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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 PLoS+One
2017 ; 12
(3
): e0173510
Nephropedia Template TP
gab.com Text
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English Wikipedia
Fecal carriage of extended spectrum ?-lactamase producing Escherichia coli and
Klebsiella pneumoniae after urinary tract infection - A three year prospective
cohort study
#MMPMID28267783
Jørgensen SB
; Søraas A
; Sundsfjord A
; Liestøl K
; Leegaard TM
; Jenum PA
PLoS One
2017[]; 12
(3
): e0173510
PMID28267783
show ga
We have performed a prospective cohort study to investigate the duration of and
risk factors for prolonged fecal carriage of ESBL-producing Escherichia coli or
Klebsiella pneumoniae in patients with community acquired urinary tract infection
caused by these bacteria. From 2009 to 2011, 101 Norwegian patients were
recruited. Stool swabs and questionnaires were collected every three months for
one year and at the end of the study in 2012. Information on antibiotic
prescriptions was collected from the Norwegian Prescription Database. Stool
samples were cultured directly on ChromID ESBL agar as well as in an enrichment
broth, and culture positive isolates were examined by blaCTX-M multiplex PCR.
Isolates without blaCTX-M were investigated for alternative ESBL-determinants
with a commercial microarray system. Time to fecal clearance of ESBL producing
Enterobacteriaceae was also analysed using Kaplan-Meier estimates. Uni- and
multivariate logistic regression was used to compare groups according to
previously described risk factors. The ESBL point prevalence of fecal carriage
were 61% at 4 months, 56% at 7 months, 48% at 10 months, 39% at 13 months, 19%
after two years, and 15% after three years or more. We found no correlation
between duration of carriage, comorbidity, antibiotic use or travel to ESBL
high-prevalence countries. Prolonged carriage was associated with E. coli
isolates of phylogroup B2 or D. Importantly, comparative MLST and MLVA analyses
of individual paired urine and fecal E. coli isolates revealed that ESBL
production commonly occurred in diverse strains within the same host. When
investigating cross-transmission of ESBL producing bacteria in health care
institutions, this notion should be taken into account.