[Expanded-spectrum beta-lactamase-producing strains of E. coli: origin, characteristics and incidence in Southern Alicante (Spain) in the period 1999-2003].
BACKGROUND
In the last years, we have verified the increasing emergence of bacteria, specially Escherichia coli, that produce expanded spectrum beta-lactamases (ESBL), enzymes which confer resistance to all cephalosporins (except cephamycins) and aztreonam. These bacteria are frequently resistant also to non-beta-lactam antibiotics, a fact which poses an important clinical problem.


METHODS
Descriptive study of ESBL-producing strains of E. coli isolated in all kind of specimens in two hospitals of Southern Alicante (Spain), throughout a period of 57 months (January 1999 to September 2003), paying a close attention to their origin (outpatients or admitted patients), co-resistance to non beta-lactam antibiotics and evolution of their incidence.


RESULTS
Respectively, 3% and 2.25% of E. coli strains isolated in each hospital produce ESBL (3.83% and 2.85% of strains from admitted and 2.74% and 2.1% from outpatients). 30.73% and 24.58% of strains ESBL were isolated in admitted patients. We found in both hospitals much higher percentages of co-resistance to ciprofloxacin, gentamicin and trimetoprim-sulfamethoxazole in ESBL-producing strains.


CONCLUSIONS
The percentage of ESBL-producing E. coli is high in our environment, but it is even more noteworthy its clear trend to increase. It is very remarkable the high percentage of ESBL-producing strains isolated from outpatients. Finally, we emphasize the high percentages of co-resistance to non-beta-lactam antibiotics.
Yagüe
Alberto
A
Laboratorio de Microbiología, Hospital Comarcal Vega Baja, Ctra. Almoradí s/n, 03314 Orihuela, Alicante, Spain. yague_alb@gva.es
Cebrián
Laura
L
Rodríguez-Díaz
Juan Carlos
JC
Gonzalo-Jiménez
Nieves
N
Royo
Gloria
G
Campillos
Pilar
P
López-Lozano
José María
JM
D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology*; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D029968:Escherichia coli Proteins / Q000032:analysis*; D006769:Hospitals, General / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007297:Inpatients; D010045:Outpatients; D013030:Spain / Q000453:epidemiology; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000032:analysis*; D047090:beta-Lactams / Q000378:metabolism / Q000494:pharmacology
D029968:Escherichia coli Proteins; D047090:beta-Lactams; D001618:beta-Lactamases