title: Risk Factors and Outcomes for Intestinal Carriage of AmpC-Hyperproducing Enterobacteriaceae in Intensive Care Unit Patients.
abstract: In a cohort of 1,209 intensive care unit (ICU) patients, the prevalence of intestinal colonization with high-level expressed AmpC cephalosporinase-producing Enterobacteriaceae (HLAC-PE) rose steadily from 2% at admission to 30% in patients with lengths of stay (LOS) exceeding 4 weeks. In multivariate analysis, LOS was the main predictor of carriage acquisition after adjustment on antimicrobial exposure. HLAC-PE infection occurred in 15% of carriers. Carriage and infection were associated with a marked increase in carbapenem consumption.
authors.affiliation: Medical Intensive Care Unit, La Source Hospital, CHR Orléans, Orléans, France.
authors.forename: Simon
authors.initials: S
authors.lastname: Poignant
authors.affiliation: Department of Microbiology, La Source Hospital, CHR Orléans, Orléans, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Guinard
authors.affiliation: Department of Microbiology, La Source Hospital, CHR Orléans, Orléans, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Guigon
authors.affiliation: Department of Microbiology, La Source Hospital, CHR Orléans, Orléans, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Bret
authors.affiliation: Department of Microbiology, La Source Hospital, CHR Orléans, Orléans, France.
authors.forename: Didier-Marc
authors.initials: DM
authors.lastname: Poisson
authors.affiliation: Medical Intensive Care Unit, La Source Hospital, CHR Orléans, Orléans, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Boulain
authors.affiliation: Medical Intensive Care Unit, La Source Hospital, CHR Orléans, Orléans, France francois.barbier@chr-orleans.fr.
authors.forename: François
authors.initials: F
authors.lastname: Barbier
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism*; D015780:Carbapenems / Q000627:therapeutic use*; D002353:Carrier State / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007422:Intestines / Q000382:microbiology*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; C048795:AmpC beta-lactamases; D001618:beta-Lactamases