title: Faecal carriage of multidrug-resistant Gram-negative bacilli during a non-outbreak situation in a French university hospital.
abstract: OBJECTIVE
  To determine the prevalence of multidrug-resistant (MDR) Gram-negative bacilli and extended spectrum β-lactamase (ESBL)-producing isolates in stool specimens obtained from patients hospitalized for acute diarrhoea in a French university hospital.
  
  
  METHODS
  Bacteria in stool specimens were screened for ESBL production on Drigalski agar supplemented with ceftazidime, ESBL CHROMagar(®) and CTX CHROMagar(®) media and confirmed by the double-disc synergy test. Genetic detection was performed by PCR and sequencing with bacterial DNA extracted from isolates.
  
  
  RESULTS
  The presence of MDR bacteria was markedly high (96 of 303 patients, 31.7%). The majority of MDR bacteria were Enterobacter cloacae (44, 38%) and Escherichia coli (32, 28%). Moreover, the prevalence of ESBL and CTX-M producers among all included patients was 15.8% and 5.9%, respectively. The clone E. coli O25b : H4-ST131 was detected in 63% of CTX-M strains. Surprisingly, 16 carbapenemases (5.3% of patients) were isolated.
  
  
  CONCLUSIONS
  The study revealed the wide dissemination of MDR bacteria, including carbapenemase producers, in a French hospital during a non-outbreak situation. Public health efforts to combat emergence and dissemination of MDR organisms need to be developed.
authors.affiliation: Institut National de la Santé et de la Recherche Médicale, Espri 26, Université Montpellier 1, UFR de Médecine, 30908 Nîmes cedex 08, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Vidal-Navarro
authors.forename: Caroline
authors.initials: C
authors.lastname: Pfeiffer
authors.forename: Nicole
authors.initials: N
authors.lastname: Bouziges
authors.forename: Albert
authors.initials: A
authors.lastname: Sotto
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lavigne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000235:genetics; D003967:Diarrhea / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D005243:Feces / Q000382:microbiology*; D005260:Female; D005602:France; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology*; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D055815:Young Adult; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D004269:DNA, Bacterial; D001618:beta-Lactamases