ArticleBMC infectious diseases2018
Drug-resistant Enterobacteriaceae colonization is associated with healthcare utilization and antimicrobial use among inpatients in Pune, India.
Article in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 16 citations in OpenAlex.
- Carbapenemase-producing carbapenem-resistant Enterobacterales in surgical intensive care unit patients in a tertiary hospital in India.Nature communications · 2026Article
- Risk factors and outcome for bloodstream infections due to fluconazole-resistant Candida parapsilosis: a 22-year single-center retrospective study.Antimicrobial resistance and infection control · 2025Article
- An observational study on carbapenem-resistant Enterobacterales (CRE) colonisation and subsequent risk of infection in an adult intensive care unit (ICU) at a tertiary care hospital in India.Infection prevention in practice · 2023Article
- High-level Colonization With Antibiotic-Resistant Enterobacterales Among Individuals in a Semi-Urban Setting in South India: An Antibiotic Resistance in Communities and Hospitals (ARCH) Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Risk factors for antibiotic-resistant bacteria colonisation in children with chronic complex conditions.Scientific reports · 2022Article
- Analysis of antibiotic treatment of children in a Shanghai tertiary hospital based on point prevalence surveys.BMC infectious diseases · 2020Article
- Carbapenem-Resistant Enterobacteriaceae Posing a Dilemma in Effective Healthcare Delivery.Antibiotics (Basel, Switzerland) · 2019Article
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Authors and funding
19 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundHealthcare exposure may increase drug-resistant Enterobacteriaceae colonization risk. Nascent antimicrobial stewardship efforts in low- and middle-income countries require setting-specific data. We aimed to evaluate risk factors for inpatient drug resistant Enterobacteriaceae colonization in a resource-limited setting in India.
methodsPatients age ≥ 6 months admitted with ≥24 h of fever to a tertiary hospital in Pune, India were enrolled in a prospective cohort. Perirectal swabs, collected on admission and hospitalization day 3 or 4, were cultured in vancomycin- and ceftriaxone-impregnated media to assess for ceftriaxone-resistant Enterobacteriaceae (CTRE) and carbapenem-resistant Enterobacteriaceae (CPRE). Multivariable analyses assessed risk factors for drug-resistant Enterobacteriaceae colonization among participants without admission colonization.
resultsAdmission perirectal swabs were collected on 897 participants; 87 (10%) had CTRE and 14 (1.6%) had CPRE colonization. Admission CTRE colonization was associated with recent healthcare contact (p < 0.01). Follow-up samples were collected from 620 participants, 67 (11%) had CTRE and 21 (3.4%) had CPRE colonization. Among 561 participants without enrollment CTRE colonization, 49 (9%) participants were colonized with CTRE at follow-up. Detection of CTRE colonization among participants not colonized with CTRE at admission was independently associated with empiric third generation cephalosporin treatment (adjusted odds ratio [OR] 2.9, 95% CI 1.5-5.8). Follow-up transition to CPRE colonization detection was associated with ICU admission (OR 3.0, 95% CI 1.0-8.5).
conclusionsPatients who receive empiric third generation cephalosporins and are admitted to the ICU rapidly develop detectable CTRE and CPRE colonization. Improved antimicrobial stewardship and infection control measures are urgently needed upon hospital admission.
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