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.
Reinheimer C, Kempf VA, Göttig S, Hogardt M, Wichelhaus TA, O’Rourke F, Brandt C. Multidrug-resistant organisms detected in refugee patients admitted to a University Hospital, Germany June–December 2015. Euro Surveill. 2016;21(2). doi: 10.2807/1560-7917.ES.2016.21.2.30110.
Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18:268–81. doi: 10.1111/j.1469-0691.2011.03570. CrossRefPubMed
Izdebski R, Bojarska K, Baraniak A, Literacka E, Herda M, Żabicka D, et al. NDM-1- or OXA-48-producing Enterobacteriaceae colonizing Polish tourists following a terrorist attack in Tunis, March 2015. Euro Surveill. 2015; 20. DOI: 10.2807/1560-7917.ES2015.20.23.21150.
Mathers AJ, Hazen KC, Carroll J, Yeh AJ, Cox HL, Bonomo RA, et al. First clinical cases of OXA-48-producing carbapenem-resistant Klebsiella pneumoniae in the United States: the “menace” arrives in the new world. J Clin Microbiol. 2013;51:680–3. doi: 10.1128/JCM.02580-12. Erratum in: J Clin Microbiol. 2013;51(4):1352. CrossRefPubMedPubMedCentral
Simms I, Gilbart VL, Byrne L, Jenkins C, Adak GK, Hughes G et al. Identification of verocytotoxin-producing Escherichia coli O117:H7 in men who have sex with men, England, November 2013 to August 2014. Euro Surveill. 2014;19(43).
Simms I, Field N, Jenkins C, Childs T, Gilbart VL, Dallman TJ et al. Intensified shigellosis epidemic associated with sexual transmission in men who have sex with men- Shigella flexneri and S. sonnei in England, 2004 to end of February 2015. Euro Surveill. 2015;20(15).
Erens B, Phelps A, Clifton S, Mercer CH, Tanton C, et al. Methodology of the third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3) Sexually transmitted infections. 2014;90(2):84–9. doi: 10.1136/sextrans-2013-051359.
Epidemiologisches Bulletin 50/2014, Robert Koch-Institut, Berlin, Germany, https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2014/Ausgaben/50_14.pdf?__blob=publicationFile. Accessed 5 Mar 2017.
Epidemiologisches Bulletin 26/2014, Robert Koch-Institut, Berlin, Germany, https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2014/Ausgaben/26_14.pdf?__blob=publicationFile. Accessed 5 Mar 2017.
http://www.cdc.gov/mmwr/preview/mmwrhtml/00018871.htm. Accessed 5 Mar 2017.
Koch J, Hellenbrand W, Schink S, Wichmann O, Carganico A, Drewes J et al. Evaluation of a temporary vaccination recommendation in response to an outbreak of invasive meningococcal serogroup C disease in men who have sex with men in Berlin, 2013-2014. Euro Surveill. 2016;21(5). doi: 10.2807/1560-7917.ES.2016.21.5.30122.
Hellenbrand W, Claus H, Schink S, Marcus U, Wichmann O, Vogel U. Risk of invasive meningococcal disease in men who have sex with men: lessons learned from an outbreak in Germany, 2012-2013. PLoS One. 2016;11(8):e0160126. doi: 10.1371/journal.pone.0160126. PMID: 27486669. CrossRefPubMedPubMedCentral
Stephan C, Just-Nübling G, Franck S, Bickel M, Shah PM, Babacan E, et al. No obvious difference in Streptococcus pneumoniae antibiotic resistance profiles--isolates from HIV-positive and HIV-negative patients. Med Klin. 2008;103:69–74. CrossRef
- Elevated prevalence of multidrug-resistant gram-negative organisms in HIV positive men
Oliver T. Keppler
Thomas A. Wichelhaus
Volkhard A. J. Kempf
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II