Prevalence and Risk Factors of Fecal Carriage of Extended-Spectrum β-lactamase (ESBL) -Producing Enterobacteriaceae in Hospitalized and Ambulatory Children

Kiremitci, Abdurrahman; Durmaz, Gül; Aybey, Aşkin; Dinleyici, Ener Çağrı; Yargiç, Zeynel Abidin; Tekin, Ahmet; AKŞİT, M. Arif

doi:10.5152/ced.2011.22

Cited by 7 publications

(9 citation statements)

References 17 publications

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“…This data is comparable with results of a study reported in India 43%. 23 Our results showed higher carriage rate compared to studies conducted in Turkey 24%, 24 Israel 8%, 25 India 9.3% 26 and USA 2%, 27 but lower than the rates found in other studies conducted in Ethiopia 52%, 19 Ecuador 56%, 28 Morocco 58%, 29 Egypt 68%, 30 and Cambodia 61.9%. 31 The possible reason for the variability of colonization rate found among different studies could be attributed to variations in the socioeconomic status of the population included and the study design.…”

Section: Discussioncontrasting

confidence: 50%

<p>Gastrointestinal Tract Colonization Rate of Extended-Spectrum Beta-Lactamase- and Carbapenemase-Producing Enterobacteriaceae and Associated Factors Among Hospitalized Patients in Arba Minch General Hospital, Arba Minch, Ethiopia</p>

Aklilu¹,

Manilal²,

Ameya³

et al. 2020

IDR

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Background: The incidence of hospital-acquired enterobacteria that produce extendedspectrum beta-lactamases (ESBLs) is on the rise worldwide. Colonization of gastrointestinal tract by extended-spectrum beta-lactamase Enterobacteriaceae, a prominent causative agent, results in life-threatening infections.Objective: To determine the rate of gastrointestinal colonization by extended-spectrum beta-lactamase-and carbapenemase-producing Enterobacteriaceae and also to elucidate the antibiotic susceptibility profile and associated risk factors among hospitalized patients in Arba Minch General Hospital, Ethiopia. Methodology: A facility-based cross-sectional study was conducted in Arba Minch General Hospital from May 2018 to July 2019. Sociodemographic data and associated factors were collected using a pre-tested-structured questionnaire. Stool specimens were collected using sterile stool cups. Each sample was then inoculated onto MacConkey agar. Bacterial isolates were identified using various biochemical tests. Screening and confirmatory tests for extended-spectrum beta-lactamase-and carbapenemase-producing Enterobacteriaceae were performed using the modified Kirby-Bauer disc diffusion technique. Statistical package for Social Science was used to analyze the data. The P-value ≤0.05 was considered as statistically significant. Results: A total of 421 hospitalized patients were enrolled in this study of which there were 240 (57%) females. The mean age of the study participants was 28.8 with SD of 15.7. Majority of participants were in the age range of 25-40 years 179 (42.5%). About 146 (34.7%) participants were found to be colonized by extended-spectrum beta-lactamaseproducing Enterobacteriaceae. The predominant ESBL-producing isolates were Escherichia coli 62 (42.46%) followed by Klebsiella pneumoniae 60 (41.09%). Six (1.43%) carbapenemase-producing K. pneumoniae were isolated. ESBL-producing Enterobacteriaceae showed higher resistance against tetracycline (91.1%) and cotrimoxazole (93.84%). Colonization of the gastrointestinal tract by ESBL showed statistically significant association with regard to chronic diseases (p<0.001) and the administration of oral antibiotics after admission (p=0.020). Conclusion:The overall colonization rate of the gastrointestinal tract by extended-spectrum beta-lactamase-producing Enterobacteriaceae was prominent. The extended-spectrum betalactamase-producing isolates exhibited a higher level of resistance against the commonly used antibiotics which further needs greater attention.

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Section: Discussioncontrasting

confidence: 50%

<p>Gastrointestinal Tract Colonization Rate of Extended-Spectrum Beta-Lactamase- and Carbapenemase-Producing Enterobacteriaceae and Associated Factors Among Hospitalized Patients in Arba Minch General Hospital, Arba Minch, Ethiopia</p>

Aklilu¹,

Manilal²,

Ameya³

et al. 2020

IDR

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“…In a tertiary care center in Turkey, fecal carriage of ESBL-producing E. coli and Klebsiella spp. was 24% (66/270) in hospitalized pediatric patients and 7.2% (14/194) in ambulatory children [35]. Our investigation showed that the majority of ESBL-PE isolated from healthy Lebanese infants carried multiple bla genes and that blaCTX-M was the predominant (91.4%) gene.…”

Section: Discussionmentioning

confidence: 57%

Multidrug-resistant ESBL-producing Enterobacteriaceae and associated risk factors in community infants in Lebanon

Hijazi

Fawzi

Ali

et al. 2016

J Infect Dev Ctries

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Introduction: Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) infections are a growing threat to children, and the treatment of these infections becomes more and more challenging. A huge reservoir for ESBLs in the community is the fecal flora of children. This study investigates the rectal colonization, associated risk factors, antimicrobial susceptibility, and molecular characterization of ESBL-PE in Lebanese community infants. Methodology: A total of 117 rectal swabs were taken from healthy infants between 1 and 12 months of age. Detection of ESBLs was carried out using the double-disk synergy test, combination-disk method, and multiplex polymerase chain reaction (PCR). A questionnaire about the infant's history and risk factors for carrying ESBL-PE was administered. Results: In total, 58 (49.6%) of 117 participants were ESBL-PE carriers. Some significant important risk factors for colonization in this study were male gender, hospital birth, caesarean delivery, and being formula-fed. Observed decrease in colonization rate was associated with intimate hygiene habits. Carriers of multiple bla genes were the most common. CTX-M type was the major harbored, gene and CTX-M-9 was the most predominant, followed by CTX-M-15 type. Conclusions: To the best of our knowledge, this is the first available data about the carriage rate of ESBL-PE in community infants in Lebanon and the Middle East, the first study showing that birth in hospital, caesarean delivery, and being formula-fed are all significantly associated risk factors for the high colonization rates in community -not hospitalized -infants, and showing the dominance of multiple resistance gene carriage and wide dissemination of CTX-M-9 ESBL.

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“…Çocuklarda GSBL üreten enterik bakteri taşıyıcılığının klinik sonuçlarının tam olarak bilinmediği, çocuklarda GSBL üreten enterik bakterilerin zamanla feçesten kaybolup yerini duyarlı suşların alabileceği ve bu değişim meydana gelmeden önceki sessiz taşıyıcılık periyodunda pediatri servislerinde özellikle de yenidoğan yoğun bakım ünitelerinde bu bakterilerin salgınlara yol açabileceği bildirilmektedir [6] . Ülkemizde çocukluk yaş grubunda GSBL üreten bakterilerin toplumdaki fekal taşıyıcılığı ile ilgili çok az sayıda yayın mevcut olup bunlar genel olarak yatan hastalarla ilişkilidir [15,16] . Kiremitçi ve arkadaşları 2007 yılında üçüncü basamak sağlık hizmeti veren bir hastanede polikliniğe başvuran çocuklarda yaptıkları incelemede %7.2 taşıyıcılık oranı bildirmişlerdir [16] .…”

Section: Discussionunclassified

“…Ülkemizde çocukluk yaş grubunda GSBL üreten bakterilerin toplumdaki fekal taşıyıcılığı ile ilgili çok az sayıda yayın mevcut olup bunlar genel olarak yatan hastalarla ilişkilidir [15,16] . Kiremitçi ve arkadaşları 2007 yılında üçüncü basamak sağlık hizmeti veren bir hastanede polikliniğe başvuran çocuklarda yaptıkları incelemede %7.2 taşıyıcılık oranı bildirmişlerdir [16] . Bizim çalışmamızda çocukluk yaş grubunda GSBL fekal taşıyıcılık oranı %33 (150/454) olarak belirlenmiştir.…”

Section: Discussionunclassified

“…Birgy ve arkadaşları küçük çocuklarda üçüncü kuşak sefalosporin kullanımının GSBL üreten bakterilerin fekal taşıyıcılığını arttırdığını bildirmişlerdir [25] . Ülkemizde Kiremitçi ve arkadaşları hastanede yatan veya polikliniğe başvuran çocuklarda taşıyıcılık riskini arttıran faktörlerden birisinin sefalosporin kullanımı öyküsü olduğunu, ayaktan hastalarda ikinci ya da üçüncü kuşak sefalosporin kullanımının fekal taşıyıcılıkta 2.4 katlık bir artışa yol açtığını bildirmişlerdir [16] . Mesa ve arkadaşları Ekim ve Kasım aylarında yüksek antibiyotik kullanımına rağmen belirlemiş oldukları düşük GSBL üreten bakteri sıklığının, bazı GSBL üreten suşlara karşı aktif olan amoksisilin/klavulanik asitin yüksek kullanımına bağlı olabileceğini ve benzer olarak Temmuz ve Eylül ayları arasında amoksisilin/klavulanik asit kullanımının azalmış olmasıyla GSBL üreten bakteri sıklığının artmış olabileceğini bildirmişlerdir [32] .…”

Section: Discussionunclassified

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Fecal Carriage of Extended Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli and Klebsiella spp. in Children in Zonguldak

Söğütlü¹,

Cömert²,

Pişkin³

et al. 2019

FLORA

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Giriş: Bu çalışmanın amacı, çocuklarda genişlemiş spektrumlu beta-laktamaz (GSBL) üreten Escherichia coli ve Klebsiella spp.'nin intestinal taşıyıcılık sıklığının araştırılması, GSBL enzim tiplerinin ve taşıyıcılığa etki eden risk faktörlerinin belirlenmesidir. Materyal ve Metod: Kasım 2012-Mayıs 2013 tarihleri arasında pediatri polikliniğine herhangi bir nedenle başvuran 0-15 yaş grubu çocukların rutin dışkı örnekleri değerlendirildi. Hastaların demografik özellikleri anket ile toplandı. Hasta örnekleri seçici eozin-metilen blue (EMB) agara ekildi. GSBL varlığı çift disk sinerji testi ile araştırıldı, gerekli durumlarda agar gradient yöntemi kullanıldı. İzole edilen bakterilerde enzim tipleri polimeraz zincir reaksiyonu (PCR) ile gösterildi.

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Prevalence and Risk Factors of Fecal Carriage of Extended-Spectrum β-lactamase (ESBL) -Producing Enterobacteriaceae in Hospitalized and Ambulatory Children

Cited by 7 publications

References 17 publications

<p>Gastrointestinal Tract Colonization Rate of Extended-Spectrum Beta-Lactamase- and Carbapenemase-Producing Enterobacteriaceae and Associated Factors Among Hospitalized Patients in Arba Minch General Hospital, Arba Minch, Ethiopia</p>

<p>Gastrointestinal Tract Colonization Rate of Extended-Spectrum Beta-Lactamase- and Carbapenemase-Producing Enterobacteriaceae and Associated Factors Among Hospitalized Patients in Arba Minch General Hospital, Arba Minch, Ethiopia</p>

Multidrug-resistant ESBL-producing Enterobacteriaceae and associated risk factors in community infants in Lebanon

Fecal Carriage of Extended Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli and Klebsiella spp. in Children in Zonguldak

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