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Resistant Bacteria in Hospitals a Growing Problem

Antibiotic use, older age and comorbid conditions are risk factors for colonization

WEDNESDAY, Aug. 29 (HealthDay News) -- Among patients admitted to intensive care units (ICUs), antibiotic use, older age and comorbid conditions are risk factors for colonization with extended-spectrum beta-lactamase (ESBL)-producing bacteria, according to a report published in the August issue of Emerging Infectious Diseases.

Anthony D. Harris, M.D., of the University of Maryland and the Veterans Affairs Maryland Health Care System, both in Baltimore, and colleagues cultured samples of perianal swabs taken from 5,209 patients admitted to surgical and medical ICUs at the University of Maryland Medical Center during a 3.5-year period. Multivariate analyses were performed to identify risk factors for colonization with ESBL-producing bacteria.

Overall, 117 individuals were colonized with ESBL-producing Escherichia coli and Klebsiella species. Of these, 25 percent developed subsequent positive clinical cultures of the same organism. Risk factors for colonization with ESBL-producing organisms were piperacillin-tazobactam use, vancomycin use, age over 60 years, and chronic disease score.

"In this study, we identified risk factors for ESBL-producing bacterial colonization among ICU patients," the authors write. "These data may be useful for identifying which patients may warrant empiric ESBL-targeted antimicrobial drug therapy. We also demonstrate that subsequent infections with ESBL-producing bacteria develop in a large percentage of ICU patients colonized with ESBL-producing bacteria."

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