Prevalence and incidence of antimicrobial-resistant organisms among hospitalized inflammatory bowel disease patients
- PMID: 24489571
- PMCID: PMC3905012
- DOI: 10.1155/2013/609230
Prevalence and incidence of antimicrobial-resistant organisms among hospitalized inflammatory bowel disease patients
Abstract
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.
Historique: Les patients atteints d’une maladie inflammatoire de l’intestin (MII) sont souvent hospitalisés et prennent souvent des immunosuppresseurs, ce qui peut les prédisposer à des organismes résistants aux antimicrobiens (ORA).
Objectif: Déterminer la prévalence de colonisation par des ORA à l’admission à l’hôpital ainsi que l’incidence d’infection pendant l’hospitalisation de patients atteints d’une MII.
Méthodologie: Les chercheurs ont procédé à l’analyse des dossiers comparant la prévalence de colonisation et d’incidence d’infection par le Staphylococcus aureus résistant à la méthicilline (SARM), les entérocoques résistant à la vancomycine (EVM) et les entérobactériacées productrices de bêta-lactamase à spectre étendu (BLSE) des patients hospitalisés atteints d’une MII à celle de sujets témoins n’ayant pas de MII.
Résultats: À l’admission, les chercheurs n’ont pas constaté de dif-férences significatives entre les patients hospitalisés atteints d’une MII et les sujets témoins pour ce qui est de la prévalence de colonisation par le SARM (1,0 % par rapport à 1,2 %; P=0,74), les EVM (0,2 % par rapport à 0 %; P=1,0) ou les BLSE (4,1 % par rapport à 5,5 %; P=0,33). Selon les données regroupées de cohortes cliniques rétrospectives, les patients atteints d’une MII étaient plus susceptibles que les sujets témoins d’être colonisés par des BLSE (19 % par rapport à 6,6 %; P<0,05). L’utilisation d’antibiotiques à l’admission s’associait à une colonisation par les BLSE chez les patients atteints d’une MII (RRR 4,2 [95 % IC1,4 à 12,6]). L’incidence d’infections par des ORA pendant l’hospitalisation n’était pas significativement différente entre les patients atteints d’une MII et les sujets témoins. Chez les patients atteints d’une MII qui avaient contracté une infection par des ORA pendant l’hospitalisation, l’intervalle moyen entre l’admission et l’infection était plus court pour ceux qui étaient déjà colonisés par des ORA à l’admission.
Conclusions: Cette population de patients hospitalisés atteints d’une MII ne présentait pas de prévalence ou d’incidence plus élevée de colonisation par des ORA que les patients n’ayant pas de MII.
Keywords: Crohn disease; Extended spectrum beta-lactamase; Inflammatory bowel disease; Methicillin-resistant Staphylococcus aureus; Ulcerative colitis; Vancomycin-resistant enterococci.
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