Emergence of Enterobacter aerogenes as a major antibiotic-resistant nosocomial pathogen in Belgian hospitals.
OBJECTIVE
To study the epidemiology of Enterobacter aerogenes infections in Belgian hospitals and determine whether recent trends show an increase in incidence of E. aerogenes infections and antimicrobial resistance.


METHODS
Data from the bloodstream infection component of the National Surveillance of Hospital Infections (October 1992 to September 1996 data in 45 hospitals) and from a retrospective study on E. aerogenes clinical isolates (1994 and 1995 data in 41 hospitals) were analyzed.


RESULTS
E. aerogenes was recovered from clinical specimens with a mean incidence of 4.6 isolates per 10 000 patient-days and caused 0.20 bloodstream infections per 10 000 patient-days during the surveyed periods, respectively. Both rates increased significantly throughout the years. The proportion of E aerogenes within the Enterobacter genus was 35.4% in clinical isolates and 41.2% in bloodstream infections. Both proportions significantly increased over time. Incidence was not statistically different by hospital size but showed major differences between geographic regions. Resistance rates to third-generation cephalosporins and fluoroquinolones increased, and imipenem resistance emerged in several hospitals.


CONCLUSIONS
This report provides evidence of an increase in E. aerogenes infections in Belgian hospitals and documents an increase in antimicrobial resistance of E. aerogenes strains. These figures provide a baseline for further surveillance data.
Ronveaux
O
O
Epidemiology Unit, Scientific Institute of Public Health Louis Pasteur, BrusselsLaboratory of Microbiology, University Hospital Erasme, Université Libre de Bruxelles, BrusselsLaboratory of Microbiology, University Hospital Mont-Godinne, YvoirLaboratory of Microbiology, University Hospital Sart-Tilman, Liège, Belgium.
Gheldre
Y
Y
Glupczynski
Y
Y
Struelens
M
M
Mol
P
P