Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-23T03:29:39.209Z Has data issue: false hasContentIssue false
  • English
  • Français

Seasonal and Ascending Trends in the Incidence of Carriage of Extended-Spectrum β-Lactamase–Producing Escherichia coli and Klebsiella Species in 2 German Hospitals

Published online by Cambridge University Press:  02 January 2015

Klaus Kaier Dipl-Vw ,
Uwe Frank ,
Andreas Conrad  and
Elisabeth Meyer
Klaus Kaier Dipl-Vw*
Affiliation:
Department of Environmental Health Sciences, University Medical Center Freiburg, Berlin, Germany Research Center for Generational Contracts, Freiburg University, Freiburg, Germany
Uwe Frank
Affiliation:
Department of Environmental Health Sciences, University Medical Center Freiburg, Berlin, Germany
Andreas Conrad
Affiliation:
Department of Environmental Health Sciences, University Medical Center Freiburg, Berlin, Germany
Elisabeth Meyer
Affiliation:
Institute of Hygiene and Environmental Medicine, Charité University Medicine, Berlin, Germany
*
Department of Environmental Health Sciences, University Medical Center Freiburg, Breisacher Straße ] 15b, D-79106 Freiburg, Germany, ([email protected])
Get access Rights & Permissions [Opens in a new window]

Extract

Background.

Extended-spectrum β-lactamase (ESBL)–producing strains of bacteria have become a major public health concern. In the present study, the incidence of carriage of ESBL-producing strains was analyzed for general trends and seasonality.

Methods.

Monthly data on ESBL-producing strains were collected retrospectively at 2 large university hospitals in Germany. The mean monthly temperatures for the 2 settings were collected from Germany's national meteorological service. Multivariable time series analyses were performed to explain variations in the monthly incidence densities of carriage of ESBL-producing bacteria (number of cases involving ESBL-producing Escherichia coli and/or Klebsiella species per 1,000 patient days). For the final models, we incorporated variables for the ascending linear trends and other variables representing the mean monthly temperature.

Results.

Our models demonstrated that there was an increasing trend in the incidences of carriage of ESBL-producing bacteria. In addition, the incidences of carriage of all ESBL-producing bacteria responded positively to the mean temperature, meaning that during the summer, more cases involving ESBL-producing bacteria were detected than during the winter. The same methodology was also applied to the incidence of methicillin-resistant Staphylococcus aureus carriage, but no association was found with the mean temperature.

Conclusions.

In the present study, we demonstrated that the monthly incidence of carriage of ESBL-producing bacteria was highly correlated with the mean monthly temperature, a fact that should be considered in experimental studies as an additional parameter influencing the incidence of ESBL-producing bacteria.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 11 , November 2010 , pp. 1154 - 1159
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Pitout, JDD, Laupland, KB. Extended-spectrum β-lactamase-producing Enterobacteriaceae: an emerging public-health concern. Lancet Infect Dis 2008;8:159–166.Google Scholar
2.Coque, TM, Baquero, F, Canton, R. Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe. Euro Surveill 2008;13:pii: 19051.Google Scholar
3.Meyer, E, Gastmeier, P, Schwab, F. The burden of multiresistant bacteria in German intensive care units. J Antimicrob Chemother 2008;62:1474–1476.Google Scholar
4.Perencevich, EN, McGregor, JC, Shardell, M, et al.Summer peaks in the incidences of gram-negative bacterial infection among hospitalized patients. Infect Control Hosp Epidemiol 2008;29:1124–1131.Google Scholar
5.Livermore, DM, Canton, R, Gniadkowski, M, et al.CTX-M: changing the face of ESBLs in Europe. J Antimicrob Chemother 2007;59:165–174.CrossRefGoogle ScholarPubMed
6.Al-Hasan, MN, Lahr, BD, Eckel-Passow, JE, et al.Seasonal variation in Escherichia coli bloodstream infection: a population-based study. Clin Microbiol Infect 2009;15:947–950.Google Scholar
7.Freeman, J, Anderson, D, Sexton, D. Emerging evidence for seasonality of gram-negative bacterial infections. Infect Control Hosp Epidemiol 2009;30:813–814.Google Scholar
8.McDonald, LC, Banerjee, SN, Jarvis, WR. Seasonal variation of Acineto-bacter infections: 1987-1996. Clin Infect Dis 1999;29:1133–1137.CrossRefGoogle ScholarPubMed
9.Fisman, DN. Seasonality of infectious diseases. Ann Rev Public Health 2007;28:127–143.Google Scholar
10.Stone, L, Olinky, R, Huppert, A. Seasonal dynamics of recurrent epidemics. Nature 2007;446:533.Google Scholar
11.Livermore, DM, Hawkey, PM. CTX-M: changing the face of ESBLs in the UK. J Antimicrob Chemother 2005;56:451–454.Google Scholar
12.Dagan, R, Barkai, G, Givon-Lavi, N, et al. Seasonality of antibiotic-resistant streptococcus pneumoniae that causes acute otitis media: a clue for an antibiotic-restriction policy? J Infect Dis 2008;197:1094–1102.Google Scholar
13.Anderson, DJ, Riebet, H, Chen, LF, et al.Seasonal variation in Klebsiella pneumoniae bloodstream infection on 4 continents. J Infect Dis 2008;197:752–756.Google Scholar
14.Greene, WH. Econometric analysis. Upper Saddle River, NJ: Prentice Hall; 1997.Google Scholar
15.Borg, MA, Suda, D, Scicluna, E. Time-series analysis of the impact of bed occupancy rates on the incidence of methicillin-resistant Staphylococcus aureus infection in overcrowded general wards. Infect Control Hosp Epidemiol 2008;29:496–502.Google Scholar
16.Cunningham, JB, Kernohan, WG, Sowney, R. Bed occupancy and turnover interval as determinant factors in MRSA infections in acute settings in Northern Ireland: 1 April 2001 to 31 March 2003. J Hosp Infect 2005;61:189–193.CrossRefGoogle ScholarPubMed
17.Kaier, K, Hagist, C, Frank, U, et al.Two time-series analyses of the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant Staphylococcus aureus infection and Clostridium difficile infection. Infect Control Hosp Epidemiol 2009;30:346–353.Google Scholar
18.Kaier, K, Frank, U, Hagist, C, et al.The impact of antimicrobial drug consumption and alcohol-based hand rub use on the emergence and spread of extended-spectrum β-lactamase-producing strains: a time-series analysis. J Antimicrob Chemother 2009;63:609–614.Google Scholar
19.Pitout, JDD, Nordmann, P, Laupland, KB, et al.Emergence of Entero-bacteriaceae producing extended-spectrum β-lactamases (ESBLs) in the community. J Antimicrob Chemother 2005;56:52–59.CrossRefGoogle Scholar
20.Pitout, IDD, Gregson, DB, Church, DL, et al.Community-wide outbreaks of clonally related CTX-M-14 β-lactamase-producing Escherichia coli strains in the Calgary Health Region. J Clin Microbiol 2005;43:2844–2849.CrossRefGoogle ScholarPubMed