The enemy in our gut? Infections due to extended-spectrum beta-lactamase producing Enterobacterales (ESBL-E) in hospital patients: a cohort study comparing 2971 ESBL-E-carriers and 2971 non-carriers.

IF 3.9 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2026-09-14 DOI:10.1007/s15010-026-02966-w

Milad Fahimi, Selin Saydan, Frank Schwab, Friederike Maechler, Axel Kola, Christine Geffers, Petra Gastmeier, Rasmus Leistner, Luisa A Denkel

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引用次数: 0

Abstract

Purpose: To quantify the risk of healthcare-associated infections (HAI) with extended spectrum beta-lactamase-producing Enterobacterales (ESBL-E) and other pathogens in carriers and non-carriers, and to identify risk factors for HAI.

Methods: In 2014 and 2015, a cohort study was conducted including all eligible ESBL‑E-colonized hospital patients and a randomly 1:1 selected sample of non‑colonized controls. Incidence densities per 1,000 patient‑days were calculated, and Fine-Gray sub-distribution hazard models were applied.

Results: In total, 2,971 ESBL-E carriers and 2,971 non-carriers were included. Among carriers, incidence densities were 3.29 (95% CI 2.76-3.93) per 1,000 patient days for HAI with ESBL-E, and 4.41 (95% CI 3.78-5.14) for HAI with other pathogens. In contrast, ESBL-E HAI among non-carriers was rare with an incidence density of 0.05 (95% CI 0.01-0.21) per 1,000 patient days. ESBL-E colonization was identified as most important risk factor specific for ESBL-E HAI followed by peptic ulcer, congestive heart failure and age.

Conclusion: Incidence of HAI with ESBL-E was high among ESBL-E carriers, but HAI with other pathogens remained more common. ESBL‑E colonization was the dominant determinant of ESBL‑E HAI, with cases occurring almost exclusively in carriers. In conclusion, a known ESBL-E colonization status is an important predictor, but should not be the only factor to rationalize an empirical strategy targeting ESBL-E without considering additional factors.

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我们肚子里的敌人？医院患者因产广谱β -内酰胺酶肠杆菌（ESBL-E）感染：一项比较2971名ESBL-E携带者和2971名非携带者的队列研究

目的：量化携带者和非携带者中与扩展谱β -内酰胺酶产生肠杆菌（ESBL-E）和其他病原体有关的医疗保健相关感染（HAI）的风险，并确定HAI的危险因素。方法：在2014年和2015年进行了一项队列研究，包括所有符合条件的ESBL - e定植的医院患者和随机1:1选择的非定植的对照样本。计算每1000患者日的发病率密度，并应用Fine-Gray亚分布风险模型。结果：共纳入ESBL-E携带者2971例，非携带者2971例。在携带者中，esble型HAI的发病率密度为每1000患者日3.29例（95% CI 2.76-3.93），其他病原体HAI的发病率密度为4.41例（95% CI 3.78-5.14）。相比之下，非携带者的ESBL-E HAI发生率为0.05 (95% CI 0.01-0.21) / 1000患者日。ESBL-E定植被确定为ESBL-E HAI最重要的危险因素，其次是消化性溃疡、充血性心力衰竭和年龄。结论：ESBL-E感染的HAI在ESBL-E携带者中发病率较高，但合并其他病原体的HAI更为常见。ESBL - E定植是ESBL - E HAI的主要决定因素，病例几乎只发生在携带者中。总之，已知的ESBL-E定殖状态是一个重要的预测因素，但不应是在不考虑其他因素的情况下合理化针对ESBL-E的经验策略的唯一因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.