Profiling the fecal carriage of β-lactamase genes in long-term care facility residents: A longitudinal study

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• 作者：Chang-Hua Chen ; MD ; MSc ; PhD^a ; ^b ; ^c ; Ming-Chuan Chang ; MD^d ; Kuan-Hsueh Chen ; MSc^e ; Han-Yueh Kuo ; MD^f ; ^g ; Ming-Li Liou ; MSc ; PhD^h ; ^{d918229@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Fecal carriage ; β-lactamase genes ; long-term care facility ; longitudinal study
• 刊名：American Journal of Infection Control
• 出版年：2016
• 出版时间：1 November 2016
• 年：2016
• 卷：44
• 期：11
• 页码：e227-e233
• 全文大小：916 K

文摘

The fecal carriage of β-lactamase (BL)–producing bacteria may play a major role in the spread of these organisms in long-term care facilities (LTCFs). The aims of this study were (1) to describe the gene profiles of fecal BL in 3 LCTFs in Taiwan and (2) to analyze the fecal carriage burden of BL genes between the residents (patient group) and staff (staff group) of LTCFs.

Methods

Thirty fecal samples were collected during June 2013 and July 2015: 20 were obtained from 10 residents both during hospitalization (T1) and 1 month after discharge (T2), and 10 were obtained from 10 staff members.

Results

In total, 80%, 70%, and 50% of the samples in the patient group at T1, staff group at T2, and patient group at T2, respectively, contained >2 BL genes. In the patient group, the predominant genes belonged to extended-spectrum BL genes (90%-100%) and AmpC BL genes (90%-100%). Furthermore, carbapenemase genes were approximately 20% during T1 and T2. The relative levels of SHV-type BLs were significantly higher (P < .05) in the patient group at T2 compared with the staff group.

Conclusions

In this study, we found a high carriage of fecal BLs among LTCF residents and staff. The monitoring of fecal BL carriage in LTCFs is needed for infection control measures and antibiotic choice for health care–associated infections.