High prevalence of intestinal colonization by beta-lactam resistant Enterobacterales in patients admitted to an emergency department in Lima, Peru

Objectives To determine the prevalence of intestinal colonization by extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) and carbapenem-resistant Enterobacterales (CRE) among patients admitted to the emergency department of a tertiary care hospital in Lima, Peru. Factors associated with colonization were also evaluated. Methods A cross-sectional study was conducted from December 2019 to March 2020. Patients were enrolled on one to two randomly selected days per week. A rectal or fecal swab was collected, and a standardized questionnaire was administered. Samples were cultured on chromogenic media (ChromAgar ESBL and ChromAgar mSuperCarba) and disc diffusion methods were used for confirmation of ESBL production and carbapenem resistance. The association of epidemiological and clinical factors with ESBL-E and CRE colonization was analyzed using bivariate generalized linear models with a Poisson distribution and robust variance. Results A total of 148 patients were sampled. The prevalence of ESBL-E and CRE colonization was 73.6% (109/148) and 8.1% (12/148), respectively. Hospitalization during the previous year (PR = 1.23, 95% CI: 1.02-1.49) was associated with ESBL-E colonization. Conclusions A high prevalence of ESBL-E intestinal colonization was found among patients with and without prior healthcare exposure admitted to the emergency department of a tertiary care hospital in Lima.