caa a22 4500 606156704 CHVBK 20210128100610.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s10096-015-2436-4 doi (NATIONALLICENCE)springer-10.1007/s10096-015-2436-4 Co-colonization by multidrug-resistant bacteria in two Greek intensive care units [Elektronische Daten] [M. Papadimitriou-Olivgeris, I. Spiliopoulou, M. Christofidou, D. Logothetis, P. Manolopoulou, V. Dodou, F. Fligou, M. Marangos, E. Anastassiou] Our goal was to identify the risk factors for co-colonization by KPC-producing Klebsiella pneumoniae (KPC-Kp), vancomycin-resistant enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA) upon intensive care unit (ICU) admission and during stay. Rectal and nasal samples were taken from each patient upon admission at two Greek ICUs and each week afterwards, and were inoculated onto chromogenic agar. Representative colonies were characterized with standard methods and Vitek-2 technology. The presence of the bla KPC gene (K. pneumoniae isolates), vanA and vanB (Enterococcus faecium and E. faecalis isolates), and mecA (S. aureus isolates) was confirmed by polymerase chain reaction (PCR). Upon ICU admission, among 481 patients, 59 (12%), 63 (13%), and 20 (4%) were colonized by KPC-Kp, VRE, or MRSA, respectively. Simultaneous colonization by KPC-Kp and VRE upon admission (34 patients) was associated with the number of co-morbidities [adjusted odds ratio (aOR): 1.5; confidence interval (CI) 1.0-2.5], administered antibiotics (aOR: 1.7; CI 1.3-2.3), and prior KPC-Kp infection (aOR: 24.4; CI 1.5-396.0). Among patients with an ICU stay of more than 6 days, 181 (73%), 31 (13%), and 9 (4%) became KPC-Kp, VRE, or MRSA colonized during ICU stay, respectively. KPC-Kp colonization was an independent risk factor for VRE colonization upon admission (aOR: 2.7; CI 1.0-7.2) and during stay (aOR: 7.4; CI 2.0-27.4), whereas VRE colonization was a risk factor for KPC-Kp upon admission (aOR: 5.1; CI 1.9-13.9) and MRSA colonization upon admission (aOR: 3.5; CI 1.2-10.1) and during ICU stay (aOR: 14.5; CI 2.1-100.1). Colonization by a multidrug pathogen could promote colonization by another. Springer-Verlag Berlin Heidelberg, 2015 Papadimitriou-Olivgeris M. Division of Infectious Diseases, School of Medicine, University of Patras, 26504, Rion, Patras, Greece aut Spiliopoulou I. Department of Microbiology, School of Medicine, University of Patras, 26504, Rion, Patras, Greece aut Christofidou M. Department of Microbiology, School of Medicine, University of Patras, 26504, Rion, Patras, Greece aut Logothetis D. Department of Anaesthesiology and Critical Care Medicine, University of Patras, 26504, Rion, Patras, Greece aut Manolopoulou P. Intensive Care Unit, Saint Andrew's General Hospital, 26335, Patras, Greece aut Dodou V. Intensive Care Unit, Saint Andrew's General Hospital, 26335, Patras, Greece aut Fligou F. Department of Anaesthesiology and Critical Care Medicine, University of Patras, 26504, Rion, Patras, Greece aut Marangos M. Division of Infectious Diseases, School of Medicine, University of Patras, 26504, Rion, Patras, Greece aut Anastassiou E. Department of Microbiology, School of Medicine, University of Patras, 26504, Rion, Patras, Greece aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/10(2015-10-01), 1947-1955 0934-9723 34:10<1947 2015 34 10096 https://doi.org/10.1007/s10096-015-2436-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2436-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Papadimitriou-Olivgeris M. Division of Infectious Diseases, School of Medicine, University of Patras, 26504, Rion, Patras, Greece aut NATIONALLICENCE 700 1- Spiliopoulou I. Department of Microbiology, School of Medicine, University of Patras, 26504, Rion, Patras, Greece aut NATIONALLICENCE 700 1- Christofidou M. Department of Microbiology, School of Medicine, University of Patras, 26504, Rion, Patras, Greece aut NATIONALLICENCE 700 1- Logothetis D. Department of Anaesthesiology and Critical Care Medicine, University of Patras, 26504, Rion, Patras, Greece aut NATIONALLICENCE 700 1- Manolopoulou P. Intensive Care Unit, Saint Andrew's General Hospital, 26335, Patras, Greece aut NATIONALLICENCE 700 1- Dodou V. Intensive Care Unit, Saint Andrew's General Hospital, 26335, Patras, Greece aut NATIONALLICENCE 700 1- Fligou F. Department of Anaesthesiology and Critical Care Medicine, University of Patras, 26504, Rion, Patras, Greece aut NATIONALLICENCE 700 1- Marangos M. Division of Infectious Diseases, School of Medicine, University of Patras, 26504, Rion, Patras, Greece aut NATIONALLICENCE 700 1- Anastassiou E. Department of Microbiology, School of Medicine, University of Patras, 26504, Rion, Patras, Greece aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/10(2015-10-01), 1947-1955 0934-9723 34:10<1947 2015 34 10096