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Abstract

Background

Emergence of colistin resistance has been related to increased use in clinical settings, following global spread of carbapenem-resistant Gram-negative bacteria. Use of colistin in animal production may constitute a further source of spread of resistant strains to humans. We sought to determine risk factors for human colonisation or infection with colistin-resistant and in a setting where colistin is mainly used for animal production. This retrospective matched case–control study was performed during a 5-year period at two university-affiliated hospitals in Basel, Switzerland. Conditional univariable logistic regression was used to calculate odds ratios (OR) for colistin resistance. All variables found to be significant in univariable analyses were included in the conditional multivariable regression model using stepwise forward and backward selection. Forty-two cases (33 with colistin-resistant , 9 with colistin-resistant ) and 126 matched controls were identified. Baseline characteristics, comorbidities, prior exposure to antibiotics and healthcare settings did not differ between cases and controls, except for prior exposure to carbapenems, hospitalisation and stay abroad during the prior 3 months. In multivariable analyses, only prior exposure to carbapenems remained associated with colistin resistance (OR: 5.00; 95% confidence interval (95% CI): 1.19–20.92; p = 0.028). In a low-endemicity setting for carbapenem resistance, prior exposure to carbapenems was the only risk factor for colonisation or infection with colistin-resistant or . Prior exposure to colistin was not significantly associated with detection of colistin resistance, which mainly occurred in the absence of concurrent carbapenem resistance.

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/content/10.2807/1560-7917.ES.2018.23.30.1700777
2018-07-26
2018-08-20
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.30.1700777
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References

  1. Xu Y, Gu B, Huang M, Liu H, Xu T, Xia W, et al. Epidemiology of carbapenem resistant Enterobacteriaceae (CRE) during 2000-2012 in Asia. J Thorac Dis. 2015;7(3):376-85. PMID: 25922715 
  2. Perez F, El Chakhtoura NG, Papp-Wallace KM, Wilson BM, Bonomo RA. Treatment options for infections caused by carbapenem-resistant Enterobacteriaceae: can we apply "precision medicine" to antimicrobial chemotherapy? Expert Opin Pharmacother. 2016;17(6):761-81.  https://doi.org/10.1517/14656566.2016.1145658  PMID: 26799840 
  3. Liu Y-Y, Wang Y, Walsh TR, Yi LX, Zhang R, Spencer J, et al. Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study. Lancet Infect Dis. 2016;16(2):161-8.  https://doi.org/10.1016/S1473-3099(15)00424-7  PMID: 26603172 
  4. Xavier BB, Lammens C, Ruhal R, Kumar-Singh S, Butaye P, Goossens H, et al. Identification of a novel plasmid-mediated colistin-resistance gene, mcr-2, in Escherichia coli, Belgium, June 2016. Euro Surveill. 2016;21(27):30280.  https://doi.org/10.2807/1560-7917.ES.2016.21.27.30280  PMID: 27416987 
  5. Zurfuh K, Poirel L, Nordmann P, Nüesch-Inderbinen M, Hächler H, Stephan R. Occurrence of the Plasmid-Borne mcr-1 Colistin Resistance Gene in Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in River Water and Imported Vegetable Samples in Switzerland. Antimicrob Agents Chemother. 2016;60(4):2594-5. PMID:26883696
  6. Swiss Centre for Antibiotic resistance (ANRESIS) [Internet]. Bern: ANRESIS. [Accessed Feb 2018]. Available from: www.anresis.ch.
  7. Federal Office of Public Health (FOPH). Swiss Antibiotic Resistance Report 2016. Bern: FOPH; 2016. Available from:https://www.blv.admin.ch/blv/de/home/tiere/publikationen-und-forschung/statistiken-berichte-tiere.html
  8. Kempf I, Jouy E, Chauvin C. Colistin use and colistin resistance in bacteria from animals. Int J Antimicrob Agents. 2016;48(6):598-606.  https://doi.org/10.1016/j.ijantimicag.2016.09.016  PMID: 27836380 
  9. Nordmann P, Lienhard R, Kieffer N, Clerc O, Poirel L. Plasmid-Mediated Colistin-Resistant Escherichia coli in Bacteremia in Switzerland. Clin Infect Dis. 2016;62(10):1322-3.  https://doi.org/10.1093/cid/ciw124  PMID: 26936673 
  10. Centers for Disease Control and Prevention (CDC). CDC/NHSN Surveillance Definitions of Specific Types of Infections. Atlanta: CDC; Jan 2017. Available from: https://www.cdc.gov/nhsn/pdfs/validation/2017/pcsmanual_2017.pdf
  11. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters Version 7.1, valid from 2017-03-10. Växjö: EUCAST; 2017. Available from: http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_7.1_Breakpoint_Tables.pdf
  12. R Development Core Team. A Language and Environment for Statistical Computing. R Foundation for Statistical Computing. Vienna: the R Foundation for Statistical Computing; 2016. Available from: http://www.R-project.org/
  13. Ho D, Imai K, King G, Stuart EA. MatchIt: Nonparametric Preprocessing for Parametric Causal Inference. J Stat Softw. 2011;42(8):1-28.  https://doi.org/10.18637/jss.v042.i08 
  14. Zurfluh K, Stephan R, Widmer A, Poirel L, Nordmann P, Nüesch HJ, et al. Screening for fecal carriage of MCR-producing Enterobacteriaceae in healthy humans and primary care patients. Antimicrob Resist Infect Control. 2017;6(1):28.  https://doi.org/10.1186/s13756-017-0186-z  PMID: 28316780 
  15. Liassine N, Assouvie L, Descombes MC, Tendon VD, Kieffer N, Poirel L, et al. Very low prevalence of MCR-1/MCR-2 plasmid-mediated colistin resistance in urinary tract Enterobacteriaceae in Switzerland. Int J Infect Dis. 2016;51:4-5.  https://doi.org/10.1016/j.ijid.2016.08.008  PMID: 27544715 
  16. Qamar S, Shaheen N, Shakoor S, Farooqi J, Jabeen K, Hasan R. Frequency of colistin and fosfomycin resistance in carbapenem-resistant Enterobacteriaceae from a tertiary care hospital in Karachi. Infect Drug Resist. 2017;10:231-6.  https://doi.org/10.2147/IDR.S136777  PMID: 28814888 
  17. Monaco M, Giani T, Raffone M, Arena F, Garcia-Fernandez A, Pollini S, et al. Network EuSCAPE-Italy. Colistin resistance superimposed to endemic carbapenem-resistant Klebsiella pneumoniae: a rapidly evolving problem in Italy, November 2013 to April 2014. Euro Surveill. 2014;19(42):19.  https://doi.org/10.2807/1560-7917.ES2014.19.42.20939  PMID: 25358041 
  18. Arjun R, Gopalakrishnan R, Nambi PS, Kumar DS, Madhumitha R, Ramasubramanian V. A Study of 24 Patients with Colistin-Resistant Gram-negative Isolates in a Tertiary Care Hospital in South India. Indian J Crit Care Med. 2017;21(5):317-21.  https://doi.org/10.4103/ijccm.IJCCM_454_16  PMID: 28584435 
  19. Irrgang A, Roschanski N, Tenhagen BA, Grobbel M, Skladnikiewicz-Ziemer T, Thomas K, et al. Prevalence of mcr-1 in E. coli from Livestock and Food in Germany, 2010-2015. PLoS One. 2016;11(7):e0159863.  https://doi.org/10.1371/journal.pone.0159863  PMID: 27454527 
  20. Perrin-Guyomard A, Bruneau M, Houée P, Deleurme K, Legrandois P, Poirier C, et al. Prevalence of mcr-1 in commensal Escherichia coli from French livestock, 2007 to 2014. Euro Surveill. 2016;21(6):30135.  https://doi.org/10.2807/1560-7917.ES.2016.21.6.30135  PMID: 26898350 
  21. Federal Office of Public Health (FOPH). ARCH-Vet Bericht über den Vertrieb von Antibiotika in der Veterinärmedizin und das Antibiotikaresistenzmonitoring bei Nutztieren in der Schweiz. [ARCH-Vet report on antibiotic consumption in veterinary medicine and surveillance of antibiotic resistance in farm animals in Switzerland]. Bern: FOPH; 2015. German. Available from: https://www.blv.admin.ch/blv/de/home/tiere/publikationen-und-forschung/statistiken-berichte-tiere.html
  22. European Medicines Agency (EMA). Sales of veterinary antimicrobial agents in 26 EU/EEA countries in 2013. Fifth ESVAC report. London: EMA; 2015. Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Report/2015/10/WC500195687.pdf
  23. European Food Safety Authority (EFSA). ECDC/EFSA/EMA second joint report on the integrated analysis of the consumption of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from humans and food-producing animals. EFSA Journal. 2017;15(7):4872.
  24. Kontopidou F, Plachouras D, Papadomichelakis E, Koukos G, Galani I, Poulakou G, et al. Colonization and infection by colistin-resistant Gram-negative bacteria in a cohort of critically ill patients. Clin Microbiol Infect. 2011;17(11):E9-11.  https://doi.org/10.1111/j.1469-0691.2011.03649.x  PMID: 21939468 
  25. Giacobbe DR, Del Bono V, Trecarichi EM, De Rosa FG, Giannella M, Bassetti M, et al. ISGRI-SITA (Italian Study Group on Resistant Infections of the Società Italiana Terapia Antinfettiva). Risk factors for bloodstream infections due to colistin-resistant KPC-producing Klebsiella pneumoniae: results from a multicenter case-control-control study. Clin Microbiol Infect. 2015;21(12):1106.e1-8.  https://doi.org/10.1016/j.cmi.2015.08.001  PMID: 26278669 
  26. Ling ML, Tee YM, Tan SG, Amin IM, How KB, Tan KY, et al. Risk factors for acquisition of carbapenem resistant Enterobacteriaceae in an acute tertiary care hospital in Singapore. Antimicrob Resist Infect Control. 2015;4(1):26.  https://doi.org/10.1186/s13756-015-0066-3  PMID: 26106476 
  27. Zarkotou O, Pournaras S, Voulgari E, Chrysos G, Prekates A, Voutsinas D, et al. Risk factors and outcomes associated with acquisition of colistin-resistant KPC-producing Klebsiella pneumoniae: a matched case-control study. J Clin Microbiol. 2010;48(6):2271-4.  https://doi.org/10.1128/JCM.02301-09  PMID: 20375234 
  28. Wang Y, Tian G-B, Zhang R, Shen Y, Tyrrell JM, Huang X, et al. Prevalence, risk factors, outcomes, and molecular epidemiology of mcr-1-positive Enterobacteriaceae in patients and healthy adults from China: an epidemiological and clinical study. Lancet Infect Dis. 2017;17(4):390-9.  https://doi.org/10.1016/S1473-3099(16)30527-8  PMID: 28139431 
  29. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Antimicrobial susceptibility testing of colistin - problems detected with several commercially available products. Available from: http://www.eucast.org/ast_of_bacteria/warnings/
  30. Dafopoulou K, Zarkotou O, Dimitroulia E, Hadjichristodoulou C, Gennimata V, Pournaras S, et al. Comparative Evaluation of Colistin Susceptibility Testing Methods among Carbapenem-Nonsusceptible Klebsiella pneumoniae and Acinetobacter baumannii Clinical Isolates. Antimicrob Agents Chemother. 2015;59(8):4625-30.  https://doi.org/10.1128/AAC.00868-15  PMID: 26014928 
  31. Chew KL, La MV, Lin RTP, Teo JWP. Colistin and Polymyxin B Susceptibility Testing for Carbapenem-Resistant and mcr-Positive Enterobacteriaceae: Comparison of Sensititre, MicroScan, Vitek 2, and Etest with Broth Microdilution. J Clin Microbiol. 2017;55(9):2609-16.  https://doi.org/10.1128/JCM.00268-17  PMID: 28592552 
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