Clinical Features of Extended-Spectrum Beta-Lactamase-Producing Organisms Colonized in Patients Prior to Admission to a Respiratory Intensive Care Unit

Background: The prevalence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coil and Klebsiella pneumoniae has increased markedly in recent years. The aim of this study was to determine the risk factors of colonization by ESBL-producing E. coli or K. pneumoniae and their association with the patient's location prior to admission. Methods: The study was conducted over a 5-month period in a respiratory intensive care unit. All patients were enrolled with their consent. A rectal swab was done within 48 hours of admission, and a double-disc diffusion test was used to detect the ESBL-producing organisms. The medical records of those patients were reviewed retrospectively. Results: In all, 260 cases were enrolled. Twenty-eight of the patients revealed ESBL-producing E. coil or K. pneumoniae colonization in the feces. According to their location for 48 hours before admission, we divided the patients into 3 groups: community (n=93), local hospital (n=92), and medical center (n=75). The incidence of fecal colonization of ESBL-producing organisms was 6%, 14%, 8% in each group. However, the clinical features between the ESBL and non-ESBL patients were similar in our series. Conclusions: Fecal colonization of ESBL-producing organisms was common in patients on admission to the respiratory intensive care unit, especially those from the local hospital. There were no clinical characteristics to predict colonization on admission, so a cohort barrier observation should be considered in the RICU to prevent the nosocomial spread of ESBL-producing E. coil or K. pneumoniae infections.