Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Strenger, V; Gschliesser, T; Grisold, A; Zarfel, G; Feierl, G; Masoud, L; Hoenigl, M; Resch, B; Müller, W; Urlesberger, B.
Orally administered colistin leads to colistin-resistant intestinal flora and fails to prevent faecal colonisation with extended-spectrum β-lactamase-producing enterobacteria in hospitalised newborns.
Int J Antimicrob Agents. 2011; 37(1):67-69
Doi: 10.1016/j.ijantimicag.2010.09.010
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Strenger Volker
- Co-Autor*innen der Med Uni Graz
- Feierl Gebhard
- Grisold Andrea
- Hönigl Martin
- Masoud-Landgraf Lilian
- Müller Wilhelm
- Resch Bernhard
- Urlesberger Berndt
- Zarfel Gernot
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- Abstract:
- Colonisation and infection with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) is an emerging problem. The aim of this study was to investigate whether colistin, which is reported to be effective against multiresistant enterobacteria, prevents ESBL-E colonisation in neonates. For prophylaxis of necrotising enterocolitis, oral gentamicin (15 mg/kg/day) is routinely used in all neonates hospitalised at the Neonatal Intensive Care Unit of University Hospital Graz (Austria). During the study period from May 2005 to September 2007, three ESBL-E outbreaks (total duration 18 months) occurred. During these outbreaks, gentamicin was immediately replaced by oral colistin (8 mg/kg/day) in all hospitalised neonates. All neonates colonised with ESBL-E during the study period were retrospectively analysed with regard to the influence of colistin on ESBL-E colonisation. Genetic relatedness of isolates was assessed by repetitive sequence-based polymerase chain reaction (rep-PCR). During the study period, 30 (4.5%) of 667 neonates were colonised with ESBL-E. Twelve of twenty-one patients colonised with Klebsiella pneumoniae (ESBL-Kp) and one of nine patients colonised with Klebsiella oxytoca (ESBL-Ko) had received oral colistin at time of colonisation with ESBL-E. Amongst ESBL-Kp, the rate of colistin resistance was significantly higher in the colistin group (P=0.0075). Four different clones of ESBL-Kp and three different clones of ESBL-Ko were isolated, indicating the occurrence of patient-to-patient transmission. Colistin-resistant as well as colistin-susceptible isolates were detected within the same clones, indicating induction of resistance. At the dosage used, oral colistin did not prevent colonisation with ESBL-E and appeared to select colistin-resistant strains or to induce colistin resistance. Copyright © 2010 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Anti-Bacterial Agents - administration & dosage
- Antibiotic Prophylaxis - methods
- Antibiotic Prophylaxis - epidemiology
- Bacterial Typing Techniques -
- Carrier State - microbiology
- Cluster Analysis -
- Colistin - administration & dosage
- Disease Outbreaks -
- Enterobacteriaceae - drug effects Enterobacteriaceae - enzymology Enterobacteriaceae - isolation & purification
- Enterobacteriaceae Infections - epidemiology Enterobacteriaceae Infections - microbiology
- Female -
- Gastrointestinal Tract - microbiology
- Genotype -
- Hospitals -
- Humans -
- Infant, Newborn -
- Male -
- Molecular Typing -
- Retrospective Studies -
- Selection, Genetic -
- beta-Lactamases - biosynthesis
- Find related publications in this database (Keywords)
- Extended-spectrum beta-lactamase
- ESBL
- Neonatal Intensive Care Unit
- Intestinal colonisation
- Colistin
- Selective digestive decolonisation