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High frequency of colonization by extended-spectrum beta-lactamase-producing Gram-negative bacilli in hemodialysis patients and their household contacts in Colombia: dissemination between the community and the hospital
Daniela Montoya-Urrego, Sara Tellez-Carrasquilla, Johanna M. Vanegas, Judy Natalia Jiménez Quiceno
Epidemiol Health. 2022;44:e2022069.   Published online August 27, 2022
DOI: https://doi.org/10.4178/epih.e2022069
  • 3,318 View
  • 103 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Increasing colonization by beta-lactam-resistant Gram-negative bacilli (BR-GNB) represents a risk for infections and bacterial resistance spread, both in hospitals and the community. Hemodialysis patients and their household contacts regularly transit between these environments. This study investigated the clinical and epidemiological characteristics of BR-GNB colonization in hemodialysis patients and their household contacts, as well as the genetic relationship between their isolates.
METHODS
A cross-sectional study was conducted on hemodialysis patients at a hospital-associated dialysis center in Medellín, Colombia and their household contacts. Clinical and epidemiological information was collected. Colonization was assessed from stool or rectal swab samples. Bacterial identification and susceptibility were determined using chromogenic media and Vitek-2. Molecular characterization included beta-lactamase detection by polymerase chain reaction, multiple-locus sequence typing (MLST), pulsed-field gel electrophoresis, and identification of Escherichia coli phylogroups by the Clermont protocol.
RESULTS
This study included 36 hemodialysis patients and 90 household contacts. Colonization by BR-GNB occurred in 58.3% of patients and 22.2% of household contacts. The main beta-lactamase detected was CTX-M group-1 (40.5%). In 3 of the 9 homes that had more than 1 colonized individual, a genetic relationship was found. MLST showed a high diversity in E. coli isolates, and the most frequent phylogroups were B1 and B2.
CONCLUSIONS
These results show a high frequency of colonization and the presence of potentially pathogenic BR-GBN both in hospitals and the community. This highlights the importance of populations who move between those 2 environments, and the need to prevent the spread of bacterial resistance outside hospitals.
Summary
Key Message
Colonization by beta-lactam-resistant Gram-negative bacilli has increased in hospitals and communities. Populations that constantly move between these 2 environments, such as hemodialysis patients and their household contacts, can transport these bacteria and turn their homes into potential reservoirs. In this work, a high frequency of colonization was found in patients and household contacts, as well as a high diversity of E. coli isolates, suggesting different sources of acquisition. However, there could be an exchange of potentially pathogenic resistant bacteria in homes. This highlights the importance of including these populations in epidemiological surveillance and interventions to prevent bacterial resistance spread.

Citations

Citations to this article as recorded by  
  • Molecular and Clinical Data of Antimicrobial Resistance in Microorganisms Producing Bacteremia in a Multicentric Cohort of Patients with Cancer in a Latin American Country
    Sergio Andrés Cruz-Vargas, Laura García-Muñoz, Sonia Isabel Cuervo-Maldonado, Carlos Arturo Álvarez-Moreno, Carlos Humberto Saavedra-Trujillo, José Camilo Álvarez-Rodríguez, Angélica Arango-Gutiérrez, Julio César Gómez-Rincón, Katherine García-Guzman, Aur
    Microorganisms.2023; 11(2): 359.     CrossRef
Oral colonization by Candida species and associated factors in HIV-infected patients in Ahvaz, southwest Iran
Elham Aboualigalehdari, Maryam Tahmasebi Birgani, Mahnaz Fatahinia, Mehran Hosseinzadeh
Epidemiol Health. 2020;42:e2020033.   Published online May 24, 2020
DOI: https://doi.org/10.4178/epih.e2020033
  • 12,096 View
  • 151 Download
  • 13 Web of Science
  • 10 Crossref
AbstractAbstract PDF
Abstract
Objectives
Oropharyngeal candidiasis is one of the most common opportunistic fungal infections among human immunodeficiency virus (HIV)-infected individuals. The most common cause is <i>Candida albicans</i>, followed by non-<i>albicans Candida</i>. This study aimed to identify colonized <i>Candida</i> species in HIV-infected patients from Ahvaz, Iran. Additionally, the relationships between immunity-related factors, lifestyle, and colonization of <i>Candida</i> spp. were studied.
Methods
Oral swabs were taken from 201 HIV-positive patients referred for consultations at the Behavioral Modification Center. Oral <i>Candida</i> colonization was detected using culture-based and molecular assays. Data were assessed by descriptive statistics and analyzed to investigate the correlation between <i>Candida</i> colonization and various factors, including the CD4<sup>+</sup> cell count and viral load.
Results
It was found that 43.8% of patients were positive for <i>Candida</i>. The most common species was C. <i>albicans</i> (48.0%), followed by non-<i>albicans Candida</i> isolates, including <i>C. dubliniensis, C. glabrata, C. tropicalis, C. parapsilosis, C. guilliermondii, C. kefyr</i>, and <i>C. krusei.</i> Colonization of <i>Candida</i> spp. in patients was associated with a CD4 count ≤200 cells/mm<sup>3</sup> (odds ratio [OR], 4.62; p<0.05), history of shared injections (OR, 6.96; p<0.001), and sex (OR, 3.59; p<0.05).
Conclusions
The results of this study showed that C. <i>albicans</i> was the dominant pathogen. The risk factors for colonization of <i>Candida</i> spp. were a CD4 count ≤ 200/mm<sup>3</sup> , a history of shared injections, and sex. Other factors with potential relationships include viral load, age, and opportunistic infections, but further investigations are needed.
Summary

Citations

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  • Antifungal Susceptibility and Candida sp. Biofilm Production in Clinical Isolates of HIV-Positive Brazilian Patients under HAART Therapy
    Anelise Maria Costa Vasconcelos Alves, Érika Helena Salles de Brito, Márcio Flávio Moura de Araújo, Juliana Jales de Hollanda Celestino, Ana Caroline Rocha de Melo Leite, Gabriela Silva Cruz, Nuno Filipe Azevedo, Célia Fortuna Rodrigues
    Biomedicines.2024; 12(2): 310.     CrossRef
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    Aynaz Ghojoghi, Sadegh Khodavaisy, Ali Zarei Mahmoudabadi, Eisa Nazar, Mahnaz Fatahinia
    Scientific Reports.2024;[Epub]     CrossRef
  • Recuento de linfocitos CD4, carga viral y colonización oral por Candida en personas viviendo con VIH/SIDA
    Esperanza Gissela Vargas-Díaz, Graciela Albino Cornejo, Hans Ramón Quiroz-Ruiz
    Gaceta Médica Boliviana.2023; 46(1): 18.     CrossRef
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    Maryam Erfaninejad, Ali Zarei Mahmoudabadi, Elham Maraghi, Mohammad Hashemzadeh, Mahnaz Fatahinia
    Letters in Applied Microbiology.2023;[Epub]     CrossRef
  • Epidemiology, prevalence, and associated factors of oral candidiasis in HIV patients from southwest Iran in post-highly active antiretroviral therapy era
    Maryam Erfaninejad, Ali Zarei Mahmoudabadi, Elham Maraghi, Mohammad Hashemzadeh, Mahnaz Fatahinia
    Frontiers in Microbiology.2022;[Epub]     CrossRef
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    Reza Ghasemi, Ensieh Lotfali, Kamran Rezaei, Seyed Ataollah Madinehzad, Mahdi Falah Tafti, Nikta Aliabadi, Ebrahim Kouhsari, Mahsa Fattahi
    Brazilian Journal of Microbiology.2022; 53(4): 1761.     CrossRef
  • HIV-infected patients rarely develop invasive fungal diseases under good immune reconstitution after ART regardless high prevalence of pathogenic filamentous fungi carriage in nasopharynx/oropharynx
    Xiaoman Chen, Yi Cao, Meijun Chen, Haodi Wang, Peishan Du, Hong Li, Huolin Zhong, Quanmin Li, Santao Zhao, Zhenjiang Yao, Wanshan Chen, Weiping Cai, Xiaoping Tang, Linghua Li
    Frontiers in Microbiology.2022;[Epub]     CrossRef
  • Neglected mycobiome in HIV infection: Alterations, common fungal diseases and antifungal immunity
    Shuang Li, Xiaodong Yang, Christiane Moog, Hao Wu, Bin Su, Tong Zhang
    Frontiers in Immunology.2022;[Epub]     CrossRef
  • Update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA 13: suitability of taxonomic units notified to EFSA until September 2020
    Kostas Koutsoumanis, Ana Allende, Avelino Alvarez‐Ordóñez, Declan Bolton, Sara Bover‐Cid, Marianne Chemaly, Robert Davies, Alessandra De Cesare, Friederike Hilbert, Roland Lindqvist, Maarten Nauta, Luisa Peixe, Giuseppe Ru, Marion Simmons, Panagiotis Skan
    EFSA Journal.2021;[Epub]     CrossRef
  • Transcription Factors of CAT1, EFG1, and BCR1 Are Effective in Persister Cells of Candida albicans-Associated HIV-Positive and Chemotherapy Patients
    Elham Aboualigalehdari, Maryam Tahmasebi Birgani, Mahnaz Fatahinia, Mehran Hosseinzadeh
    Frontiers in Microbiology.2021;[Epub]     CrossRef
Risk Factors for Group B Streptococcus Colonization Among Pregnant Women in Korea
Eun Ju Kim, Kwan Young Oh, Moon Young Kim, Yong Soo Seo, Jung-Hwan Shin, Young Rae Song, Jae-Hyug Yang, Betsy Foxman, Moran Ki
Epidemiol Health. 2011;33:e2011010.   Published online November 11, 2011
DOI: https://doi.org/10.4178/epih/e2011010
  • 16,077 View
  • 127 Download
  • 19 Crossref
AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>To identify obstetric and maternal factors related to Group B Streptococcus (GBS) colonization in pregnant women in Korea.</p></sec><sec><title>METHODS</title><p>The study was conducted between the years 2006-2008 in four hospitals, Cheil and Eulji hospital in Seoul, and Motae and Eulji hospital in Daejeon. We recruited 2,644 pregnant women between 35 to 37 weeks of gestation who had visited for antenatal care. Participants completed a questionnaire, and urine, vaginal and rectal specimens were obtained and cultured using selective broth media. After delivery, medical records were reviewed.</p></sec><sec><title>RESULTS</title><p>GBS colonization was significantly associated with hospital, age group, education, frequency of pregnancy, and premature rupture of membranes (PROM, more than 18 hours). After adjustment for other variables, Cheil hospital (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.20-3.52), and the first pregnancy (OR, 2.32; 95% CI, 1.12-4.81) remained significant. History of vaginitis showed marginal significance (OR, 1.50; 95% CI, 0.98-2.29).</p></sec><sec><title>CONCLUSION</title><p>To prevent GBS infection of neonates, clinicians should be alert to the potentially higher risk of GBS colonization in pregnant women in their first pregnancy, and women with premature rupture of membranes (PROM) (18 hours+) or who have a history of vaginitis.</p></sec>
Summary

Citations

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