Risk Factors and Outcomes for Intestinal Carriage of AmpC-Hyperproducing Enterobacteriaceae in Intensive Care Unit Patients

• Published in: Antimicrobial agents and chemotherapy Vol. 60; no. 3; pp. 1883 - 1887
• Main Authors: Poignant, Simon, Guinard, Jérôme, Guigon, Aurélie, Bret, Laurent, Poisson, Didier-Marc, Boulain, Thierry, Barbier, François
• Format: Journal Article
• Language: English
• Published: United States American Society for Microbiology 01.03.2016
• Subjects: Aged; Anti-Bacterial Agents; Anti-Bacterial Agents - therapeutic use; Bacterial Proteins; Bacterial Proteins - genetics; Bacterial Proteins - metabolism; beta-Lactamases; beta-Lactamases - genetics; beta-Lactamases - metabolism; Carbapenems; Carbapenems - therapeutic use; Carrier State - epidemiology; Cross Infection - epidemiology; Enterobacteriaceae; Enterobacteriaceae - drug effects; Enterobacteriaceae - genetics; Enterobacteriaceae Infections; Enterobacteriaceae Infections - drug therapy; Enterobacteriaceae Infections - epidemiology; Enterobacteriaceae Infections - microbiology; Epidemiology and Surveillance; Female; Humans; Intensive Care Units; Intensive Care Units - statistics & numerical data; Intestines; Intestines - microbiology; Length of Stay - statistics & numerical data; Male; Middle Aged; Retrospective Studies; Risk Factors
• ISSN: 0066-4804; 1098-6596
• DOI: 10.1128/AAC.02101-15

In a cohort of 1,209 intensive care unit (ICU) patients, the prevalence of intestinal colonization with high-level expressed AmpC cephalosporinase-producing Enterobacteriaceae (HLAC-PE) rose steadily from 2% at admission to 30% in patients with lengths of stay (LOS) exceeding 4 weeks. In multivariate analysis, LOS was the main predictor of carriage acquisition after adjustment on antimicrobial exposure. HLAC-PE infection occurred in 15% of carriers. Carriage and infection were associated with a marked increase in carbapenem consumption.