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Published in: European Journal of Clinical Microbiology & Infectious Diseases 3/2023

Open Access 21-01-2023 | Escherichia Coli | Review

Intestinal colonization with multidrug-resistant Enterobacterales: screening, epidemiology, clinical impact, and strategies to decolonize carriers

Authors: Edgar I. Campos-Madueno, Melika Moradi, Yasmine Eddoubaji, Fatemeh Shahi, Sina Moradi, Odette J. Bernasconi, Aline I. Moser, Andrea Endimiani

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 3/2023

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Abstract

The clinical impact of infections due to extended-spectrum β-lactamase (ESBL)- and/or carbapenemase-producing Enterobacterales (Ent) has reached dramatic levels worldwide. Infections due to these multidrug-resistant (MDR) pathogens—especially Escherichia coli and Klebsiella pneumoniae—may originate from a prior asymptomatic intestinal colonization that could also favor transmission to other subjects. It is therefore desirable that gut carriers are rapidly identified to try preventing both the occurrence of serious endogenous infections and potential transmission. Together with the infection prevention and control countermeasures, any strategy capable of effectively eradicating the MDR-Ent from the intestinal tract would be desirable. In this narrative review, we present a summary of the different aspects linked to the intestinal colonization due to MDR-Ent. In particular, culture- and molecular-based screening techniques to identify carriers, data on prevalence and risk factors in different populations, clinical impact, length of colonization, and contribution to transmission in various settings will be overviewed. We will also discuss the standard strategies (selective digestive decontamination, fecal microbiota transplant) and those still in development (bacteriophages, probiotics, microcins, and CRISPR-Cas-based) that might be used to decolonize MDR-Ent carriers.
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Metadata
Title
Intestinal colonization with multidrug-resistant Enterobacterales: screening, epidemiology, clinical impact, and strategies to decolonize carriers
Authors
Edgar I. Campos-Madueno
Melika Moradi
Yasmine Eddoubaji
Fatemeh Shahi
Sina Moradi
Odette J. Bernasconi
Aline I. Moser
Andrea Endimiani
Publication date
21-01-2023
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Clinical Microbiology & Infectious Diseases / Issue 3/2023
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-023-04548-2

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