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Dynamics of colistin and tobramycin resistance among Enterobacter cloacae during prolonged use of selective decontamination of the digestive tract

Overview of attention for article published in Antimicrobial Resistance & Infection Control, May 2018
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Title
Dynamics of colistin and tobramycin resistance among Enterobacter cloacae during prolonged use of selective decontamination of the digestive tract
Published in
Antimicrobial Resistance & Infection Control, May 2018
DOI 10.1186/s13756-018-0356-7
Pubmed ID
Authors

M. J. D. Dautzenberg, J. R. Bayjanov, M. A. Leverstein-van Hall, A. E. Muller, L. B. S. Gelinck, C. L. Jansen, E. M. S. Leyten, T. Ruys, J. Scharringa, R. E. van der Starre, A. C. Fluit, M. J. M. Bonten

Abstract

A high prevalence of colistin resistance among E. cloacae isolates in two intensive care units (ICU) (of 16 and 6 beds) using selective digestive decontamination (SDD) since 1990 instigated a retrospective and prospective investigation to quantify the role of clonal transmission. SDD is topical application of colistin and tobramycin and systemic use of cefotaxime during the first days of ICU-admission. Multi-resistant E. cloacae (MREb) was defined as ESBL production and/or tobramycin non-susceptibility and/or colistin non-susceptibility. Incidence of acquisition and prevalence of carriage with MREb was determined from microbiological culture results. Colistin-resistant E. cloacae was first detected in November 2009 and carriage was demonstrated in 141 patients until October 2014. Mean incidence of MREb acquisition was 4.61 and 1.86 per 1000 days at risk in ICUs 1 and 2, respectively, and the mean monthly prevalence of MREb in both ICUs was 7.0 and 3.1%, respectively, without a discernible trend in time. Conversion rates from carriage of colistin-susceptible to resistant E. cloacae were 0.20 and 0.13 per 1000 patient days, respectively. Whole genome sequencing of 149 isolates revealed eight clusters, with the number of SNPs of the largest two clusters ranging between 0 and 116 for cluster 1 (n = 49 isolates), and 0 and 27 for cluster 2 (n = 36 isolates), among isolates derived between 2009 and 2014. This study demonstrates a stable low-level endemicity of MREb in two Dutch ICUs with prolonged use of SDD, which was characterized by the persistent presence of two clusters, suggesting incidental clonal transmission.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 25 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 25 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 5 20%
Student > Bachelor 4 16%
Student > Doctoral Student 2 8%
Student > Master 2 8%
Professor 1 4%
Other 2 8%
Unknown 9 36%
Readers by discipline Count As %
Medicine and Dentistry 7 28%
Biochemistry, Genetics and Molecular Biology 3 12%
Agricultural and Biological Sciences 2 8%
Pharmacology, Toxicology and Pharmaceutical Science 1 4%
Computer Science 1 4%
Other 1 4%
Unknown 10 40%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 31 May 2018.
All research outputs
#14,820,112
of 25,711,518 outputs
Outputs from Antimicrobial Resistance & Infection Control
#835
of 1,475 outputs
Outputs of similar age
#172,840
of 344,955 outputs
Outputs of similar age from Antimicrobial Resistance & Infection Control
#21
of 29 outputs
Altmetric has tracked 25,711,518 research outputs across all sources so far. This one is in the 41st percentile – i.e., 41% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,475 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 15.2. This one is in the 41st percentile – i.e., 41% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 344,955 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 48th percentile – i.e., 48% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 29 others from the same source and published within six weeks on either side of this one. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.