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Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs) colonization as a risk factor for developing ESBL

Amine Cheikh1, Bouchra Belefquih2, Younes Chajai3

  • 1Department of pharmacy, Abulcasis University, Cheikh Zaid Hospital, Rabat, Morocco. cheikh.amine@gmail.com.

BMC Infectious Diseases
|March 31, 2017
PubMed

Insights

Children undergoing cardiac surgery are at high risk for multidrug-resistant bacteria infections. Screening for extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) colonization can help prevent life-threatening postoperative infections.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Pediatric Surgery

Background:

  • Children with cardiac defects face frequent hospitalizations and antibiotic use, increasing colonization risk with multidrug-resistant bacteria (MDRB).
  • Postoperative infections caused by MDRB, like extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E), pose a significant threat in pediatric cardiac surgery.
  • Understanding ESBL-E colonization prevalence and its link to infections is crucial for patient outcomes.

Purpose of the Study:

  • To determine the prevalence of ESBL colonization in pediatric cardiac surgery patients.
  • To compare the incidence of postoperative infections in ESBL-colonized versus non-colonized patients.
  • To investigate the correlation between postoperative infection and factors like age, length of stay, and prior antibiotic use.

Main Methods:

  • A retrospective cohort study of pediatric cardiac surgery patients (2011-2014) in Rabat, Morocco.
  • ESBL colonization screening was performed on admission for high-risk patients (prior hospitalization/antibiotics).
  • Swabs from throat, nose, and anus were analyzed; statistical analysis used R software.

Main Results:

  • ESBL colonization was detected in 15% (17/111) of patients, with Klebsiella pneumoniae being the most common species.
  • Patients colonized with ESBL-E had a significantly higher rate of postoperative infections (23.5%) compared to non-colonized patients (1%).
  • Positive ESBL colonization was associated with a 22-fold increased relative risk of developing a postoperative infection (p=0.001).

Conclusions:

  • Colonization with MDRB presents a major challenge in pediatric cardiac surgery, necessitating effective infection prevention strategies.
  • Systematic ESBL colonization screening can guide prophylactic antibiotic choices and help prevent the spread of nosocomial infections.
  • Implementing screening protocols can significantly improve patient safety and reduce the incidence of severe postoperative infections.
Abstract

Keywords:
Cardiac surgeryESBLsPositive colonizationPostoperative nosocomial infections

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