (4/70). The ST15 OXA-232 producer and ST48 NDM-5 producer were frequently observed in CRKPN isolates, while the majority of NDM-1-producing CRECL isolates were assigned as ST45. Phylogenetic analysis showed that partial CRE isolates from intestinal colonization and nosocomial infection were closely related, especially for ST11 KPC-2-producing CRKPN and ST45 NDM-1-producing CRECL. Furthermore, plasmid typing demonstrated that IncF and IncFIB were the most prevalent plasmids in KPC-2 producers, while IncX3/IncX2 and ColE were widely spread in NDM producer and OXA-232 producer, respectively. Then, class 1 integron intergrase intI1 was positive in 74.0% (71/96) of the “CRE colonization” group and 52.9% (37/70) of the “CRE infection” group.ConclusionThis study revealed that CRE strains from intestinal colonization and nosocomial infection showed a partial correlation in the prevalence of CRE, especially for ST11 KPC-2-producing CRKPN and ST45 NDM-1-producing CRECL. Therefore, before admission, long-term active screening of rectal colonization of CRE isolates should be emphasized.

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Section: Introductionmentioning

confidence: 99%