TY - JOUR
T1 - Prevalence and predictors of MRSA, ESBL, and VRE colonization in the ambulatory IBD population
AU - Leung, Wesley
AU - Malhi, Gurtej
AU - Willey, Barbara M.
AU - McGeer, Allison J.
AU - Borgundvaag, Bjug
AU - Thanabalan, Reka
AU - Gnanasuntharam, Piraveina
AU - Le, Brian
AU - Weizman, Adam V.
AU - Croitoru, Kenneth
AU - Silverberg, Mark S.
AU - Steinhart, A. Hillary
AU - Nguyen, Geoffrey C.
PY - 2012/8
Y1 - 2012/8
N2 - Background and aims: Inflammatory bowel disease (IBD) patients may be at increased risk of acquiring antibiotic-resistant organisms (ARO). We sought to determine the prevalence of colonization of methicillin-resistant Staphylococcus aureus (MRSA), Enterobacteriaceae containing extended spectrum beta-lactamases (ESBL), and vancomycin-resistant enterococi (VRE) among ambulatory IBD patients. Methods: We recruited consecutive IBD patients from clinics (n = 306) and 3 groups of non-IBD controls from our colon cancer screening program (n = 67), the family medicine clinic (n = 190); and the emergency department (n = 428) from the same medical center in Toronto. We obtained nasal and rectal swabs for MRSA, ESBL, and VRE and ascertained risk factors for colonization. Results: Compared to non-IBD controls, IBD patients had similar prevalence of colonization with MRSA (1.5% vs. 1.6%), VRE (0% vs. 0%), and ESBL (9.0 vs. 11.1%). Antibiotic use in the prior 3. months was a risk factor for MRSA (OR, 3.07; 95% CI: 1.10-8.54), particularly metronidazole. Moreover, gastric acid suppression was associated with increased risk of MRSA colonization (adjusted OR, 7.12; 95% CI: 1.07-47.4). Predictive risk factors for ESBL included hospitalization in the past 12. months (OR, 2.04, 95% CI: 1.05-3.95); treatment with antibiotics it the past 3. months (OR, 2.66; 95% CI: 1.37-5.18), particularly prior treatment with vancomycin or cephalosporins. Conclusions: Ambulatory IBD patients have similar prevalence of MRSA, ESBL and VRE compared to non-IBD controls. This finding suggests that the increased MRSA and VRE prevalence observed in hospitalized IBD patients is acquired in-hospital rather than in the outpatient setting.
AB - Background and aims: Inflammatory bowel disease (IBD) patients may be at increased risk of acquiring antibiotic-resistant organisms (ARO). We sought to determine the prevalence of colonization of methicillin-resistant Staphylococcus aureus (MRSA), Enterobacteriaceae containing extended spectrum beta-lactamases (ESBL), and vancomycin-resistant enterococi (VRE) among ambulatory IBD patients. Methods: We recruited consecutive IBD patients from clinics (n = 306) and 3 groups of non-IBD controls from our colon cancer screening program (n = 67), the family medicine clinic (n = 190); and the emergency department (n = 428) from the same medical center in Toronto. We obtained nasal and rectal swabs for MRSA, ESBL, and VRE and ascertained risk factors for colonization. Results: Compared to non-IBD controls, IBD patients had similar prevalence of colonization with MRSA (1.5% vs. 1.6%), VRE (0% vs. 0%), and ESBL (9.0 vs. 11.1%). Antibiotic use in the prior 3. months was a risk factor for MRSA (OR, 3.07; 95% CI: 1.10-8.54), particularly metronidazole. Moreover, gastric acid suppression was associated with increased risk of MRSA colonization (adjusted OR, 7.12; 95% CI: 1.07-47.4). Predictive risk factors for ESBL included hospitalization in the past 12. months (OR, 2.04, 95% CI: 1.05-3.95); treatment with antibiotics it the past 3. months (OR, 2.66; 95% CI: 1.37-5.18), particularly prior treatment with vancomycin or cephalosporins. Conclusions: Ambulatory IBD patients have similar prevalence of MRSA, ESBL and VRE compared to non-IBD controls. This finding suggests that the increased MRSA and VRE prevalence observed in hospitalized IBD patients is acquired in-hospital rather than in the outpatient setting.
KW - Crohn's disease
KW - Extended spectrum beta-lactamase
KW - Inflammatory bowel disease
KW - Methicillin-resistant Staphylococcus aureus
KW - Ulcerative colitis
KW - Vancomycin-resistant enterococci
UR - http://www.scopus.com/inward/record.url?scp=84863434858&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863434858&partnerID=8YFLogxK
U2 - 10.1016/j.crohns.2011.12.005
DO - 10.1016/j.crohns.2011.12.005
M3 - Article
C2 - 22398097
AN - SCOPUS:84863434858
SN - 1873-9946
VL - 6
SP - 743
EP - 749
JO - Journal of Crohn's and Colitis
JF - Journal of Crohn's and Colitis
IS - 7
ER -