title: Multiresistant CTX-M-15 ESBL-producing Escherichia coli in southern Sweden: Description of an outbreak.
abstract: An outbreak caused by a multiresistant Escherichia coli producing CTX-M-15 ESBL occurred during autumn 2005 and spring 2006 in Kristianstad, a town in southern Sweden. The outbreak comprised 27 cases and was related to an infectious diseases ward and a neighbouring long-term care facility. Our primary objective was to investigate the epidemiology in order to control the outbreak. In addition, we studied the time of carriage of multiresistant ESBL-producing Escherichia coli by follow-up samples and measured the frequency of carriage of ESBL-producing bacteria in the patient population admitted to the infectious diseases ward during autumn 2006. The outbreak described is one of the first caused by ESBL-producing Escherichia coli in Sweden. The source of the outbreak was not found. Infection control measures were reinforced in the outbreak situation, and epidemiological and microbiological methods, including PFGE typing, were used for analysis. The carriage time of multiresistant Escherichia coli was longer in several of the affected patients than has previously been reported. The longest carriage time to date is 33 months. This demonstrates the risk for new outbreaks unless strict infection control measures are implemented. Among the patients admitted to the ward during autumn 2006, 2.5% carried ESBL-producing enterobacteria.
authors.affiliation: Department of Infectious Diseases, Central Hospital, Kristianstad, Sweden. rolf.alsterlund@skane.se
authors.forename: Rolf
authors.initials: R
authors.lastname: Alsterlund
authors.forename: Barbro
authors.initials: B
authors.lastname: Carlsson
authors.forename: Lena
authors.initials: L
authors.lastname: Gezelius
authors.forename: Sara
authors.initials: S
authors.lastname: Haeggman
authors.forename: Barbro
authors.initials: B
authors.lastname: Olsson-Liljequist
mesh_terms: D000368:Aged; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D004783:Environmental Microbiology; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D013548:Sweden / Q000453:epidemiology; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics / Q000378:metabolism
chemical_list: C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases