title: Nosocomial infection and characterization of extended-spectrum β-lactamases-producing Enterobacteriaceae in Northeast Brazil.
abstract: BACKGROUND
  Extended spectrum β-lactamases (ESBLs) are enzymes that degrade β-lactam antibiotics and have been reported to be an important cause of nosocomial infection in worldwide.
  
  
  METHODS
  During 2009, 659 enterobacteria strains were isolated from different clinical specimens and tested for ESBL production. The disk approximation test, combined disk method and addition of clavulanic acid were used for phenotypic detection of the ESBL-producing strains and PCR for detection of the bla(TEM) and bla(CTX-M) genes.
  
  
  RESULTS
  Among the isolates, 125 were ESBL producers. The bla(CTX-M) and bla(TEM) genes were detected in 90.4% and 75% of the strains, respectively. Most strains were isolated from urine. Klebsiella pneumoniae was the most prevalent organism. Microorganisms presented high resistance to the antibiotics.
  
  
  CONCLUSIONS
  These results support the need for extending ESBL detection methods to different pathogens of the Enterobacteriaceae family because these methods are only currently standardized by the CLSI for Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Proteus mirabilis. Carbapenems were the antibiotic class of choice for the treatment of infections caused by ESBL-producing Enterobacteriaceae.
authors.affiliation: Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Maranhão, São Luís, MA, Brasil.
authors.forename: Afonso Gomes
authors.initials: AG
authors.lastname: Abreu
authors.forename: Sirlei Garcia
authors.initials: SG
authors.lastname: Marques
authors.forename: Valério
authors.initials: V
authors.lastname: Monteiro-Neto
authors.forename: Roberto Morais Luz de
authors.initials: RM
authors.lastname: Carvalho
authors.forename: Azizedite Guedes
authors.initials: AG
authors.lastname: Gonçalves
mesh_terms: D000900:Anti-Bacterial Agents / Q000378:metabolism / Q000494:pharmacology*; D001938:Brazil; D003428:Cross Infection / Q000382:microbiology*; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D010641:Phenotype; D018440:beta-Lactam Resistance / Q000187:drug effects / Q000235:genetics*; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases