C. Pena et al., RISK-FACTORS FOR FECAL CARRIAGE OF KLEBSIELLA-PNEUMONIAE PRODUCING EXTENDED-SPECTRUM BETA-LACTAMASE (ESBL-KP) IN THE INTENSIVE-CARE UNIT, The Journal of hospital infection, 35(1), 1997, pp. 9-16
In the course of an outbreak of extended-spectrum beta-lactamase-produ
cing Klebsiella pneumoniae (ESBL-KP) in an intensive care unit (ICU),
we conducted active surveillance to determine the risk factors for ESB
L-KP faecal colonization of patients. We used weekly rectal samples du
ring a four-month period. ESBL-KP was found in the faeces of 72 of 188
(38%) patients, and 42 (58%) of them were colonized within the first
week of admisson to the ICU. The probability of remaining free of faec
al colonization was less than 20% at 30 days of ICU admission. The ris
k factors associated with ESBL-KP faecal colonization were clinical se
verity score at admission (P = 0.004), arterial catheterization (P = 0
.002), total parenteral nutrition (P = 0.04), urinary catheterization
(P = 0.01), mechanical ventilation (P<0.001), and previous antibiotic
therapy (P = 0.04). A logistic regression analysis indentified duratio
n of urinary catheterization (OR:3.5; 95% CI 1.2-10.3) and mechanical
ventilation (OR: 4.6; 95% CI 1.1-19.3) as independent risk factors for
ESBL-KP faecal colonization. Our results suggest that in an ESBL-KP p
revalent environment, manipulations that facilitate cross-infection ar
e the most relevant in the acquisition of the micro-organism and risk
increases throughout hospitalization.