{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T02:37:13Z","timestamp":1773283033101,"version":"3.50.1"},"reference-count":35,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2015,8,11]],"date-time":"2015-08-11T00:00:00Z","timestamp":1439251200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>Nursing homes (NHs) have been implicated as significant reservoirs of antibiotic-resistant organisms causing severe infectious disease. We investigated the prevalence and molecular epidemiology of, and risk factors for, faecal carriage of extended-spectrum <jats:italic>\u03b2<\/jats:italic>-lactamase-producing Enterobacteriaceae (ESBL-E). A multicentre cross-sectional study was conducted in seven NHs in Shanghai between March 2014 and May 2014. Antimicrobial susceptibility testing and polymerase chain reaction were used to detect genes coding for ESBLs and carbapenemases. NH records at individual-resident level and facility level were examined for potential risk factors. Four hundred and fifty-seven Enterobacteriaceae isolates were collected of which 183 (46\u00b792%) were colonized by ESBL-E. CTX-M enzymes (198\/200, 99%) predominated, with CTX-M-14 (84\/200, 42%) the most common types. Two carbapenemase producers harboured bla<jats:sub>KPC-2<\/jats:sub>. Resistance rates to carbapenems, TZP, AK, FOS, CL and TGC were low. History of invasive procedures [odds ratio (OR) 2\u00b7384, 95% confidence interval (CI) 1\u00b7318\u20134\u00b7310, <jats:italic>P<\/jats:italic> = 0\u00b7004], narrow-spectrum cephalosporins (OR 1\u00b7635, 95% CI 1\u00b7045\u20132\u00b7558, <jats:italic>P<\/jats:italic> = 0\u00b7031) and broad-spectrum cephalosporins (OR 3\u00b7276, 95% CI 1\u00b7278\u20138\u00b7398, <jats:italic>P<\/jats:italic> = 0\u00b7014) were independently associated with ESBL-E carriage. In conclusion, NH residents have a very high prevalence of faecal carriage of ESBL-E. Continuous and active surveillance is important, as are prudent infection control measures and antibiotic use to prevent and control the spread of these antibiotic-resistant strains.<\/jats:p>","DOI":"10.1017\/s0950268815001879","type":"journal-article","created":{"date-parts":[[2015,8,11]],"date-time":"2015-08-11T03:08:39Z","timestamp":1439262519000},"page":"695-702","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":24,"title":["Epidemiology and risk factors for faecal extended-spectrum <i>\u03b2<\/i>-lactamase-producing Enterobacteriaceae (ESBL-E) carriage derived from residents of seven nursing homes in western Shanghai, China"],"prefix":"10.1017","volume":"144","author":[{"given":"S.-Y.","family":"ZHAO","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"ZHANG","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.-L.","family":"ZHANG","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.-C.","family":"WANG","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.-Z.","family":"XIAO","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.-F.","family":"GU","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"X.-K.","family":"GUO","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.-X.","family":"NI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.-Z.","family":"HAN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,8,11]]},"reference":[{"key":"S0950268815001879_ref1","doi-asserted-by":"publisher","DOI":"10.1017\/S0195941700086562"},{"key":"S0950268815001879_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2010.02.002"},{"key":"S0950268815001879_ref28","doi-asserted-by":"publisher","DOI":"10.3143\/geriatrics.48.530"},{"key":"S0950268815001879_ref21","first-page":"307","article-title":"Drug resistance and genotype analysis of carbapenem-resistant Enterobacteriaceae","volume":"31","author":"Pang","year":"2013","journal-title":"Chinical Journal of Clinical Laboratory Science"},{"key":"S0950268815001879_ref20","first-page":"374","article-title":"\u03b2-Lactamase genes and virulence genes in Escherichia coli isolated from old patients","volume":"19","author":"Jin","year":"2009","journal-title":"Chinese Journal of Nosocomiology"},{"key":"S0950268815001879_ref31","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dks429"},{"key":"S0950268815001879_ref18","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dki412"},{"key":"S0950268815001879_ref27","doi-asserted-by":"publisher","DOI":"10.3109\/00365548.2012.717232"},{"key":"S0950268815001879_ref11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2009.02227.x"},{"key":"S0950268815001879_ref2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.50.7s.2.x"},{"key":"S0950268815001879_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2012.10.016"},{"key":"S0950268815001879_ref16","unstructured":"Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing, 24th Informational Supplement, M100-S24. Wayne, PA: CLSI, 2014."},{"key":"S0950268815001879_ref12","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12383"},{"key":"S0950268815001879_ref19","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.4.1572-1575.2005"},{"key":"S0950268815001879_ref14","unstructured":"Putuo Civil Affairs Bureau. Putuo nursing home list. (http:\/\/www.shmzj.gov.cn\/gb\/mzptq\/bmfw\/node28\/userobject1ai247.html). Accessed 6 Jun 2015."},{"key":"S0950268815001879_ref29","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0074323"},{"key":"S0950268815001879_ref30","doi-asserted-by":"publisher","DOI":"10.3201\/eid1707.110209"},{"key":"S0950268815001879_ref10","doi-asserted-by":"publisher","DOI":"10.1086\/317489"},{"key":"S0950268815001879_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwf173"},{"key":"S0950268815001879_ref9","doi-asserted-by":"crossref","first-page":"2321","DOI":"10.1128\/AAC.41.11.2321","article-title":"Why are antibiotic resistance genes so resistant to elimination?","volume":"41","author":"Salyers","year":"1997","journal-title":"Antimicrobial Agents and Chemotherapy"},{"key":"S0950268815001879_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2012.09.026"},{"key":"S0950268815001879_ref7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200012283432604"},{"key":"S0950268815001879_ref17","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01588-06"},{"key":"S0950268815001879_ref26","unstructured":"Shanghai Statistics Bureau. The latest living report of Shanghai older adults. 2014. (http:\/\/www.stats-sh.gov.cn\/xwdt\/201103\/95569.html). Accessed 15 January 2015."},{"key":"S0950268815001879_ref13","unstructured":"Shanghai Civil Affairs Bureau. Statistical information on the aged population in Shanghai. 2010 (http:\/\/www.shmzj.gov.cn\/gb\/shmzj\/node8\/node15\/node58\/node72\/node99\/u1ai29584.html). Accessed 6 Jun 2015."},{"key":"S0950268815001879_ref3","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.06469-11"},{"key":"S0950268815001879_ref23","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.110.959171"},{"key":"S0950268815001879_ref32","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dks295"},{"key":"S0950268815001879_ref22","first-page":"75","article-title":"Multilevel logistic regression model applied to binary outcome measure data and its software implementation","volume":"10","author":"Ni","year":"2013","journal-title":"Chinese Journal of Health Informatics and Management"},{"key":"S0950268815001879_ref24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03718.x"},{"key":"S0950268815001879_ref35","doi-asserted-by":"publisher","DOI":"10.1086\/502045"},{"key":"S0950268815001879_ref33","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1985.00360100064009"},{"key":"S0950268815001879_ref4","doi-asserted-by":"publisher","DOI":"10.1086\/598194"},{"key":"S0950268815001879_ref8","doi-asserted-by":"crossref","first-page":"2399","DOI":"10.1128\/AAC.40.10.2399","article-title":"Problem of antimicrobial resistance of faecal aerobic gram-negative bacilli in the elderly","volume":"40","author":"Leistevuo","year":"1996","journal-title":"Antimicrobial Agents and Chemotherapy"},{"key":"S0950268815001879_ref34","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38602.586343.55"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268815001879","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,19]],"date-time":"2019-04-19T21:57:32Z","timestamp":1555711052000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268815001879\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8,11]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2016,3]]}},"alternative-id":["S0950268815001879"],"URL":"https:\/\/doi.org\/10.1017\/s0950268815001879","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,11]]},"assertion":[{"value":"Copyright \u00a9 Cambridge University Press 2015\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}