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BMJ Open ; 9(3): e024879, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30826764

RESUMO

OBJECTIVE: To assess the prevalence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) faecal carriers at admission in a University Hospital in Spain. DESIGN: Prevalence survey. SETTING: Pneumology, gastroenterology, urology and neurosurgery units at a university tertiary hospital in Madrid (Spain). PARTICIPANTS: A total of 10 643 patients aged 18 and older admitted from March 2014 to April 2016 with a rectal swab taken at admission or as soon as possible within the first 48 hours. PRIMARY AND SECONDARY OUTCOME MEASURES: Prevalence of ESBL-E faecal carriers and prevalence of ESBL-E infections at admission. RESULTS: The prevalance of ESBL-E carriers at admission was 7.69% (CI 95% 7.18 to 8.19). Most of the isolates were Escherichia coli (77.51%), followed by Klebsiella pneumoniae (20.71%). Eighty-eight (10.41%) of ESBL-E were simultaneous ESBL and carbapenemase (CP) producers, 1.83% in the case of E. coli and 42.86% among K. pneumoniae isolates. Of the ESBL typed, 52.15% belonged to the cefotaximases (CTX-M-15) type and 91.38% of the CP were oxacillinase (OXA-48) type. Only 0.43% patients presented an active infection by ESBL-E at admission. CONCLUSIONS: The prevalence found in our study is very similar to that found in literature. However, we found a high percentage of simultaneous ESBL and CP producers, particularly in K. pneumoniae. Despite the high prevalence of colonised patients, the ESBL-infection rate at admission was very low.


Assuntos
Proteínas de Bactérias/isolamento & purificação , Infecções por Enterobacteriaceae , Enterobacteriaceae , Klebsiella pneumoniae , beta-Lactamases/isolamento & purificação , Doenças Assintomáticas/epidemiologia , Testes Diagnósticos de Rotina/métodos , Testes Diagnósticos de Rotina/estatística & dados numéricos , Farmacorresistência Bacteriana Múltipla , Enterobacteriaceae/isolamento & purificação , Enterobacteriaceae/fisiologia , Infecções por Enterobacteriaceae/diagnóstico , Infecções por Enterobacteriaceae/epidemiologia , Infecções por Enterobacteriaceae/microbiologia , Feminino , Hospitais Universitários/estatística & dados numéricos , Humanos , Intestinos/microbiologia , Klebsiella pneumoniae/isolamento & purificação , Klebsiella pneumoniae/fisiologia , Masculino , Testes de Sensibilidade Microbiana/métodos , Testes de Sensibilidade Microbiana/estatística & dados numéricos , Pessoa de Meia-Idade , Prevalência , Espanha/epidemiologia , Inquéritos e Questionários
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