title: Risk factors of fecal carriage with extended-spectrum β-lactamase-producing Enterobacteriaceae in hospitalized patients.
abstract: BACKGROUND
  Colonization of multidrug-resistant microorganisms is a potential source of cross transmission and subsequent infection. Screening of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) is not yet a routine practice in most hospitals.
  
  
  METHODS
  The purpose of this study was to investigate the risk factors of fecal carriage of ESBL-E in hospitalized patients. A total of 174 samples (from 97 patients) was collected. Screening test was accomplished using commercial chromogenic medium (ChromID ESBL agar; bioMérieux, Marcy l'Etoile, France). The presence of ESBLs of grown isolates was confirmed by Clinical and Laboratory Standards Institute guidelines. Analysis of the risk factors of ESBL-E carriage was performed by multivariate logistic regression.
  
  
  RESULTS
  Among the risk factors, multivariate analysis demonstrated that prolonged hospitalization (≥90 days) (odds ratio [OR], 6.76; 95% confidence interval [CI]: 1.17-39.23; P = .033), prolonged intensive care unit stay (≥14 days) (OR, 4.78; 95% CI: 1.70-13.42; P = .003), and methicillin-resistant Staphylococcus aureus carriage (OR, 3.29; 95% CI: 1.20-9.01; P = .020) were found to be significantly associated with fecal carriers.
  
  
  CONCLUSIONS
  This study clarified the characteristics and the risk factors of hospitalized patients carrying ESBL-E. In addition, the cost-benefit of routine screening in addition to methicillin-resistant Staphylococcus aureus and vancomycin-resitant Enterococci needs to be assessed.
authors: Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors: Young Jin
authors: YJ
authors: Ko
authors: Hee-Won
authors: HW
authors: Moon
authors: Mina
authors: M
authors: Hur
authors: Yeo-Min
authors: YM
authors: Yun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001431:Bacteriological Techniques; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D004755:Enterobacteriaceae / Q000201:enzymology* / Q000302:isolation & purification*; D005243:Feces / Q000382:microbiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D001618:beta-Lactamases
keywords: Colonization; ESBL; Factors; Risk