Colonisation with ESBL-producing and carbapenemase-producing Enterobacteriaceae, vancomycin-resistant enterococci, and methicillin-resistant Staphylococcus aureus in a long-term care facility over one year

Hdl Handle:
http://hdl.handle.net/10147/574920
Title:
Colonisation with ESBL-producing and carbapenemase-producing Enterobacteriaceae, vancomycin-resistant enterococci, and methicillin-resistant Staphylococcus aureus in a long-term care facility over one year
Authors:
Ludden, Catherine; Cormican, Martin; Vellinga, Akke; Johnson, James R; Austin, Bernie; Morris, Dearbháile
Citation:
BMC Infectious Diseases. 2015 Apr 01;15(1):168
Issue Date:
1-Apr-2015
URI:
http://dx.doi.org/10.1186/s12879-015-0880-5; http://hdl.handle.net/10147/574920
Abstract:
Abstract Background This study examined colonisation with and characteristics of antimicrobial-resistant organisms among residents of a long-term care facility (LTCF) over one year, including strain persistence and molecular diversity among isolates of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. Methods Sixty-four residents of a LTCF were recruited (51 at baseline, 13 during the year). Data on dependency levels, hospitalisations, and antimicrobial prescribing were collected. Nasal and rectal swabs and catheter urine specimens were examined quarterly, using chromogenic agars, for ESBL-producing Enterobacteriaceae, carbapenemase-producing Enterobacteriaceae (CPE), vancomycin-resistant enterococci (VRE), and meticillin-resistant S. aureus (MRSA). All ESBL-producing E. coli (ESBL-EC) were characterised by pulsed-field gel electrophoresis (PFGE) and PCR to assess for sequence type (ST) ST131, its resistance-associated H30 and H30-Rx subclones, and bla CTX-M, bla TEM, bla SHV, and bla OXA-1. Results The overall number of residents colonised, by organism, was as follows: ESBL-EC, 35 (55%); MRSA, 17 (27%); ESBL-producing K. pneumoniae (ESBL-KP), 5 (8%); VRE, 2 (3%) and CPE, 0 (0%). All 98 ESBL-EC isolates were H30-Rx ST131, with bla CTX-M-group 1. By PFGE, a group of 91 ESBL-EC (from 33 participants) had ≥ 85% similar profiles and resembled UK epidemic strain A/ international pulsotype PFGE812. Sequential ESBL-EC from individual residents were closely related. Six ESBL-KP isolates, from five participants, had bla CTX-M-group 1 and by PFGE were closely related. Colonisation with ESBL and MRSA was associated with location within the LTCF and previous exposure to antimicrobials. Conclusions Among LTCF residents, colonisation with ESBL-EC and MRSA was common. All ESBL-EC were H30-Rx ST131, consistent with clonal dissemination.
Language:
en
Keywords:
COMMUNICABLE DISEASE; INFECTION CONTROL; RESIDENTIAL CARE; METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS

Full metadata record

DC FieldValue Language
dc.contributor.authorLudden, Catherineen
dc.contributor.authorCormican, Martinen
dc.contributor.authorVellinga, Akkeen
dc.contributor.authorJohnson, James Ren
dc.contributor.authorAustin, Bernieen
dc.contributor.authorMorris, Dearbháileen
dc.date.accessioned2015-08-17T14:55:42Zen
dc.date.available2015-08-17T14:55:42Zen
dc.date.issued2015-04-01en
dc.identifier.citationBMC Infectious Diseases. 2015 Apr 01;15(1):168en
dc.identifier.urihttp://dx.doi.org/10.1186/s12879-015-0880-5en
dc.identifier.urihttp://hdl.handle.net/10147/574920en
dc.description.abstractAbstract Background This study examined colonisation with and characteristics of antimicrobial-resistant organisms among residents of a long-term care facility (LTCF) over one year, including strain persistence and molecular diversity among isolates of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. Methods Sixty-four residents of a LTCF were recruited (51 at baseline, 13 during the year). Data on dependency levels, hospitalisations, and antimicrobial prescribing were collected. Nasal and rectal swabs and catheter urine specimens were examined quarterly, using chromogenic agars, for ESBL-producing Enterobacteriaceae, carbapenemase-producing Enterobacteriaceae (CPE), vancomycin-resistant enterococci (VRE), and meticillin-resistant S. aureus (MRSA). All ESBL-producing E. coli (ESBL-EC) were characterised by pulsed-field gel electrophoresis (PFGE) and PCR to assess for sequence type (ST) ST131, its resistance-associated H30 and H30-Rx subclones, and bla CTX-M, bla TEM, bla SHV, and bla OXA-1. Results The overall number of residents colonised, by organism, was as follows: ESBL-EC, 35 (55%); MRSA, 17 (27%); ESBL-producing K. pneumoniae (ESBL-KP), 5 (8%); VRE, 2 (3%) and CPE, 0 (0%). All 98 ESBL-EC isolates were H30-Rx ST131, with bla CTX-M-group 1. By PFGE, a group of 91 ESBL-EC (from 33 participants) had ≥ 85% similar profiles and resembled UK epidemic strain A/ international pulsotype PFGE812. Sequential ESBL-EC from individual residents were closely related. Six ESBL-KP isolates, from five participants, had bla CTX-M-group 1 and by PFGE were closely related. Colonisation with ESBL and MRSA was associated with location within the LTCF and previous exposure to antimicrobials. Conclusions Among LTCF residents, colonisation with ESBL-EC and MRSA was common. All ESBL-EC were H30-Rx ST131, consistent with clonal dissemination.en
dc.language.isoenen
dc.subjectCOMMUNICABLE DISEASEen
dc.subjectINFECTION CONTROLen
dc.subjectRESIDENTIAL CAREen
dc.subjectMETHICILLIN RESISTANT STAPHYLOCOCCUS AUREUSen
dc.titleColonisation with ESBL-producing and carbapenemase-producing Enterobacteriaceae, vancomycin-resistant enterococci, and methicillin-resistant Staphylococcus aureus in a long-term care facility over one yearen
dc.language.rfc3066enen
dc.rights.holderLudden et al.; licensee BioMed Central.en
dc.date.updated2015-08-14T13:19:33Zen
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