ArticlePloS one2013
High proportion of intestinal colonization with successful epidemic clones of ESBL-producing Enterobacteriaceae in a neonatal intensive care unit in Ecuador.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Neonatal Colonization With Antibiotic-Resistant Pathogens in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.JAMA network open · 2024Pooled it
- Transmission routes of antibiotic resistant bacteria: a systematic review.BMC infectious diseases · 2022Pooled it
- Epidemic potential of Escherichia coli ST131 and Klebsiella pneumoniae ST258: a systematic review and meta-analysis.BMJ open · 2016Pooled it
- Bacterial pathogens and antimicrobial resistance patterns in infections associated with stillbirths and under-five deaths in Ethiopia: a post-mortem surveillance study.BMC infectious diseases · 2026Article
- Use of Newer and Repurposed Antibiotics against Gram-Negative Bacteria in Neonates.Antibiotics (Basel, Switzerland) · 2023Review
- Pandemic one health clones ofFrontiers in cellular and infection microbiology · 2023Article
- Article
- Neonatal multidrug-resistant gram-negative infection: epidemiology, mechanisms of resistance, and management.Pediatric research · 2022Review
- Extended-Spectrum Beta-Lactamases ProducingInfection and drug resistance · 2022Review
- Colonization with Multidrug-Resistant Bacteria in the First Week of Life among Hospitalized Preterm Neonates in Serbia: Risk Factors and Outcomes.Microorganisms · 2021Article
- Efficacy of a coordinated strategy for containment of multidrug-resistant Gram-negative bacteria carriage in a Neonatal Intensive Care Unit in the context of an active surveillance program.Antimicrobial resistance and infection control · 2021Article
- Investigation of Extended-Spectrum β-Lactamase and Carbapenemase Producing Gram-Negative Bacilli in Rectal Swabs Collected from Neonates and Their Associated Factors in Neonatal Intensive Care Units of Southern Ethiopia.Infection and drug resistance · 2021Article
- Article
- Gastrointestinal Tract Colonization Rate of Extended-Spectrum Beta-Lactamase- and Carbapenemase-Producing Enterobacteriaceae and Associated Factors Among Hospitalized Patients in Arba Minch General Hospital, Arba Minch, Ethiopia.Infection and drug resistance · 2020Article
- Article
- Carriage and Acquisition of Extended-spectrum β-Lactamase-producing Enterobacterales Among Neonates Admitted to Hospital in Kilifi, Kenya.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Characterization of an Outbreak of Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae in a Neonatal Intensive Care Unit in Italy.Microbial drug resistance (Larchmont, N.Y.) · 2018Article
- Acquisition of extended spectrum beta-lactamase-producing enterobacteriaceae in neonates: A community based cohort in Madagascar.PloS one · 2018Article
- ESBL-producingFood safety (Tokyo, Japan) · 2017Review
- The potential role of microbiota for controlling the spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) in neonatal population.F1000Research · 2017Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsNeonatal infections caused by Extended-spectrum beta-lactamase (ESBL)-producing bacteria are associated with increased morbidity and mortality. No data are available on neonatal colonization with ESBL-producing bacteria in Ecuador. The aim of this study was to determine the proportion of intestinal colonization with ESBL-producing Enterobacteriaceae, their resistance pattern and risk factors of colonization in a neonatal intensive care unit in Ecuador.
methodsDuring a three month period, stool specimens were collected every two weeks from hospitalized neonates. Species identification and susceptibility testing were performed with Vitek2, epidemiologic typing with automated repetitive PCR. Associations between groups were analyzed using the Pearson X (2) test and Fisher exact test. A forward step logistic regression model identified significant predictors for colonization.
resultsFifty-six percent of the neonates were colonized with ESBL-producing Enterobacteriaceae. Length of stay longer than 20 days and enteral feeding with a combination of breastfeeding and formula feeding were significantly associated with ESBL-colonization. The strains found were E. coli (EC, 89%) and K. pneumoniae (KP, 11%) and epidemiological typing divided these isolates in two major clusters. All EC and KP had bla CTX-M group 1 except for a unique EC isolate that had bla CTX-M group 9. Multi-locus sequence typing performed on the K. pneumoniae strains showed that the strains belonged to ST855 and ST897. The two detected STs belong to two different epidemic clonal complexes (CC), CC11 and CC14, which previously have been associated with dissemination of carbapenemases. None of the E. coli strains belonged to the epidemic ST 131 clone.
conclusionsMore than half of the neonates were colonized with ESBL-producing Enterobacteriaceae where the main risk factor for colonization was length of hospital stay. Two of the isolated clones were epidemic and known to disseminate carbapenemases. The results underline the necessity for improved surveillance and infection control in this context.
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