Hostname: page-component-84b7d79bbc-dwq4g Total loading time: 0 Render date: 2024-07-31T03:22:47.307Z Has data issue: false hasContentIssue false
  • English
  • Français

The Epidemiology of Colonization

Published online by Cambridge University Press:  02 January 2015

William R. Jarvis
William R. Jarvis*
Affiliation:
Investigation and Prevention Branch, Hospital Infections Program, Centers for Disease Control and Prevention, US Public Health Service, Atlanta, Georgia
*
Investigation and Prevention Branch, Hospital Infections Program, Centers for Disease Control and Prevention, Mailstop E-69, 1600 Clifton Road NW Atlanta, GA 30333
Get access Rights & Permissions [Opens in a new window]

Abstract

Colonization is the presence of a microorganism in or on a host, with growth and multiplication but without any overt clinical expression or detected immune response in the host at the time it is isolated. Normal colonization in humans begins during the birth process and through subsequent contacts with the inanimate or animate environments until a delicately balanced “normal” flora is established; subsequently, the precise components of this flora evolve. This normal flora, such as coagulase-negative Staphylococcus or Staphylococcus aureus on the skin or Candida albicansin the gastrointestinal tract, vagina, or perineal area, can result in infection when normal body defenses are impaired through underlying disease, immunomodulating therapy, or the use of invasive devices, or when the delicate balance of the normal flora is altered through antimicrobial therapy. Many, if not most, hospital-acquired infections result directly or indirectly from patient colonization; studies have shown that hospitalized patients are colonized rapidly with hospital flora. Recognizing this reservoir of patients colonized with epidemiologically important pathogens in our hospitals and improving barrier precaution measures or altering host susceptibility will be necessary if we are to reduce the incidence of infections with these organisms.

Type
Symposium: Nosocomial Colonization
Information
Infection Control & Hospital Epidemiology , Volume 17 , Issue 1 , January 1996 , pp. 47 - 52
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Brachman, PS. Epidemiology of nosocomial infections. Hospital Infection. 2nd ed. Boston. MA: Little. Brown and Co: 1986.Google Scholar
2. Long, SS, Swenson, RM. Development of anaerobic fecal flora in healthy newborn infants. J Pediatr 1977;91:298–301.10.1016/S0022-3476(77)80836-6CrossRefGoogle ScholarPubMed
3. Goldmann, DA. Bacterial colonization and infection in the neonate. Am J Med 1981;70:417–422.10.1016/0002-9343(81)90782-8CrossRefGoogle Scholar
4. Goldmann, DA, Leclair, J, Macone, A. Bacterial colonization of neonates admitted to an intensive care environment. J Pediatr 1978;93:288–293.10.1016/S0022-3476(78)80523-XCrossRefGoogle Scholar
5. Peter, G, Nelson, JS. Factors affecting neonatal E coli K1 rectal colonization. J Pediatr 1978;93:866–869.10.1016/S0022-3476(78)81104-4Google Scholar
6. Sprunt, K. Practical use of surveillance for prevention of nosocomial infection. Semin Perinatol 1985;9:47–50.Google ScholarPubMed
7. Brook, I, Martin, WJ. Bacterial colonization in intubated newborns. Respiration 1980;40:323–328.10.1159/000194300CrossRefGoogle ScholarPubMed
8. Evans, HE, Akpata, SO, Baki, A. Factors influencing the establishment of the neonatal bacterial flora. Arch Environ Health 1970;21:514–519.10.1080/00039896.1970.10667281CrossRefGoogle ScholarPubMed
9. Isaacs, D, Wilkinson, AR, Moxon, ER. Surveillance of colonization and late-onset septicemia in neonates. J Hosp Infect 1987;10:114–119.10.1016/0195-6701(87)90136-8Google Scholar
10. Gerards, LJ, Cats, BP, Hoogkamp-Korstanje, JAA. Early neonatal group B streptococcal disease: degree of colonization as an important determinant. J Infect 1985;11:119–124.10.1016/S0163-4453(85)91955-3CrossRefGoogle Scholar
11. Hoogkamp-Korstanje, JAA, Gerards, LJ, Cats, BP Maternal carriage and neonatal acquisition of group B streptococci. J Infect Dis 1982;145:800–803.10.1093/infdis/145.6.800Google Scholar
12. Centers for Disease Control and Prevention. Prevention of group B streptococcal diseases: a public health perspective. Federal Register 12 15, 1994;59(240):64764–64773.Google Scholar
13. Boyer, KM, Gadzala, CA, Kelly, PD, Gotoff, SP. Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease, III: interruption of mother-tdnfant transmission. J Infect Dis 1983;148:810–816.10.1093/infdis/148.5.810CrossRefGoogle Scholar
14. Harris, H, Wirtschafter, D, Cassady, G. Endotracheal intubation and its relationship to bacterial colonization and systemic infection of newborn infants. J Pediatr 1976;58:816–823.10.1542/peds.58.6.816Google Scholar
15. Slagle, TA, Bifano, EM, Wolf, JW, Gross, SJ. Routine endotracheal cultures for the prediction of sepsis in ventilated babies. Arch Dis Child 1989;64:34–38.10.1136/adc.64.1_Spec_No.34CrossRefGoogle ScholarPubMed
16. Finelli, L, Livengood, JR, Saiman, L. Surveillance of pharyngeal colonization: detection and control of serious bacterial illness in low-birthweight infants. Pediatr Infect Dis J 1994;13:854–859.10.1097/00006454-199410000-00002Google Scholar
17. Fulginiti, VA Body surface cultures in the newborn infant: an exercise in futility, wastefulness, and inappropriate practice. Am J Dis Child 1988;142:19–20.10.1001/archpedi.1988.02150010029014CrossRefGoogle ScholarPubMed
18. Johanson, WG, Pierce, AK, Sandford, J, Thomas, JD. Changing pharyngeal bacterial flora of hospitalized patients. Emergence of gram-negative bacilli. N Engl J Med 1969;281:1137–1140.10.1056/NEJM196911202812101Google Scholar
19. Torres, A, El-Ebiary, M, Gonzalez, J, et al Gastric and pharyngeal flora in nosocomial pneumonia acquired during mechanical ventilation. Am Rev Respir Dis 1993:148:352–357.10.1164/ajrccm/148.2.352Google Scholar
20. Fryklund, B, Tullus, K, Berglund, B, Burman, LG. Importance of the environment and the faecal flora of infants, nursing staff, and parents as sources of gram-negative bacteria colonizing newborns in three neonatal wards. Infection 1992;20:253–257.10.1007/BF01710789CrossRefGoogle ScholarPubMed
21. Ribner, BS, Rudrik, JT, Ferrigno, SR, Stranaes, MC. Epidemiology of resistant aerobic gram-negative bacilli (RGNB) in a Department of Veterans Affairs Nursing Home Care Unit (VANHCU). The Third Annual Meeting of SHEA; 04 18-20, 1993; Chicago, IL. Abstract 539, p A20.Google Scholar
22. Boyce, JM. Increasing prevalence of methicillin-resistant Staphylococcus aureus in the United States . Infect Control Hosp Epidemiol 1990;11:639–642.10.2307/30146866Google Scholar
23. Peacock, JE Jr, Moorman, DR, Wenzel, RP, Mandell, GL. Methicillin-resistant Staphylococcus aureus: microbiologic characteristics, antimicrobial susceptibilities, and assessment of virulence of an epidemic. J Infect Dis 1981;144:575–582.10.1093/infdis/144.6.575CrossRefGoogle ScholarPubMed
24. Panlilio, AL, Culver, DH, Gaynes, RP, et al. Methicillin-resistant Staphylococcus aureus in US hospitials. 1975-1991. Infect Control Hosp Epidemiol 1992;13:582–586.Google Scholar
25. Haley, RW, Hightower, AW, Khabbaz, RF, et al. The emergence of methicillin-resistant Staphylococcus aureus infections in United States hospitals. Possible role of the house staff-patient transfer circuit. Ann Intern Med 1982;97:297–308.10.7326/0003-4819-97-3-297Google Scholar
26. Layton, MC, Hierholzer, WJ, Patterson, JE. The evolving epidemiology of methicillin-resistant Staphylococcus aureus at a university hospital Infect Control Hosp Epidemiol 1995;16:12–17.10.2307/30140995CrossRefGoogle ScholarPubMed
27. Starch, CA, Radcliif, JS, Meyer, PL, et al. Methicillin-resistant Staphylococcus aureus in a nursing home. Infect Control 1987;8:24–29.10.1017/S0195941700066947CrossRefGoogle Scholar
28. Thomas, JC, Bridge, J, Waterman, S, Vagt, J, Kilman, L, Hancock, G. Transmission and control of methicillin-resistant Staphylococcus aureus in a skilled nursing home. Infect Control Hosp Epidemiol 1989;10:106–110.10.2307/30105108CrossRefGoogle Scholar
29. Hus, CCs, Macaluso, CP, Special, L, Hubble, RH. High rate of methicillin-resistant Staphylococcus aureus isolated from haspitalized nursing home patients. Arch Intern Med 1988;148:569–570.Google Scholar
30. Strausbaugh, LJ, Jacobson, C, Sewell, DL, Potter, S, Ward, TT. Methicillin-resistant Staphylococcus aureus in extended-care facilities. Ann Intern Med 1991;12:36–45.Google Scholar
31. Bradley, SF, Terpenning, MS, Ramsey, MA, et al. Methicillin-resistant Staphylococcus aureus: colonization and infection in a long-term care facility. Ann Intern Med 1991;115:417–422.10.7326/0003-4819-115-6-417CrossRefGoogle ScholarPubMed
32. McFarland, LV, Stamm, WE. Review of Clostridium difficile associated disease. Am J Infect Control 1986;14:99–109.10.1016/0196-6553(86)90018-0CrossRefGoogle Scholar
33. McFarland, LV. Mulligan, ME. Kwok, RYY. Stamm, WE Nosocomial acquisition of Clostridium difficile infection. N Engl J Med 1989;320:204–210.10.1056/NEJM198901263200402CrossRefGoogle ScholarPubMed
34. Clabots, CR, Johnson, S, Olson, MM, Peterson, LR, Gerding, D. Acquisition of Clostridium difficile by hospitalized patients: evidence for colonized new admissions as a source of infection. J Infect Dis 1992;166:561–567.10.1093/infdis/166.3.561Google Scholar
35. Beck-Sague, CM, Jarvis, WR, the National Nosocomial Infections Surveillance System. Secular trends in the epidemiology of nosocornial fungal infections in the United States, 1988-1990. J Infect Dis 1993;167:1247–1251.10.1093/infdis/167.5.1247CrossRefGoogle Scholar
36. Richet, H. Andremont, A, Tancrede, C, Pica, JL, Jarvis, WR. Risk factors for candidemia in patients with acute lymphocytic leukemia. Clin Infect Dis 1991:13:211–215.10.1093/clinids/13.2.211CrossRefGoogle ScholarPubMed
37. Rangel-Frausto, MS, Martin, MA, Saiman, L, et al. High-prevalence of Candida species on hands of healthcare workers (HCWs) in surgical (S) and neonatal (N) intensive care units (ICUs): a multicenter study. 34th ICAAC; 10 4-7, 1994; Orlando, FL Abstract.Google Scholar
38. Centers for Disease Control and Prevention. Nosocomial enterococci resistant to vancomycin-United States, 1989-1993. MMWR 1993;42:597–599.Google Scholar
39. Shay, DK, Maloney, SA, Montecalvo, M, et al. Epidemiology and mortality risk of vancomycin-resistant enterococcal bloodstream infections. J Infect Dis. In Press.Google Scholar
40. Livornese, LL, Dias, S, Samel, C, et al. Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers. Ann Intern Med 1992;117:112–116.10.7326/0003-4819-117-2-112Google Scholar
41. Montecalvo, MA, Horowitz, H, Gedris, C, et al. Outbreak of vancomycin-, ampicillin-, and aminoglycoside-resistant Enterococcus faecium bacteremia in an adult oncology unit. Antimicrob Agents Chemother 1994;38:1363–1367.10.1128/AAC.38.6.1363Google Scholar
42. Boyce, JM, Opal, SM, Chow, JW, et al. Outbreak of multidrugresistant Enterococcus faecium with transferable vanB class vancomycin resistance. J Clin Microbiol 1994;32:1148–1153.10.1128/jcm.32.5.1148-1153.1994Google Scholar
43. Centers for Disease Control and Prevention. Notice of a proposed report from the Hospital Infection Control Practices Advisory Committee-preventing the spread of vancomycin resistance. Federal Register 09 22, 1995;59(94):25758–25763.Google Scholar