title: Fecal carriage of extended-spectrum and AmpC β-lactamase-producing Enterobacteriaceae in surgical patients before and after antibiotic prophylaxis.
abstract: The impact of antibiotic prophylaxis on fecal carriage of ESBL-/AmpC-/carbapenemase-producing Enterobacteriaceae (CPE) was investigated. Patients admitted for elective surgery or diagnostic procedure in a Department of Surgical Gastroenterology (SG) (n= 450) and Orthopedic Surgery (OS) (n= 300) provided a fecal swab at admission and responded to a questionnaire on possible exposures. SG patients received gentamicin/penicillin G (±metronidazole); OS patients received cefuroxime. Two days after surgery a second swab was taken. From SG patients, 6% of first swabs and 9% of second swabs were positive for ESBL-/AmpC-producers. A similar carriage rate was observed in OS patients (6% and 8%, respectively). No CPE were detected. Escherichia coli was the predominant species and blaCTX-M-15 (29% and 22%) and blaCTX-M-14 (11% and 17%) were the most prevalent ESBL genotypes among SG and OS patients. Two different prophylactic antibiotic regimens had no impact on carriage rates. Previous hospitalization and antimicrobial treatment were associated with carriage for SG patients.
authors: Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark. Electronic address: lottejakobsen@gmail.com.
authors: Lotte
authors: L
authors: Jakobsen
authors: Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark.
authors: Katrin G
authors: KG
authors: Kuhn
authors: Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark.
authors: Frank
authors: F
authors: Hansen
authors: Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark.
authors: Robert L
authors: RL
authors: Skov
authors: Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark.
authors: Anette M
authors: AM
authors: Hammerum
authors: Department of Clinical Microbiology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors: Pia J
authors: PJ
authors: Littauer
authors: Department of Gastrointestinal Surgery, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors: Ole
authors: O
authors: Thorlacius-Ussing
authors: Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors: Peter H
authors: PH
authors: Gebuhr
authors: Department of Clinical Microbiology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors: Jenny D
authors: JD
authors: Knudsen
authors: Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark.
authors: Henrik C
authors: HC
authors: Schønheyder
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis; D002353:Carrier State / Q000382:microbiology*; D003718:Denmark; D004755:Enterobacteriaceae / Q000201:enzymology* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D055815:Young Adult; D001618:beta-Lactamases / Q000032:analysis*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases
keywords: AmpC; Antibiotic prophylaxis; Beta-lactamases; Denmark; ESBL; Enterobacteriaceae; Operative; Surgical procedures