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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Nursing homes as a reservoir of extended-spectrum β-lactamase (ESBL)-producing ciprofloxacin-resistant Escherichia coli
Journal of Antimicrobial Chemotherapy, Volume 64, No. 3, Year 2009
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Description
Background: To assess the prevalence and risk factors for faecal carriage of fluoroquinolone-resistant, extended-spectrum β-lactamase (ESBL)-producing, Escherichia coli (MDR E. coli) among residents in nursing homes in Northern Ireland. Methods: Between January 2004 and May 2006, retrospective histories of hospital admissions, antimicrobial treatment and co-morbidities were collected. Faecal samples were cultured for MDR E. coli. These isolates and their ESBL genes were typed by a reference laboratory. Results: Of the 294 patients included in the study, faecal samples from 119 (40.5%) grew MDR E. coli. The proportion of carriers in the different homes ranged from 0% to 75%. Epidemic strain A belonging to the ST131, O25:H4 lineage with the CTX-M-15 enzyme accounted for 58 (49%) of all isolates; its proportion varied from 0% to 100% among homes. Fifty-one percent of carriers had no history of recent hospital admission and only 13.5% had a known history of ESBL E. coli colonization or infection. In a multivariate logistic regression model, days of fluoroquinolone use [odds ratio (OR) = 1.33, 95% confidence interval (CI) 1.04-1.69, P = 0.02] and a history of urinary tract infection (OR = 2.56, 95% CI 1.37-4.78, P = 0.003) were the only variables independently associated with the risk of carrying MDR E. coli. Conclusions: The high level of faecal carriage of MDR E. coli in nursing home residents demonstrates their importance as a reservoir population. Public health measures to combat spread of these organisms should address the needs of this group. © The Author 2009. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Authors & Co-Authors
Rooney, Paul J.
United Kingdom, Belfast
Belfast City Hospital
O'Leary, Maureen C.
United Kingdom, Belfast
Eastern Health and Social Services Board
Loughrey, Anne C.
United Kingdom, Belfast
Belfast City Hospital
McCalmont, Mark
United Kingdom, Belfast
Belfast City Hospital
Smyth, Brian
United Kingdom, Belfast
Belfast City Hospital
Donaghy, Philip
United Kingdom, Belfast
Eastern Health and Social Services Board
Badri, Motasim A.
United Kingdom, Belfast
Royal Victoria Hospital Belfast
South Africa, Cape Town
University of Cape Town
Woodford, Neil
United Kingdom, London
Public Health England
Karisik, Edi
United Kingdom, London
Public Health England
Livermore, David M.
United Kingdom, London
Public Health England
Statistics
Citations: 212
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1093/jac/dkp220
ISSN:
03057453
e-ISSN:
14602091
Research Areas
Cancer
Health System And Policy
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study