Diversity of extended-spectrum beta-lactamase-producing Enterobacteriaceae on hospital admission

作者：Roux Damien^*; Huy Clarisse; Lolom Isabelle; Andremont Antoine; Arlet Guillaume; Armand Lefevre Laurence; Lucet Jean Christophe

来源：Scandinavian Journal of Infectious Diseases, 2012, 44(3): 231-236.

DOI：10.3109/00365548.2011.623314

• Enterobacterial isolates
• beta-lactamases
• epidemiology
• community-acquired infections
• risk factors

Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae have become prevalent in both the hospital and the community. We describe the epidemiology of ESBL-producing isolates and patient characteristics at hospital admission. Data on clinical properties, medical history, previous hospitalizations, and previous antibiotic treatments were collected. ESBL genes (bla(CTX-M), bla(TEM), and bla(SHV)) were identified by polymerase chain reaction. One hundred and sixteen patients carried 122 ESBL-producing Enterobacteriaceae: 79 Escherichia coli, 26 Klebsiella pneumoniae, 16 Enterobacter spp., and 1 Citrobacter koseri. ESBL-producing E. coli were associated with admission from home (odds ratio (OR) 3.04, p = 0.02) and a history of recent urinary tract infection (OR 3.38, p = 0.04), and exhibited a lower rate of antimicrobial resistance to aminoglycosides (p <= 0.005) and co-trimoxazole (p = 0.003), whereas other ESBL-producing Enterobacteriaceae tended to be associated with a recent surgery (OR 0.42, p = 0.057). Although the CTX-M enzymes were more frequently found in E. coli (76%), they were also identified in other Enterobacteriaceae (45%), suggesting penetration of CTX-M-type enzymes into both community- and hospital-acquired enterobacterial species.

• 出版日期2012-3