1432. Risk factors for community-acquired extended-spectrum beta-lactamase (ESBL) positive E.coli
Session: Poster Abstract Session: Epidemiology of Multiple Drug-Resistant Gram Negative Rods
Saturday, October 20, 2012
Room: SDCC Poster Hall F-H
Background: The prevalence of ESBL producing E.coli strains is strongly rising since recent years. In contrast to other multi-drug resistant organisms those bacteria are suspected to be predominantly not acquired in a healthcare setting. The objective of this study was to assess risk factors for a community-acquired colonization with ESBL positive (+) E.coli.Methods: We performed a case control study at the Charité university hospital Berlin, a tertiary care center with over 3,200 beds. Study period was from Mai 2011 to January 2012. Cases were defined as patients diagnosed with ESBL positive (+) E.coli colonization within 72 h after admission, controls were patients with ESBL negative (-) E.coli colonization. We developed a questionnaire that was filled by each study patient assessing various parameters including body mass index (BMI), nutritional habits, travel habits, mother tongue and household situation. ESBL (+) strains were further analyzed by PCR to determine the ESBL genotype. Univariable and multivariable analysis were performed to identify independent risk factors for ESBL(+) and for CTX-types and phylogen groups in ESBL(+) patients. Results: Within the study period we found 85 cases and 170 controls. Median age was 67 years (IQR 54; 73; p=0.482) 56% of the study population was male (p=0.714). The most common ESBL genotype was CTX-M-1 with 44% (n=37), followed by CTX-M-15 with 28% (n=24). In the conditional logistic regression analysis Asian mother tongue (OR=13.4; p<0.001) and frequently eating pork (>2 x per week) (OR=3.5; p<0.001) were independent risk factors for colonization with ESBL (+) E.coli. A lack of co-colonization with other multi-drug resistant organisms (MRSA, VRE) showed to be an independent protective factor against colonization with ESBL. In the multivariable logistic regression CTX-M-15 was associated with adipositas (BMI < 30) (OR=3.19; p=0.044). Conclusion: In this study from Germany an Asian socio-cultural background and frequently consumption of pork meat showed to be risk factors for colonization with ESBL positive E.coli. The most common community-acquired ESBL genotype was CTX-M-1.
Rasmus Leistner, MD1, Elisabeth Meyer, MD, PhD1, Frank Schwab, MSc2, Michael Behnke, MSc2, Petra Dem, RN1 and Petra Gastmeier, MD1, (1)Institute of Hygiene and Environmental Medicine, Berlin, Germany, (2)Institute of Hygiene and Environmental Medicine, Charité – University Medicine Berlin, Berlin, Germany

Disclosures:

R. Leistner, None

E. Meyer, None

F. Schwab, None

M. Behnke, None

P. Dem, None

P. Gastmeier, None

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