title: Prevalence and risk factors for carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae among patients prior to bowel surgery.
abstract: Prophylactic antibiotics are an important measure in preventing perioperative infection, Failure to cover multidrug-resistant pathogens may place carriers at increased risk of infection. We conducted a prospective, cross-sectional study in patients prior to bowel surgery to measure the carriage prevalence of extended-spectrum β-lactamase-producing Enterobacteriaceae and identify risk factors for carriage in this population. During an 11-month period, 150 patients were eligible for inclusion. 27 patients (18%) were found to be carriers of extended-spectrum β-lactamase-producing Enterobacteriaceae. Factors independently associated with carriage were immunosuppressive therapy (OR, 4.09; 95% CI 1.55-10.81; P = 0.005) and receipt of antibiotics in the prior 3 months (OR, 2.59; 95% CI 1.08-6.24; P = 0.033). Detection of a population at risk for carriage may help in devising and modifying appropriate antibiotic regimens for surgical prophylaxis in carriers of multidrug-resistant bacteria.
authors.affiliation: Division of Epidemiology and Preventive Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. Electronic address: irispf@tlvmc.gov.il.
authors.forename: Iris
authors.initials: I
authors.lastname: Pfeffer
authors.affiliation: Division of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Meir
authors.initials: M
authors.lastname: Zemel
authors.affiliation: Division of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Kariv
authors.affiliation: National Center for Infection Control, Ministry of Health, Tel Aviv, Israel.
authors.forename: Hagit
authors.initials: H
authors.lastname: Mishali
authors.affiliation: National Center for Infection Control, Ministry of Health, Tel Aviv, Israel.
authors.forename: Amos
authors.initials: A
authors.lastname: Adler
authors.affiliation: Division of Epidemiology and Preventive Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Tali
authors.initials: T
authors.lastname: Braun
authors.affiliation: Division of Epidemiology and Preventive Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Anat
authors.initials: A
authors.lastname: Klein
authors.affiliation: Division of Epidemiology and Preventive Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Meital Kazma
authors.initials: MK
authors.lastname: Matalon
authors.affiliation: Division of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Joseph
authors.initials: J
authors.lastname: Klausner
authors.affiliation: Division of Epidemiology and Preventive Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Carmeli
authors.affiliation: National Center for Infection Control, Ministry of Health, Tel Aviv, Israel.
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Schwaber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D003430:Cross-Sectional Studies; D004755:Enterobacteriaceae / Q000201:enzymology* / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D001618:beta-Lactamases
keywords: Antimicrobial resistance; Bowel surgery; Enterobacteriaceae; Extended-spectrum β-lactamase; Surgical site infection