Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Paul-Ehrlich-Str. 40, 60596, Frankfurt am Main, Germany.
University Center for Infectious Diseases, University Hospital Frankfurt am Main, Frankfurt am Main, Germany.
BMC Infect Dis. 2017 Mar 13;17(1):206. doi: 10.1186/s12879-017-2286-z.
Routes of transmission of multidrug-resistant gram-negative organisms (MDRGN) are not completely understood. Since sexual transmission of MDRGN might represent a potential mode that has not been noticed so far, this study evaluated transmission of MDRGN in HIV positive men.
Between November 2014 and March 2016, we retrospectively investigated the MDRGN prevalence in rectal swabs of n = 109 males tested positive for HIV (HP). These findings were compared to the MDRGN prevalence in n = 109 rectal swabs in age-matched males tested negative for HIV (HN) within the same period. According to the infection control protocol of University Hospital Frankfurt, Germany (UHF), patients admitted to intensive/intermediate care units have to be screened for MDRGN on day of admittance. Patients without HIV testing or MDRGN screening were excluded.
MDRGN prevalence in rectal swabs was significantly higher (p = 0.002) in male HP (23.9%; 95% confidence interval 16.2-32.9%) than in age-matched male HN (8.3%; 3.8-15.1%). In total, 35 MDRGN species were detected. The most frequent MDRGN species was Escherichia coli with resistance due to ESBL expression and additional resistance to fluoroquinolones with n = 25/35 (71.4%; 53.7-85.4%). Thereof, n = 19/26 (73.1%; 52.2-88.4%) were detected in HP and n = 6/9 (66.7%; 29.9-92.5%) in HN, respectively.
Prevalence of MDRGN is significantly higher in male HIV positive than in male HIV negative individuals. This might indicate sexual transmission of MDRGN within the male HIV positive population. As treatment options in case of MRGN infections are limited, prevention of MDRGN transmission is strongly emphasized.
多重耐药革兰氏阴性菌（MDRGN）的传播途径尚未完全了解。由于性传播可能是迄今为止尚未被注意到的一种潜在方式，因此本研究评估了 HIV 阳性男性中 MDRGN 的传播情况。
2014 年 11 月至 2016 年 3 月，我们回顾性调查了 n=109 例 HIV 阳性（HP）男性直肠拭子中 MDRGN 的流行情况。这些发现与同期年龄匹配的 HIV 阴性（HN）男性 n=109 例直肠拭子中 MDRGN 的流行情况进行了比较。根据德国法兰克福大学医院（UHF）的感染控制方案，入住重症/中级护理病房的患者必须在入院当天接受 MDRGN 筛查。排除未进行 HIV 检测或 MDRGN 筛查的患者。
HP 男性直肠拭子中 MDRGN 的流行率显著高于年龄匹配的 HN 男性（p=0.002），分别为 23.9%（95%置信区间 16.2-32.9%）和 8.3%（3.8-15.1%）。总共检测到 35 种 MDRGN 物种。最常见的 MDRGN 物种是大肠杆菌，由于 ESBL 表达和对氟喹诺酮类药物的额外耐药性，耐药率为 n=25/35（71.4%；53.7-85.4%）。其中，n=19/26（73.1%；52.2-88.4%）在 HP 中检测到，n=6/9（66.7%；29.9-92.5%）在 HN 中检测到。
MDRGN 在 HIV 阳性男性中的流行率明显高于 HIV 阴性男性。这可能表明 MDRGN 在 HIV 阳性男性人群中的性传播。由于 MDRGN 感染的治疗选择有限，因此强烈强调预防 MDRGN 传播。
