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Updated: May 31, 2026
Biosensor for Detection of Antibiotic Resistant Staphylococcus Bacteria
Published on: May 8, 2013
Increase of patients co-colonised or co-infected with methicillin-resistant Staphylococcus aureus,
E Meyer1, R Ziegler, F Mattner
1Institute of Hygiene and Environmental Medicine, Charité University Medicine, Hindenburgdamm 27, 12203 Berlin, Germany. elisabeth.meyer@charite.de
Purpose:
To determine the incidence of patients co-colonised or co-infected with methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium or extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in four German tertiary care hospitals.
Methods:
This study was conducted at four tertiary care hospitals (all with >1,000 beds) in different geographic regions in Germany (Berlin in the east, Luebeck in the north, Freiburg in the southwest and Nuernberg in the southeast). Routine surveillance data on MRSA, vancomycin-resistant enterococci (VRE) and ESBL-producing bacteria were analysed from 2007 to 2009. Co-colonisation or co-infection was defined as a patient having positive cultures for at least two of the following resistant pathogens: MRSA, VRE faecium or different species of ESBL-producing Enterobacteriaceae within one calendar year.
Results:
A total of 896,822 patients were analysed, of which 10,066 patients harboured MRSA, VRE faecium and/or ESBL-producing Enterobacteriaceae, and 542 patients co-harboured at least two of those resistant pathogens. In 2009, 7.6% of the MRSA patients, 13.7% of the VRE faecium patients and even 16.1% of the ESBL-producing Enterobacteriaceae patients were co-colonised or co-infected. The incidence of patients with co-infection or co-colonisation increased steadily from 5 (2007) to 7 per 10,000 patients (2009).
Conclusions:
Patients harbouring ESBL-producing Enterobacteriaceae or VRE faecium had a higher risk of being co-colonised or co-infected compared to what was to be extrapolated from their overall incidence. This might be linked to their gastrointestinal reservoir and impracticality to decolonise the gut of resistant VRE and ESBL-producing Enterobacteriaceae.
Insights
Patients with extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae or vancomycin-resistant Enterococcus faecium (VRE) face a higher risk of co-infection. This highlights challenges in gut decolonization for these resistant pathogens.
Area of Science:
- Infectious Diseases
- Microbiology
- Hospital Epidemiology
Background:
- Antimicrobial resistance poses a significant threat to public health.
- Methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium (VRE), and ESBL-producing Enterobacteriaceae are key multidrug-resistant organisms.
- Understanding co-colonization and co-infection patterns is crucial for infection control.
Purpose of the Study:
- To determine the incidence of patients co-colonized or co-infected with MRSA, VRE, or ESBL-producing Enterobacteriaceae.
- To analyze co-colonization and co-infection rates in German tertiary care hospitals.
Main Methods:
- Retrospective analysis of routine surveillance data from 2007 to 2009.
- Inclusion of data from four large tertiary care hospitals in Germany.
- Definition of co-colonization/co-infection as positive cultures for at least two resistant pathogens within one calendar year.
Main Results:
- Over 896,000 patients were analyzed, with 542 patients co-harboring at least two resistant pathogens.
- In 2009, co-colonization/co-infection rates were 7.6% for MRSA, 13.7% for VRE, and 16.1% for ESBL-producing Enterobacteriaceae patients.
- The overall incidence of co-infection/co-colonization increased from 5 to 7 per 10,000 patients between 2007 and 2009.
Conclusions:
- Patients with ESBL-producing Enterobacteriaceae or VRE have a disproportionately higher risk of co-colonization/co-infection.
- The gastrointestinal tract serves as a reservoir for VRE and ESBL-producing Enterobacteriaceae.
- Challenges in gut decolonization contribute to the increased risk of co-infection.
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