title: Wide dissemination of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella spp. in acute care and rehabilitation hospitals.
abstract: A prospective surveillance system for extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-E) and ESBL-producing Klebsiella spp. (ESBL-K) was implemented in 39 German hospitals with the aim of determining the incidence densities (IDs) of community-onset and hospital-onset cases and of identifying risk factors for high IDs of hospital-onset cases. During 2008, 2081 ESBL-E/K cases were documented. ESBL-E cases (n=1330, 63·9%) were more common than ESBL-K cases (n=751, 36·1%), but a higher proportion of ESBL-K cases (59%) than of ESBL-E cases (39·5%) were hospital-onset cases. The mean IDs were 0·54 (range 0-2·53) per 1000 patient-days for all ESBL-EK cases, 0·29 (range 0-1·81) per 1000 patient-days for community-onset ESBL-EK cases and 0·25 (range 0-1·82) per 1000 patient-days for hospital-onset ESBL-EK cases. Regression analysis showed a linear association between the IDs of community-onset and hospital-onset cases. The wide dissemination of ESBL-E and ESBL-K emphasizes the need for hospital-wide surveillance to guide control measures.
authors.affiliation: Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany. anke.kohlenberg@uk-koeln.de
authors.forename: A
authors.initials: A
authors.lastname: Kohlenberg
authors.forename: F
authors.initials: F
authors.lastname: Schwab
authors.forename: H
authors.initials: H
authors.lastname: Rüden
mesh_terms: D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004926:Escherichia coli / Q000201:enzymology* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology*; D005858:Germany / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007709:Klebsiella / Q000201:enzymology* / Q000302:isolation & purification; D007710:Klebsiella Infections / Q000382:microbiology*; D011446:Prospective Studies; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D001618:beta-Lactamases