1569. Risk factors of Nosocomial CTX-M Positive Escherichia coli Infections and Types of CTX-M Beta Lactamases in Turkey
Session: Poster Abstract Session: Microbial and Host Genetic Factors in Disease
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • CTX-M poster.pdf (152.4 kB)
  • Background: Most of beta-lactamases among nosocomial E. coli isolates are ESBLs (Extended spectrum beta-lactamases). Aim of this study was to determine the CTX-M frequency aamong multidrug-resistant E.coli via molecular methods and determine the risk factors associated with the development of infection with those microorganisms.

    Methods: This study included isolated E. coli strains at central laboratory from adult patients defined as hospital-acquired infection on the basis of Centers for Disease Control and Prevention (CDC) criteria between 1 March 2011 - March 1, 2012 in Adana, Turkey. The prevalence of CTX-M-type beta-lactamase producers was identified with the molecular and epidemiological methods on these isolates. Then CTX-M subgroup rates were determined with groups specific PCR. PFGE (pulse field gel electrophoresis) was use to determine a probable clonal relation between these strains and their risk factors.

    Results: Risk factors were evaluated by multivariate analyzes. Urinary tract abnormalities, 3rd generation cephalosporin use in the last 3 months, urinary catheterization, Pitt bacteremia score found to be significant risk factors in the multivariate analysis. [Respectively; OR(95% CI) = 3(1.6-5.5),  OR=(95% CI)=8(2-38), OR=(95% CI)=2(1.2-4), OR= (95% CI)= 0.1( 0.03-0,36)].

    Mortality was not significantly different between ESBL-positive and ESBL-negative groups.

    CTX-M type enzymes were positive 54.5% as a result of molecular analysis. The most frequently detected CTX-M group were CTX-M-1 with rate of 85.7%. Between CTX-M positive and CTX-M negative patient groups, no statistically significant difference was found in multivariate analysis in he means of risk factors.

    Conclusion: ESBL in the community with the species distribution, transmission routes, and possible identification of risk factors is important in the prevention of infections occur in this kind of multi-drug-resistant microorganisms. As the use of invasive devices and antibiotic use had been found as risk factors in the acquisition of ESBL positive E.coli, rational use of antibiotics and infection control measures could help in the restriction and spread of these microorganisms.

    Yesim Kurekci1, Aslihan Candevir Ulu1, Suna Kizilyildirim1, Behice Kurtaran1, Mümtaz Güran1, Akgun Yaman, Prof (MD)2, Fatih Koksal1 and Yesim Tasova1, (1)Cukurova University, Adana, Turkey, (2)Microbiology, Cukurova University, Adana, Turkey

    Disclosures:

    Y. Kurekci, None

    A. Candevir Ulu, None

    S. Kizilyildirim, None

    B. Kurtaran, None

    M. Güran, None

    A. Yaman, None

    F. Koksal, None

    Y. Tasova, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.