Colonization With Multidrug-Resistant Organisms Among Healthy Adults in the Community Setting: Prevalence, Risk Factors, and Composition of Gut Microbiome

Abstract

Background: The prevalence of colonization with multidrug-resistant organisms (MDROs) among healthy adults in the community is largely unknown. This study investigated the colonization rate of multidrug-resistant Enterobacteriaceae, methicillinresistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE) in the community in Taiwan, and compared the gut microbiota between MDRO carriers and non-carriers.

Colonization Dynamics of Multidrug-Resistant Klebsiella pneumoniae Are Dictated by Microbiota-Cluster Group Behavior over Individual Antibiotic Susceptibility: A Metataxonomic Analysis

“…and E. coli ) significantly contribute to the attributable deaths, sequelae, and disability-adjusted life-years in the burden of MDR bacteria [ 31 ]. These resistant isolates were previously prevalent in hospital-associated infections; however, their description in community-acquired infections is becoming more frequent [ 24 , 25 , 32 ]. In addition, in our globalized world, there is a substantial risk for the acquisition of ESBL-producing and/or CRE strains during travel to endemic areas, especially if one comes into contact with a hospital environment in these countries [ 21 , 26 , 27 ].…”

“…One of the main hindering factors associated with the attempts to eliminate gastrointestinal colonization is that the underlying mechanisms of developing intestinal carriage and clearance of MDR pathogens are not well understood. Apart from inter- and intra-individual differences in colonization risk (underlying conditions, immunosuppression, gut health), lifestyle factors, nutrition, and medicines are also known to influence microbiota composition [ 24 , 25 , 26 , 27 ]. Antibiotics (especially broad-spectrum agents) are known to alter gut microbiota composition and, in turn, create favorable conditions for the overgrowth of MDR or opportunistic bacteria, leading to infection [ 19 , 25 , 27 , 28 ].…”

“…Apart from inter- and intra-individual differences in colonization risk (underlying conditions, immunosuppression, gut health), lifestyle factors, nutrition, and medicines are also known to influence microbiota composition [ 24 , 25 , 26 , 27 ]. Antibiotics (especially broad-spectrum agents) are known to alter gut microbiota composition and, in turn, create favorable conditions for the overgrowth of MDR or opportunistic bacteria, leading to infection [ 19 , 25 , 27 , 28 ]. In addition, exposure to antibiotics often leads to the upregulation and rapid spread of antibiotic resistance genes among the members of the gut microbiota via horizontal gene transfer (HGT), leading to the exacerbation of resistance rates [ 29 ].…”

<p>Fecal Carriage and Molecular Epidemiology of Carbapenem-Resistant <em>Enterobacteriaceae</em> from Inpatient Children in a Pediatric Hospital of Shanghai</p>

“…11 Several studies have been conducted to investigate the epidemiology characteristics of intestinal colonization of CRE strains in hospitalized adults. 12,13 However, the fecal carriage of CRE in hospitalized children has not been well studied, especially in China. Therefore, our study was conducted to determine the clinical characteristics, antimicrobial resistance profiles and molecular epidemiology of intestinal colonization of CRE among inpatients in a pediatric hospital in Shanghai, China.…”

Study on the Distribution and Source of Multidrug-resistant Organisms Infection in Non-ICU&nbsp;Departments

“…Therefore, controlling the spread of MDRO is concerned with great public interest [1][2][3][4] . ICU patients become the high-risk group of MDRO infection due to the severe condition, invasive operations, low immunity, and antimicrobial exposure.…”