title: Faecal carriage of oxyiminocephalosporin-resistant Enterobacteriaceae among paediatric units in different hospitals in the south of France.
abstract: The aim of this study was to determine the presence of oxyiminocephalosporin-resistant (OCR) Gram-negative bacilli and extended-spectrum β-lactamase (ESBL)-producing isolates in stool specimens obtained from paediatric patients hospitalised for acute diarrhoea. We conducted a prospective, multicentre study over a period of 6 months in seven hospitals in the south of France. Samplings were carried out from infants admitted for acute diarrhoea with no previous antibiotic treatment in the last week. Bacteria in stool specimens were screened for the presence of OCR Gram-negative bacilli on Drigalski agar supplemented with ceftazidime and ESBL CHROMagar® media, and confirmed by the Rosco tablets test. Genetic detection was performed by the Check MDR® microarray and by polymerase chain reaction (PCR) and sequencing with bacterial DNA extracted from isolates. The presence of OCR enterobacteria was markedly high (177/1,118 patients, 15.2 %), with an important community origin (66.1 %). The majority of multidrug-resistant (MDR) bacteria were Enterobacter cloacae (106, 59.9 %) and Escherichia coli (61, 34.5 %). The prevalence of ESBL and CTX-M producers represented 5.2 and 4.3 % of the isolates, respectively. The main proportion of these ESBL carriers was found in children less than 1 year of age (53.4 %). One carbapenemase (IMP-1) was detected. The study revealed the wide dissemination of MDR bacteria in infants attending hospitals in the south of France during a non-outbreak situation, in particular, the spread of cefotaximase and the detection of a carbapenemase. This worrisome situation must reinforce the use of hygiene procedures and appropriate antibiotics to control the emergence and spread of OCR organisms.
authors.affiliation: Institut National de la Santé et de la Recherche Médicale, U1047, Université Montpellier 1, UFR de Médecine, 186 Chemin du Carreau des Lanes, CS83021, 30908 Nîmes Cedex 01, France.
authors.forename: A
authors.initials: A
authors.lastname: Boutet-Dubois
authors.forename: A
authors.initials: A
authors.lastname: Pantel
authors.forename: M-F
authors.initials: MF
authors.lastname: Prère
authors.forename: O
authors.initials: O
authors.lastname: Bellon
authors.forename: N
authors.initials: N
authors.lastname: Brieu-Roche
authors.forename: E
authors.initials: E
authors.lastname: Lecaillon
authors.forename: A
authors.initials: A
authors.lastname: Le Coustumier
authors.forename: A
authors.initials: A
authors.lastname: Davin-Regli
authors.forename: L
authors.initials: L
authors.lastname: Villeneuve
authors.forename: N
authors.initials: N
authors.lastname: Bouziges
authors.forename: E
authors.initials: E
authors.lastname: Gleize
authors.forename: R
authors.initials: R
authors.lastname: Lamarca
authors.forename: C
authors.initials: C
authors.lastname: Dunyach-Remy
authors.forename: A
authors.initials: A
authors.lastname: Sotto
authors.forename: J-P
authors.initials: JP
authors.lastname: Lavigne
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D002511:Cephalosporins / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004755:Enterobacteriaceae / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D005602:France / Q000453:epidemiology; D005798:Genes, Bacterial / Q000235:genetics; D006761:Hospitals; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins