Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Am J Infect Control. 2011 Aug;39(6):506-10. doi: 10.1016/j.ajic.2010.09.012. Epub 2011 Apr 13.
The characteristics of co-colonization with multiple different species of multidrug-resistant gram-negative bacteria (MDRGN) have not been fully elucidated. Quantifying the prevalence of co-colonization and those patients at higher risk of co-colonization may have important implications for strategies aimed at limiting the spread of MDRGN.
To determine the prevalence of MDRGN colonization, rectal swabs were obtained from 212 residents residing in a 600-bed long-term care facility. Co-colonization was defined as colonization with ≥2 different MDRGN species. Co-colonized residents were compared with residents colonized with a single MDRGN species to identify factors associated with an increased risk for co-colonization. Molecular typing was performed to determine the contribution of cross transmission to the co-colonized state.
A total of 53 (25%) residents was colonized with ≥1 MDRGN. Among these, 11 (21%) were colonized with ≥2 different species of MDRGN. A global deterioration score of ≥5 representing advanced dementia and an increased requirement for assistance from health care workers was significantly associated with co-colonization (P = .05). Clonally related MDRGN strains were identified among 7 (64%) co-colonized residents.
The prevalence of co-colonization with ≥2 different MDRGN is substantial. Cross transmission of MDRGN is a major contributor to the co-colonized state.
多重耐药革兰氏阴性菌（MDRGN）的多种不同物种共同定植的特征尚未完全阐明。量化共同定植的流行率以及那些更有可能共同定植的患者，可能对旨在限制 MDRGN 传播的策略具有重要意义。
为了确定 MDRGN 定植的流行率，从居住在 600 张床位的长期护理机构的 212 名居民中获得直肠拭子。共同定植定义为定植≥2 种不同的 MDRGN 物种。将共同定植的居民与单一 MDRGN 物种定植的居民进行比较，以确定与共同定植风险增加相关的因素。进行分子分型以确定交叉传播对共同定植状态的贡献。
共有 53 名（25%）居民定植≥1 种 MDRGN。其中，11 名（21%）定植≥2 种不同的 MDRGN 物种。全球恶化评分≥5 代表严重痴呆和对医护人员的帮助需求增加与共同定植显著相关（P=0.05）。在 7 名（64%）共同定植的居民中鉴定出克隆相关的 MDRGN 菌株。
定植≥2 种不同 MDRGN 的共同定植率相当高。MDRGN 的交叉传播是共同定植状态的主要原因。
