Prospective survey of colonization and infection caused by SHV-4 producing Klebsiella pneumoniae in a neurosurgical intensive care unit.
The occurrence of extended-spectrum beta-lactamase producing enterobacteria (ESBLE) has been prospectively surveyed in a neurosurgical intensive care unit (ICU). Of the 47 patients examined, 8 were identified as faecal carriers, and 2 of them developed a subsequent urinary tract infection. ESBLE were also detected in the immediate environment of five colonized and/or infected patients. All isolates were Klebsiella pneumoniae of a particular biotype which exhibited a similar antibiotype and produced an SHV-4 type beta-lactamase. However, plasmid profiling and ribotyping revealed that strains isolated from seven patients of hall A were a single epidemic clone, whereas strains isolated from the eighth patient of hall B were different. Comparison between the characteristics of patients who carried an ESBLE during the surveillance period, and control patients who did not, showed that a recent surgery, and the length of ICU stay were significantly associated with the acquisition of ESBLE.
Arpin
C
C
Laboratoire de Microbiologie, Université de Bordeaux 2, France.
Rogues
A M
AM
Kabouche
S
S
Boulard
G
G
Quesnel
C
C
Gachie
J P
JP
Quentin
C
C
D003428:Cross Infection; D004269:DNA, Bacterial / Q000032:analysis; D004275:DNA, Ribosomal / Q000032:analysis; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007710:Klebsiella Infections / Q000635:transmission*; D007711:Klebsiella pneumoniae / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012307:Risk Factors; D001618:beta-Lactamases / Q000235:genetics* / Q000302:isolation & purification
D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D001618:beta-Lactamases