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Gastrointestinal colonization with ESBL-producing Klebsiella in preterm babies—is vancomycin to blame?

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Abstract

In this study, we examine the possible association between treatment with vancomycin and colonization with extended-spectrum beta-lactamase (ESBL)-producing Klebsiella in our neonatal intensive care unit (NICU). Variables compared between newborns which developed rectal colonization and those who did not include: gestational age, birth weight, gender, and total length of hospital stay until positive stool culture or discharge, treatment with vancomycin, and positive blood culture for coagulase-negative Staphylococcus. We found that lower birth weight, younger gestational age, and treatment with vancomycin were statistically significant risk factors for gastrointestinal colonization with ESBL-producing Klebsiella. When applying a multivariate model, treatment with vancomycin, both for a full 10-day course and for a short 3-day empirical treatment, remained statistically significant. Treatment with vancomycin is a risk factor for gastrointestinal colonization with ESBL-producing Klebsiella in premature babies.

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References

  1. Bromiker R, Arad I, Peleg O, Preminger A, Engelhard D (2001) Neonatal bacteremia: patterns of antibiotic resistance. Infect Control Hosp Epidemiol 22:767–770

    Article  PubMed  CAS  Google Scholar 

  2. Du W, Warrier I, Tutag Lehr V, Salari V, Ostrea E, Aranda JV (2006) Changing patterns of drug utilization in a neonatal intensive care population. Am J Perinatol 23:279–285

    Article  PubMed  Google Scholar 

  3. Grohskopf LA, Huskins WC, Sinkowitz-Cochran RL, Levine GL, Goldmann DA, Jarvis WR (2005) Use of antimicrobial agents in United States neonatal and pediatric intensive care patients. Pediatr Infect Dis J 24:766–773

    Article  PubMed  Google Scholar 

  4. Hart CA (1993) Klebsiellae and neonates. J Hosp Infect 23:83–86

    Article  PubMed  CAS  Google Scholar 

  5. Villari P, Iacuzio L, Torre I, Scarcella A (1998) Molecular epidemiology as an effective tool in the surveillance of infections in the neonatal intensive care unit. J Infect 37:274–281

    Article  PubMed  CAS  Google Scholar 

  6. Harris AD, McGregor JC, Johnson JA, Strauss SM, Moore AC, Standiford HC, Hebden JN, Morris JG Jr (2007) Risk factors for colonization with extended-spectrum β-lactamase-producing bacteria and intensive care unit admission. Emerg Infect Dis 13:1144–1149

    PubMed  Google Scholar 

  7. Murray PR, Baron EJ; American Society for Microbiology (2003) Manual of clinical microbiology, 8th edn. ASM Press, Washington, D.C.

    Google Scholar 

  8. Wiegand I, Geiss HK, Mack D, Stürenburg E, Seifert H (2007) Detection of extended-spectrum beta-lactamases among Enterobacteriaceae by use of semiautomated microbiology systems and manual detection procedures. J Clin Microbiol 45:1167–1174

    Article  PubMed  CAS  Google Scholar 

  9. Al Naiemi N, Heddema ER, Bart A, de Jonge E, Vandenbroucke-Grauls CM, Savelkoul PHM, Duim B (2006) Emergence of multidrug-resistant Gram-negative bacteria during selective decontamination of the digestive tract on an intensive care unit. J Antimicrob Chemo 58:853–856

    Article  CAS  Google Scholar 

  10. Manzur A, Tubau F, Pujol M, Calatayud L, Dominguez MA, Peña C, Sora M, Gudiol F, Ariza J (2007) Nosocomial outbreak due to extended-spectrum-beta-lactamase-producing Enterobacter cloacae in a cardiothoracic intensive care unit. J Clin Microbiol 45:2365–2369

    Article  PubMed  CAS  Google Scholar 

  11. Peña C, Pujol M, Ardanuy C, Ricart A, Pallares R, Liñares J, Ariza J, Gudiol F (1998) Epidemiology and successful control of a large outbreak due to Klebsiella pneumoniae producing extended-spectrum β-lactamases. Antimicrob Agents Chemother 42:53–58

    PubMed  Google Scholar 

  12. Selden R, Lee S, Wang WL, Bennett JV, Eickhoff TC (1971) Nosocomial Klebsiella infections: intestinal colonization as a reservoir. Ann Intern Med 74:657–664

    PubMed  CAS  Google Scholar 

  13. Gastmeier P, Groneberg K, Weist K, Rüden H (2003) A cluster of nosocomial Klebsiella pneumoniae bloodstream infections in a neonatal intensive care department: identification of transmission and intervention. Am J Infect Control 31:424–430

    Article  PubMed  Google Scholar 

  14. Linkin DR, Fishman NO, Patel JB, Merrill JD, Lautenbach E (2004) Risk factors for extended-spectrum beta-lactamase-producing Enterobacteriaceae in a neonatal intensive care unit. Infect Control Hosp Epidemiol 25:781–783

    Article  PubMed  Google Scholar 

  15. Pessoa-Silva CL, Meurer Moreira B, Câmara Almeida V, Flannery B, Almeida Lins MC, Mello Sampaio JL, Martins Teixeira L, Vaz Miranda LE, Riley LW, Gerberding JL (2003) Extended-spectrum β-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit: risk factors for infection and colonization. J Hosp Infect 53:198–206

    Article  PubMed  CAS  Google Scholar 

  16. Crivaro V, Bagattini M, Salza MF, Raimondi F, Rossano F, Triassi M, Zarrilli R (2007) Risk factors for extended-spectrum β-lactamase-producing Serratia marcescens and Klebsiella pneumoniae in a neonatal intensive care unit. J Hosp Infect 67:135–141

    Article  PubMed  CAS  Google Scholar 

  17. Boo NY, Ng SF, Lim VKE (2005) A case–control study of risk factors associated with rectal colonization of extended-spectrum beta-lactamase producing Klebsiella sp. in newborn infants. J Hosp Infect 61:68–74

    Article  PubMed  Google Scholar 

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Correspondence to N. Ofek-Shlomai.

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R. Braunstein is an independent statistical consultant for biomedical research.

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Ofek-Shlomai, N., Benenson, S., Ergaz, Z. et al. Gastrointestinal colonization with ESBL-producing Klebsiella in preterm babies—is vancomycin to blame?. Eur J Clin Microbiol Infect Dis 31, 567–570 (2012). https://doi.org/10.1007/s10096-011-1348-1

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  • DOI: https://doi.org/10.1007/s10096-011-1348-1

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