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Infect Dis (Lond). 2017 May;49(5):405-409. doi: 10.1080/23744235.2016.1274420. Epub 2017 Jan 10.

Screening of ESBL-producing Enterobacteriacae concomitant with low degree of transmission in intensive care and bone marrow transplant units.

Author information

1
a Bavarian Health and Food Safety Authority , Erlangen , Germany.
2
b Microbiology Institute - Clinical Microbiology, Immunology and Hygiene , University Hospital of Erlangen , Erlangen , Germany.
3
c Department of Hygiene and Environmental Medicine , Central Hospital of Augsburg , Augsburg , Germany.
4
d Institute of Clinical Microbiology and Hygiene , University Hospital of Regensburg , Regensburg , Germany.
5
e Bavarian Health and Food Safety Authority , Oberschleißheim , Germany.

Abstract

BACKGROUND:

Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are spreading worldwide in both hospital and community settings. In this study, the molecular epidemiology and the transmission modalities of ESBL-E in intensive care- and bone marrow transplant were investigated.

METHODS:

All patients included in this study were screened for presence of ESBL-E on admission and weekly. Relevant β-lactamase genes were identified by PCR and sequencing.

RESULTS:

A total of 669 patients were included in this study. On admission, ESBL-producing Escherichia coli were detected in 49 (7.3%) patients and ESBL-producing Klebsiella pneumoniae in one patient. The most common ESBL types among E. coli isolates were CTX-M-15 (38.8%) and CTX-M-1 (38.8%). Furthermore, 12 of 49 (24.5%) ESBL-producing E. coli could be assigned to the epidemic clone ST131. A single patient acquired ESBL-producing E. coli during the hospital stay but cross-transmission could not be demonstrated. Among 1095 environmental samples none revealed ESBL.

CONCLUSIONS:

Our results suggest that early detection of ESBL-producing Enterobacteriaceae and consequent implementation of basic hygiene measures and contact isolation may reduce the transmission rate during the hospital stay.

KEYWORDS:

ESBL; Escherichia coli; ST131; carriage; hospital; transmission

PMID:
28071193
DOI:
10.1080/23744235.2016.1274420
[Indexed for MEDLINE]

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