International journal of antimicrobial agents · 2018
Incidence and Risk Factors for Acquisition of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Newborns in Seville, Spain: A Prospective Cohort Study.
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Rodríguez-Revuelta María Jesús, López-Cerero Lorena, Serrano Lara, Luna-Lagares Salud, Pascual Alvaro, Rodríguez-Baño Jesús
Аннотация
BACKGROUND: ESBL-producing Enterobacteriaceae (ESBL-E) are an emerging cause of infections in children. Data are scarce on incidence rates and risk factors for acquisition of colonisation with ESBL-E.
METHODS: A total of 46 and 50 newborns from colonised and non-colonised mothers, respectively, were followed during one year after birth. Rectal swabs were performed every 3 months to detect ESBL-E; blaESBL were characterised and isolates were typed for comparison. Multivariate analysis for risk factors was performed using Cox regression.
RESULTS: Incidence density of any new acquisition and of first acquisition of ESBL-E was 2.7 and 1.9 episodes per 100 children-month, respectively, among children whose mothers were colonised, and 1.2 and 1.3, respectively, among children whose mothers were not. The weighted average prevalence of colonisation rates during the first year were 15.9% and 8%, respectively. No infections due to ESBL-E were detected. Living with pets at home, breastfeeding, sterilisation of feeding bottles and out-of-home childcare were protective for ESBL-E acquisition; having a colonised mother increased the risk. The most frequent ESBL types were CTX-M-14 and CTX-M-1. In 5/19 (26.3%) children with acquisition of new clones, the acquired ESBL-E was shared with their mothers.
CONCLUSIONS: Acquisition of ESBL-E colonisation is not rare during the first year of life. Breastfeeding and out-of-home childcare were protective for acquisition, and colonised mothers were associated with increased risk. However, the same clone was shared by mother and child in only a subset of acquisition episodes.
METHODS: A total of 46 and 50 newborns from colonised and non-colonised mothers, respectively, were followed during one year after birth. Rectal swabs were performed every 3 months to detect ESBL-E; blaESBL were characterised and isolates were typed for comparison. Multivariate analysis for risk factors was performed using Cox regression.
RESULTS: Incidence density of any new acquisition and of first acquisition of ESBL-E was 2.7 and 1.9 episodes per 100 children-month, respectively, among children whose mothers were colonised, and 1.2 and 1.3, respectively, among children whose mothers were not. The weighted average prevalence of colonisation rates during the first year were 15.9% and 8%, respectively. No infections due to ESBL-E were detected. Living with pets at home, breastfeeding, sterilisation of feeding bottles and out-of-home childcare were protective for ESBL-E acquisition; having a colonised mother increased the risk. The most frequent ESBL types were CTX-M-14 and CTX-M-1. In 5/19 (26.3%) children with acquisition of new clones, the acquired ESBL-E was shared with their mothers.
CONCLUSIONS: Acquisition of ESBL-E colonisation is not rare during the first year of life. Breastfeeding and out-of-home childcare were protective for acquisition, and colonised mothers were associated with increased risk. However, the same clone was shared by mother and child in only a subset of acquisition episodes.