Low Colonization Rates with Multidrug-resistant Gram-negative Bacteria in a German Hospital-affiliated Hemodialysis Center

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2020 Oct 15

PMID 33057439

Citations 2

Authors

Ralph Wendt

Olaf Nickel

Almut Botsch

Margareta Lindner

Angela Bethge

Kathrin Marx

Bernhard R Ruf

Joachim Beige

Christoph Lubbert

Affiliations

Soon will be listed here.

Abstract

Background: Multidrug-resistant Gram-negative bacteria (MDRGN) are found with rising prevalence in non-hemodialysis risk populations as well as hemodialysis (HD) cohorts in Asia, Europe and North America. At the same time, colonization and consecutive infections with such pathogens may increase mortality and morbidity of affected individuals. We aimed to monitor intestinal MDRGN colonization in a yet not investigated German HD population.

Methods: We performed cross-sectional point-prevalence testing with 12 months follow-up and selected testing of relatives in an out-patient HD cohort of n = 77 patients by using microbiological cultures from fresh stool samples, combined with Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF-MS) and antimicrobial susceptibility testing.

Results: We detected MDRGN in 8 out of 77 patients (10.4%) and 1 out of 22 relatives (4.5%), indicating only colonization and no infections. At follow-up, 2 patients showed phenotypic persistence of MDRGN colonization, and in 6 other patients de-novo MDRGN colonization could be demonstrated. Pathogens included Escherichia coli and Klebsiella pneumoniae (with extended-spectrum beta-lactamase [ESBL]-production as well as fluoroquinolone resistance), Stenotrophomonas maltophilia and Enterobacter cloacae.

Conclusions: In a single-center study, MDRGN colonization rates were below those found in non-HD high-risk populations and HD units in the US, respectively. Reasons for this could be high hygiene standards and a strict antibiotic stewardship policy with evidence of low consumption of fluoroquinolones and carbapenems in our HD unit and the affiliated hospital.

Citing Articles

[Therapy-relevant antibiotic resistances in a One Health context].

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PMID: 37184673 PMC: 10261244. DOI: 10.1007/s00103-023-03713-4.

High frequency of colonization by extended-spectrum beta-lactamase-producing Gram-negative bacilli in hemodialysis patients and their household contacts in Colombia: dissemination between the community and the hospital.

Montoya-Urrego D, Tellez-Carrasquilla S, Vanegas J, Quiceno J Epidemiol Health. 2022; 44:e2022069.

PMID: 36097808 PMC: 9943636. DOI: 10.4178/epih.e2022069.

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