TY - JOUR
T1 - Risk factors for fecal carriage of IMP-6-producing Enterobacteriaceae at a long-term care hospital in Japan
T2 - A follow-up report from the northern Osaka multicentre study group
AU - Hagiya, Hideharu
AU - Yamamoto, Norihisa
AU - Kawahara, Ryuji
AU - Akeda, Yukihiro
AU - Shanmugakani, Rathina Kumar
AU - Ueda, Akiko
AU - Nishi, Isao
AU - Asada, Rumiko
AU - Yoshida, Hisao
AU - Tomono, Kazunori
PY - 2018/9
Y1 - 2018/9
N2 - The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing at medical institutions in Japan without even noticing. Recently, we performed a point prevalence survey for CRE carriage at a medical facility in northern Osaka that demonstrated an unexpectedly high prevalence of blaIMP-6-positive CRE, particularly at long-term care hospitals (LTCH). To identify the risk factors for CRE carriage, we collected clinical data of patients at a representative LTCH. Of 140 patients who were included in this study, 27 (19.3%) were colonized with metallo-beta-lactamase (IMP-6) producers. Pulsed-field gel electrophoresis of the IMP-6 producing Enterobacteriaceae suggested a non-clonal transmission of Escherichia coli, while a clonal spread was shown for Klebsiella pneumoniae. Risk factors for CRE colonization were a longer stay at the hospital stay and a lower independence state, as measured by Norton scales. We propose that a paradigm shift in infection control, inciting a coordinated regional effort to involve LTCHs, should be discussed in the aging society of Japan.
AB - The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing at medical institutions in Japan without even noticing. Recently, we performed a point prevalence survey for CRE carriage at a medical facility in northern Osaka that demonstrated an unexpectedly high prevalence of blaIMP-6-positive CRE, particularly at long-term care hospitals (LTCH). To identify the risk factors for CRE carriage, we collected clinical data of patients at a representative LTCH. Of 140 patients who were included in this study, 27 (19.3%) were colonized with metallo-beta-lactamase (IMP-6) producers. Pulsed-field gel electrophoresis of the IMP-6 producing Enterobacteriaceae suggested a non-clonal transmission of Escherichia coli, while a clonal spread was shown for Klebsiella pneumoniae. Risk factors for CRE colonization were a longer stay at the hospital stay and a lower independence state, as measured by Norton scales. We propose that a paradigm shift in infection control, inciting a coordinated regional effort to involve LTCHs, should be discussed in the aging society of Japan.
KW - Aging society
KW - Antimicrobial resistance
KW - Carbapenem-resistant Enterobacteriaceae
KW - Carbapenemase-producing Enterobacteriaceae
KW - Metallo-beta-lactamase
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U2 - 10.1016/j.jiac.2018.03.009
DO - 10.1016/j.jiac.2018.03.009
M3 - Article
C2 - 29656900
AN - SCOPUS:85045213779
VL - 24
SP - 769
EP - 772
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
SN - 1341-321X
IS - 9
ER -