Prevalence and predictors of MRSA, ESBL, and VRE colonization in the ambulatory IBD population

Abstract

Ambulatory IBD patients have similar prevalence of MRSA, ESBL and VRE compared to non-IBD controls. This finding suggests that the increased MRSA and VRE prevalence observed in hospitalized IBD patients is acquired in-hospital rather than in the outpatient setting.

Prevalence and Incidence of Antimicrobial‐Resistant Organisms among Hospitalized Inflammatory Bowel Disease Patients

“…In our single-centre study, we observed that the prevalence of MRSA and ESBL colonization on admission did not significantly differ between hospitalized IBD patients and non-IBD inpatients. This finding is consistent with our previous study of ARO prevalence among IBD ambulatory clinic patients and non-IBD controls recruited from the family practice clinics and emergency departments from the same tertiary centre (17). These findings are reassuring given previous reports that IBD patients incur a greater number of health care contacts and hospitalizations than the general population (18).…”

“…Two additional historical control groups were included in the analysis (17): one group of IBD patients from the ambulatory clinics at Mount Sinai Hospital recruited between July 15, 2010 and December 21, 2010; and a non-IBD cohort from the centre's affiliated family practice clinic recruited between June 15 and August 15, 2008 that was recruited as part of another MRSA prevalence study. The ambulatory IBD control group was used a comparator to assess potential differences in MRSA risk between the subgroup of IBD patients who required hospitalization and the broader ambulatory IBD population.…”

“…Furthermore, it remains unclear whether IBD patients acquire MRSA infection de novo during hospitalization or whether they are admitted with MRSA colonization that predisposes them to subsequent infection. A Toronto (Ontario)-based study suggested that the prevalence of ARO colonization is similar between IBD patients and non-IBD controls in the outpatient setting (17). However, IBD patients who require hospitalization may reflect a different subgroup of patients with respect to disease severity and exposure to risk factors for ARO.…”

Tip of the iceberg?

“…18 We recently conducted a study of 306 ambulatory IBD patients from our tertiary referral center and found that the prevalence of MRSA colonization was 1.6% and similar to that of the non-IBD control group (1.5%) comprising individuals who attended the colon cancer screening program; the family practice unit; and the emergency department. 19 There may have been selection bias because this study included only clinic patients. It is possible that a select group of patients who did not attend clinics may have had higher rates of MRSA colonization.…”

Discovery and preliminary SAR of 14-aryloxy-andrographolide derivatives as antibacterial agents with immunosuppressant activity

“…27 To meet the demand of clinical medication for the treatment of digestive diseases caused by gastrointestinal bacterial infection, antibacterial drugs with diverse and novel structural origins are required.…”