Publication: A prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a Thai University Hospital
Issued Date
2018-08-20
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20472994
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2-s2.0-85052090490
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Mahidol University
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SCOPUS
Bibliographic Citation
Antimicrobial Resistance and Infection Control. Vol.7, No.1 (2018)
Suggested Citation
Pinyo Rattanaumpawan, Chatiros Choorat, Kanchanaporn Takonkitsakul, Teerawit Tangkoskul, Chakrapong Seenama, Visanu Thamlikitkul A prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a Thai University Hospital. Antimicrobial Resistance and Infection Control. Vol.7, No.1 (2018). doi:10.1186/s13756-018-0393-2 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/46428
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Title
A prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a Thai University Hospital
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Abstract
© 2018 The Author(s). Background: Colonization with multidrug-resistant (MDR) bacteria is a major risk factor for developing subsequent MDR infections. Methods: We performed a prospective surveillance study in hospitalized patients at Siriraj Hospital. Nasal cavity, throat, inguinal area and rectal swabs were obtained within the first 48-h after admission, on day-5 after hospitalization and then every 7 days until discharge. Target bacteria included extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL), carbapenem-resistant-P.aeruginosa (CR-PA), carbapenem-resistant-A.baumannii (CR-AB) and methicillin-resistant S.aureus (MRSA). Results: From January 2013-December 2014, 487 patients were enrolled. The baseline prevalence of colonization by ESBL, CR-PA, CR-AB and MRSA at any site was 52.2%, 6.8%, 4.7% and 7.2%, respectively. After 3-week of hospitalization, the prevalence of colonization by ESBL, CR-PA, CR-AB and MRSA increased to 71.7%, 47.2%, 18.9% and 18.9%, respectively. Multivariable analysis revealed that diabetes mellitus and recent cephalosporin exposure were the independent risk factors for baseline colonization by ESBL. The independent risk factors for CR-AB and/or CR-PA colonization were cerebrovascular diseases, previous hospitalization, transfer from another hospital/a LTCF and previous nasogastric tube use, whereas those for MRSA colonization were previous fluoroquinolone exposure and previous nasogastric tube use. Conclusions: The baseline prevalence of colonization by ESBL was relatively high, whereas the baseline prevalence of colonization by CR-PA, CR-AB and MRSA was comparable to previous studies. There was an increasing trend in MDR bacteria colonization after hospitalization.