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Increase of patients co-colonised or co-infected with methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium or extended-spectrum β-lactamase-producing Enterobacteriaceae

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Abstract

Purpose

To determine the incidence of patients co-colonised or co-infected with methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium or extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in four German tertiary care hospitals.

Methods

This study was conducted at four tertiary care hospitals (all with >1,000 beds) in different geographic regions in Germany (Berlin in the east, Luebeck in the north, Freiburg in the southwest and Nuernberg in the southeast). Routine surveillance data on MRSA, vancomycin-resistant enterococci (VRE) and ESBL-producing bacteria were analysed from 2007 to 2009. Co-colonisation or co-infection was defined as a patient having positive cultures for at least two of the following resistant pathogens: MRSA, VRE faecium or different species of ESBL-producing Enterobacteriaceae within one calendar year.

Results

A total of 896,822 patients were analysed, of which 10,066 patients harboured MRSA, VRE faecium and/or ESBL-producing Enterobacteriaceae, and 542 patients co-harboured at least two of those resistant pathogens. In 2009, 7.6% of the MRSA patients, 13.7% of the VRE faecium patients and even 16.1% of the ESBL-producing Enterobacteriaceae patients were co-colonised or co-infected. The incidence of patients with co-infection or co-colonisation increased steadily from 5 (2007) to 7 per 10,000 patients (2009).

Conclusions

Patients harbouring ESBL-producing Enterobacteriaceae or VRE faecium had a higher risk of being co-colonised or co-infected compared to what was to be extrapolated from their overall incidence. This might be linked to their gastrointestinal reservoir and impracticality to decolonise the gut of resistant VRE and ESBL-producing Enterobacteriaceae.

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Acknowledgements

We thank Ryan Plocher for his help in preparing the manuscript.

Conflict of interest

All authors: none to declare.

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Author notes

  1. F. Mattner

    Present address: Department of Hygiene, Witten-Herdecke University, Campus Koeln-Merheim, Witten, Germany

  2. M. Martin

    Present address: Institute of Environmental Health Sciences, University Medical Center Freiburg, Freiburg, Germany

Authors and Affiliations

  1. Institute of Hygiene and Environmental Medicine, Charité University Medicine, Hindenburgdamm 27, 12203, Berlin, Germany

    E. Meyer, F. Schwab & P. Gastmeier

  2. National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany

    E. Meyer, F. Schwab & P. Gastmeier

  3. Institute of Hospital Hygiene, Medical Microbiology and Clinical Infectiology, Klinikum Nuernberg, Nuernberg, Germany

    R. Ziegler

  4. Institute for Medical Microbiology and Hospital Epidemiology, Luebeck University, Luebeck, Germany

    F. Mattner & M. Martin

Authors
  1. E. Meyer
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  2. R. Ziegler
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  3. F. Mattner
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  4. F. Schwab
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  5. P. Gastmeier
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Corresponding author

Correspondence to E. Meyer.

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Meyer, E., Ziegler, R., Mattner, F. et al. Increase of patients co-colonised or co-infected with methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium or extended-spectrum β-lactamase-producing Enterobacteriaceae . Infection 39, 501–506 (2011). https://doi.org/10.1007/s15010-011-0154-0

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  • DOI: https://doi.org/10.1007/s15010-011-0154-0

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