The Prevalence and Molecular Epidemiology of Multidrug-Resistant Enterobacteriaceae Colonization in a Pediatric Intensive Care Unit

Author:

Suwantarat Nuntra,Logan Latania K.,Carroll Karen C.,Bonomo Robert A.,Simner Patricia J.,Rudin Susan D.,Milstone Aaron M.,Tekle Tsigereda,Ross Tracy,Tamma Pranita D.

Abstract

OBJECTIVETo determine the prevalence and acquisition of extended-spectrum β-lactamases (ESBLs), plasmid-mediated AmpCs (pAmpCs), and carbapenemases (“MDR Enterobacteriaceae”) colonizing children admitted to a pediatric intensive care unit (PICU).DESIGNProspective study.SETTING40-bed PICU.METHODSAdmission and weekly thereafter rectal surveillance swabs were collected on all pediatric patients during a 6-month study period. Routine phenotypic identification and antibiotic susceptibility testing were performed. Enterobacteriaceae displaying characteristic resistance profiles underwent further molecular characterization to identify genetic determinants of resistance likely to be transmitted on mobile genetic elements and to evaluate relatedness of strains including DNA microarray, multilocus sequence typing, repetitive sequence-based PCR, and hsp60 sequencing typing.RESULTSEvaluating 854 swabs from unique children, the overall prevalence of colonization with an MDR Enterobacteriaceae upon admission to the PICU based on β-lactamase gene identification was 4.3% (n=37), including 2.8% ESBLs (n=24), 1.3% pAmpCs (n=11), and 0.2% carbapenemases (n=2). Among 157 pediatric patients contributing 603 subsequent weekly swabs, 6 children (3.8%) acquired an incident MDR Enterobacteriaceae during their PICU stay. One child acquired a pAmpC (E. coli containing blaDHA) related to an isolate from another patient.CONCLUSIONSApproximately 4% of children admitted to a PICU were colonized with MDR Enterobacteriaceae (based on β-lactamase gene identification) and an additional 4% of children who remained in the PICU for at least 1 week acquired 1 of these organisms during their PICU stay. The acquired MDR Enterobacteriaceae were relatively heterogeneous, suggesting that a single source was not responsible for the introduction of these resistance mechanisms into the PICU setting.Infect Control Hosp Epidemiol 2016;37:535–543

Publisher

Cambridge University Press (CUP)

Subject

Infectious Diseases,Microbiology (medical),Epidemiology

Reference35 articles.

1. Analyzing intensive care unit length of stay data

2. Attributable Costs and Length of Stay of an Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae Outbreak in a Neonatal Intensive Care Unit

3. Tschudin-Sutter S , Frei R , Dangel M , Stranden A , Widmer AM . Nosocomial spread of extended-spectrum beta-lactamases (ESBL)-producing Enterobacteriaceae without contact isolation: a prospective observational study. Abstract 0121 presented at the 22nd European Congress of Clinical Microbiology and Infectious Diseases, March 31–April 3, 2012, London, United Kingdom.

4. Extended-spectrum β-lactamase producing Klebsiella pneumoniae in neonatal intensive care unit

5. Analysis of a Uropathogenic Escherichia coli Clonal Group by Multilocus Sequence Typing

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