[Epidemiology of patients harboring extended-spectrum beta-lactamase-producing enterobacteriaceae (ESBLE), on admission].
OBJECTIVE
The incidence of extended-spectrum beta-lactamase-producing enterobacteria (ESBLE) has regularly increased over the last few years. However, little is known about epidemiology of ESBLE carriers in France. The objective of this study was to determine the ESBLE carriers or infected patients profile, identified within 48 hours following hospital admission.


METHODS
This retrospective study included all patients admitted in 2006 and 2007 at the Necker-Enfants-Malades (NEM) teaching hospital, carrying or infected with ESBLE isolated within 48 hours following admission. The pediatric and adult populations were compared.


RESULTS
There was no significant difference between pediatric and adult populations. Escherichia coli and Klebsiella pneumoniae were the two main species isolated, accounting respectively for 59.6 and 21.1 % of the 114 isolated strains. Among the 114 analyzed files, 24 patients (21 %) were known to be EBLSE carriers, 37 (32 %) were transferred from another hospital, including 16 from another country. Concerning the 54 (47 %) other patients, five (4 %) came from a country with high prevalence, and 44 (39 %) were treated for a chronic illness. Only five patients (4 %) carrying ESBLE did not have any usual risk factor for multidrug resistance (MDR) bacterial carriage.


CONCLUSIONS
In our study, 4 % of patients carrying ESBLE admitted had no usual risk factor for MDR bacteria. Targeted screening of previous carriers, patients with chronic illness, transferred patients, or patients coming from country with high prevalence, would help to limit the spread of ESBLE.
Guillet
M
M
Laboratoire de microbiologie, d'hygiène hospitalière, hôpital Necker-Enfants-Malades, AP-HP, université Paris Descartes, 145, rue de Sèvres, 75015 Paris, France.
Bille
E
E
Lecuyer
H
H
Taieb
F
F
Masse
V
V
Lanternier
F
F
Lage-Ryke
N
N
Talbi
A
A
Degand
N
N
Lortholary
O
O
Nassif
X
X
Zahar
J-R
JR
D000328:Adult; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D004755:Enterobacteriaceae / Q000201:enzymology* / Q000302:isolation & purification*; D006801:Humans; D010343:Patient Admission; D012189:Retrospective Studies; D001618:beta-Lactamases / Q000096:biosynthesis*
D001618:beta-Lactamases