Risk factors for fecal carriage of IMP-6-producing Enterobacteriaceae at a long-term care hospital in Japan: A follow-up report from the northern Osaka multicentre study group. Issue 9 (September 2018)

• Record Type: Journal Article
• Authors: Hagiya, Hideharu; Yamamoto, Norihisa; Kawahara, Ryuji; Akeda, Yukihiro; Shanmugakani, Rathina Kumar; Ueda, Akiko; Nishi, Isao; Asada, Rumiko; Yoshida, Hisao; Tomono, Kazunori
• Is Part Of: Journal of infection and chemotherapy. Volume 24:Issue 9(2018:Sep.)
• Page Start: 769
• Page End: 772
• Publication Date: 2018-09
• Subjects: Aging society -- Antimicrobial resistance -- Carbapenemase-producing Enterobacteriaceae -- Carbapenem-resistant Enterobacteriaceae -- Metallo-beta-lactamase; Chemotherapy -- Periodicals; Infection -- Periodicals; Communicable diseases -- Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1016/j.jiac.2018.03.009
• Languages: English
• ISSNs: 1341-321X

Abstract

Abstract: The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing at medical institutions in Japan without even noticing. Recently, we performed a point prevalence survey for CRE carriage at a medical facility in northern Osaka that demonstrated an unexpectedly high prevalence of bla IMP-6 -positive CRE, particularly at long-term care hospitals (LTCH). To identify the risk factors for CRE carriage, we collected clinical data of patients at a representative LTCH. Of 140 patients who were included in this study, 27 (19.3%) were colonized with metallo-beta-lactamase (IMP-6) producers. Pulsed-field gel electrophoresis of the IMP-6 producing Enterobacteriaceae suggested a non-clonal transmission of Escherichia coli, while a clonal spread was shown for Klebsiella pneumoniae . Risk factors for CRE colonization were a longer stay at the hospital stay and a lower independence state, as measured by Norton scales. We propose that a paradigm shift in infection control, inciting a coordinated regional effort to involve LTCHs, should be discussed in the aging society of Japan.