Prolonged carriage of ESBL-producing enterobacterales and potential cross-transmission among residents in geriatric long-term care facilities

被引：3

作者：

Ae, Ryusuke ^{[1
]}

Sasahara, Teppei ^{[1
,2
,3
]}

Yoshimura, Akio ^{[4
]}

Kosami, Koki ^{[1
]}

Hatakeyama, Shuji ^{[5
]}

Sasaki, Kazumasa ^{[6
]}

Kimura, Yumiko ^{[6
]}

Akine, Dai ^{[2
,7
]}

Ogawa, Masanori ^{[7
]}

Hamabata, Kenji ^{[8
]}

Cui, Longzhu ^{[3
]}

机构：

[1] Jichi Med Univ, Ctr Community Med, Div Publ Hlth, Yakushiji 3311-1, Shimotsuke, Tochigi 3290498, Japan

[2] Jichi Med Univ, Sch Med, Div Clin Infect Dis, Yakushiji 3311-1, Shimotsuke, Tochigi 3290498, Japan

[3] Jichi Med Univ, Sch Med, Div Bacteriol, Yakushiji 3311-1, Shimotsuke, Tochigi 3290498, Japan

[4] Med Corp Sanikukai Nissin Hosp, Kiryu, Gumma 3760001, Japan

[5] Jichi Med Univ Hosp, Div Infect Dis, Yakushiji 3311-1, Shimotsuke, Tochigi 3290498, Japan

[6] Jichi Med Univ Hosp, Clin Microbiol Lab, Yakushiji 3311-1, Shimotsuke, Tochigi 3290498, Japan

[7] Jichi Med Univ, Hlth Serv Ctr, Yakushiji 3311-1, Shimotsuke, Tochigi 3290498, Japan

[8] Jichi Med Univ, Sch Nursing, Gerontol Nursing, Yakushiji 3311-1, Shimotsuke, Tochigi 3290498, Japan

来源：

SCIENTIFIC REPORTS | 2021年 / 11卷 / 01期

关键词：

CAREGIVER DAILY IMPRESSION; ESCHERICHIA-COLI; KLEBSIELLA-PNEUMONIAE; INFECTIOUS-DISEASES; FECAL CARRIAGE; RISK-FACTORS; COLONIZATION; PREVALENCE; DIAGNOSIS;

D O I：

10.1038/s41598-021-01190-w

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Previous studies indicated residents in geriatric long-term care facilities (LTCFs) had much higher prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) carriage than the general population. Most ESBL-E carriers are asymptomatic. The study tested the hypothesis that residents with ESBL-E carriage may accumulate inside geriatric LTCFs through potential cross-transmission after exposure to residents with prolonged ESBL-E carriage. 260 residents from four Japanese LTCFs underwent ESBL-E testing of fecal specimens and were divided into two cohorts: Cohort 1,75 patients with >= 2 months residence at study onset; Cohort 2, 185 patients with < 2 months residence at study onset or new admission during the study period. Three analyses were performed: (1) ESBL-E carriage statuses in Cohort 1 and Cohort 2; (2) changes in ESBL-E carriage statuses 3-12 months after the first testing and >= 12 months after the second testing; and (3) lengths of positive ESBL-E carriage statuses. Compared with the residents in Cohort 1, a significantly larger proportion of residents in Cohort 2 were positive for ESBL-E carriage (28.0% in Cohort 1 vs 40.0% in Cohort 2). In the subsequent testing results, 18.3% of residents who were negative in the first testing showed positive conversion to ESBL-E carriage in the second testing, while no patients who were negative in the second testing showed positive conversion in the third testing. The maximum length of ESBL-E carriage was 17 months. The findings indicated that some residents acquired ESBL-E through potential cross-transmission inside the LTCFs after short-term residence. However, no residents showed positive conversion after long-term residence, which indicates that residents with ESBL-E carriage may not accumulate inside LTCFs. Practical infection control and prevention measures could improve the ESBL-E prevalence in geriatric LTCFs.

引用

页数：9

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