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dc.contributor.authorJørgensen, Silje
dc.contributor.authorSøraas, Arne Vasli
dc.contributor.authorSundsfjord, Arnfinn
dc.contributor.authorLiestøl, Knut
dc.contributor.authorLeegaard, Truls Michael
dc.contributor.authorJenum, Pål
dc.date.accessioned2018-02-14T09:04:20Z
dc.date.available2018-02-14T09:04:20Z
dc.date.issued2017-03-07
dc.description.abstractWe have performed a prospective cohort study to investigate the duration of and risk factors for prolonged fecal carriage of ESBL-producing Escherichia coli or Klebsiella pneumoniae in patients with community acquired urinary tract infection caused by these bacteria. From 2009 to 2011, 101 Norwegian patients were recruited. Stool swabs and questionnaires were collected every three months for one year and at the end of the study in 2012. Information on antibiotic prescriptions was collected from the Norwegian Prescription Database. Stool samples were cultured directly on ChromID ESBL agar as well as in an enrichment broth, and culture positive isolates were examined by blaCTX-M multiplex PCR. Isolates without blaCTX-M were investigated for alternative ESBL-determinants with a commercial microarray system. Time to fecal clearance of ESBL producing Enterobacteriaceae was also analysed using Kaplan-Meier estimates. Uni- and multivariate logistic regression was used to compare groups according to previously described risk factors. The ESBL point prevalence of fecal carriage were 61% at 4 months, 56% at 7 months, 48% at 10 months, 39% at 13 months, 19% after two years, and 15% after three years or more. We found no correlation between duration of carriage, comorbidity, antibiotic use or travel to ESBL high-prevalence countries. Prolonged carriage was associated with E. coli isolates of phylogroup B2 or D. Importantly, comparative MLST and MLVA analyses of individual paired urine and fecal E. coli isolates revealed that ESBL production commonly occurred in diverse strains within the same host. When investigating cross-transmission of ESBL producing bacteria in health care institutions, this notion should be taken into account.en_US
dc.descriptionSource at <a href=http://doi.org/10.1371/journal.pone.0173510>http://doi.org/10.1371/journal.pone.0173510</a>en_US
dc.identifier.citationJørgensen, S.B., Søraas, A., Sundsfjord, A., Liestøl, K., Leegaard, T.M., Jenum, P.A. Fecal carriage of extended spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae after urinary tract infection - A three year prospective cohort study. PLoS ONE. 2017;12:e017w|(16):13510-1en_US
dc.identifier.cristinIDFRIDAID 1472811
dc.identifier.doi10.1371/journal.pone.0173510
dc.identifier.issn1932-6203
dc.identifier.urihttps://hdl.handle.net/10037/12159
dc.language.isoengen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.journalPLoS ONE
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710::Medisinsk mikrobiologi: 715en_US
dc.subjectVDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710::Medical microbiology: 715en_US
dc.titleFecal carriage of extended spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae after urinary tract infection - A three year prospective cohort studyen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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