[Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in spanish hospitals (GEIH-BLEE Project 2002)].
BACKGROUND
To describe demographic aspects of a prospective multicentric nationwide study on Escherichia coli and Klebsiella pneumoniae producing extended spectrum b -lactamases (ESBL) in Spain, between March and June 2000.


METHODS
352 E. coli and K. pneumoniae strains showing a phenotype compatible to ESBL production were collected from 40 Spanish Hospitals. A form with demographic and clinical data was filled for every isolate. Identification and susceptibility testing (microdilution, NCCLS guidelines) were performed in a reference centre. RESULTS. 240 strains (170 E. coli and 70 K. pneumoniae) produced ESBL. E. coli ESBL (+) strains were isolated in 33 out of 40 participating hospitals, whereas K. pneumoniae were isolated in 17 hospitals. E. coli ESBL (+) prevalence ranged from 0% to 2.4% and K. pneumoniae ESBL (+) from 0% to 16.7%. Fifty-one percent of E. coli ESBL (+) were from outpatients, whereas 93% of K. pneumoniae ESBL (+) were from inpatients. E. coli ESBL (+) were mainly collected from Medicine and Surgery wards and K. pneumoniae from ICU and Paediatrics. ESBL (+) strains were isolated more frequently from urine samples. Patients' ages ranged from 0 to 93 years for E. coli (median 58 years) and 0 to 83 years for K. pneumoniae (median: 1 year). Paediatric cases excluded, these median values were 64 and 53 years, respectively.


CONCLUSIONS
E. coli and K. pneumoniae ESBL (+) were identificated in 90% of the participating hospitals. Although E. coli was more frequently isolated than K. pneumoniae, production of ESBL was more prevalent in K. pneumoniae. Fifty-one percent of ESBL producing E. coli were isolated from outpatients.
Hernández
José Ramón
JR
Servicio de Microbiología. Hospital Universitario Virgen de la Macarena. Sevilla. Spain.
Pascual
Alvaro
A
Cantón
Rafael
R
Martínez-Martínez
Luis
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology*; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006748:Hospital Departments / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D013030:Spain / Q000453:epidemiology; D013379:Substrate Specificity; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000378:metabolism*
D001426:Bacterial Proteins; D001618:beta-Lactamases