Prevalence and incidence of antimicrobial-resistant organisms among hospitalized inflammatory bowel disease patients.
BACKGROUND
Patients with inflammatory bowel disease (IBD) experience frequent hospitalizations and use of immunosuppressive medications, which may predispose them to colonization with antimicrobial-resistant organisms (ARO).


OBJECTIVE
To determine the prevalence of ARO colonization on admission to hospital and the incidence of infection during hospitalization among hospitalized IBD patients.


METHODS
A chart review comparing the prevalence of colonization and incidence of infection with methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci and extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL) in hospitalized IBD patients with those of non-IBD controls was performed.


RESULTS
On admission, there were no significant differences between IBD inpatients and controls in the prevalence of colonization of methicillin-resistant S aureus (1.0% versus 1.2%; P=0.74), vancomycin-resistant enterococci (0.2% versus 0%; P=1.0) or ESBL (4.1% versus 5.5%; P=0.33). Pooling data from historical clinic-based cohorts, IBD patients were more likely than controls to have ESBL colonization (19% versus 6.6%; P<0.05). Antibiotic use on admission was associated with ESBL colonization among IBD inpatients (OR 4.2 [95% CI 1.4 to 12.6]). The incidence of ARO infections during hospitalization was not significantly different between IBD patients and controls. Among IBD patients who acquired ARO infections during hospitalizations, the mean time interval from admission to infection was shorter for those who were already colonized with ARO on admission.


CONCLUSIONS
This particular population of hospitalized IBD patients was not shown to have a higher prevalence or incidence of ARO colonization or infection compared with non-IBD inpatients.
Mount Sinai Centre for Inflammatory Bowel Disease, University of Toronto;
Alon
A
Vaisman
Mount Sinai Centre for Inflammatory Bowel Disease, University of Toronto;
Kevin
K
Pivovarov
Department of Microbiology, Mount Sinai Hospital, University of Toronto;
Allison
A
McGeer
Department of Microbiology, Mount Sinai Hospital, University of Toronto;
Barbara
B
Willey
Department of Emergency Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario;
Bjug
B
Borgundvaag
Department of Microbiology, Mount Sinai Hospital, University of Toronto;
Vanessa
V
Porter
Department of Microbiology, Mount Sinai Hospital, University of Toronto;
Piraveina
P
Gnanasuntharam
Department of Microbiology, Mount Sinai Hospital, University of Toronto;
Yanliang
Y
Wei
Mount Sinai Centre for Inflammatory Bowel Disease, University of Toronto; ; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Geoffrey C
GC
Nguyen
Crohn disease; Extended spectrum beta-lactamase; Inflammatory bowel disease; Methicillin-resistant Staphylococcus aureus; Ulcerative colitis; Vancomycin-resistant enterococci