title: Hospital cross-transmission of extended-spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae.
abstract: OBJECTIVE
  We had for objective to measure the incidence and the clonal diversity of Escherichia coli and Klebsiella pneumoniae producing extended-spectrum β-lactamases (ESBL) in order to assess the role of patient stay in amplification of the phenomenon, in our teaching hospital.
  
  
  METHODS
  We measured the quarterly incidence rates of E. coli and K. pneumoniae producing or not producing ESBL in clinical samples between 1999 and 2010. The incidence of ESBL-producing isolates was season-adjusted. We determined the pulsotype of and identified the ESBL in all non-redundant strains isolated between 2009 and 2010.
  
  
  RESULTS
  The incidence for 1000 hospitalization days increased from 0.00 to 0.44 for ESBL-producing E. coli, from 0.012 to 0.24 for ESBL-producing K. pneumoniae, from 1999 to 2010. Fifty-three different clones of E. coli were identified among the 61 genotyped isolates. The 28 K. pneumoniae isolates genotyped clustered into 11 different clones, among which one major epidemic clone that included 18 isolates. Respectively 66 and 75% of E. coli and K. pneumoniae isolates produced a CTX-M group 1 ESBL.
  
  
  CONCLUSIONS
  The hospital seems to play a different role in the amplification of ESBL according to the producing species (K. pneumoniae or E. coli). ESBL-producing E. coli seem to have a limited cross-transmission within the hospital and seem to be added to non-producers. Conversely, ESBL-producing K. pneumoniae seem to be cross-transmitted within the hospital and to replace non-producers.
authors.affiliation: UMR 6249 chrono-environnement, service d'hygiène hospitalière, centre d'investigation clinique BT506, CHRU de Besançon, université de Franche-Comté, 3, boulevard Fleming, 25030 Besançon cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Cholley
authors.forename: M
authors.initials: M
authors.lastname: Thouverez
authors.forename: H
authors.initials: H
authors.lastname: Gbaguidi-Haore
authors.forename: M
authors.initials: M
authors.lastname: Sauget
authors.forename: C
authors.initials: C
authors.lastname: Slekovec
authors.forename: X
authors.initials: X
authors.lastname: Bertrand
authors.forename: D
authors.initials: D
authors.lastname: Talon
authors.forename: D
authors.initials: D
authors.lastname: Hocquet
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D004196:Disease Outbreaks; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D029968:Escherichia coli Proteins / Q000235:genetics; D005602:France / Q000453:epidemiology; D005838:Genotype; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D012189:Retrospective Studies; D012621:Seasons; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D001426:Bacterial Proteins; D029968:Escherichia coli Proteins; C055184:beta-lactamase TEM-3; D001618:beta-Lactamases
keywords: Cross-transmission in hospital; Escherichia coli; Extended-spectrum β-lactamases; Klebsiella pneumoniae; Transmission croisée hospitalière; β-lactamases à spectre étendu