title: Screening of ESBL-producing Enterobacteriacae concomitant with low degree of transmission in intensive care and bone marrow transplant units.
abstract: BACKGROUND
  Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are spreading worldwide in both hospital and community settings. In this study, the molecular epidemiology and the transmission modalities of ESBL-E in intensive care- and bone marrow transplant were investigated.
  
  
  METHODS
  All patients included in this study were screened for presence of ESBL-E on admission and weekly. Relevant β-lactamase genes were identified by PCR and sequencing.
  
  
  RESULTS
  A total of 669 patients were included in this study. On admission, ESBL-producing Escherichia coli were detected in 49 (7.3%) patients and ESBL-producing Klebsiella pneumoniae in one patient. The most common ESBL types among E. coli isolates were CTX-M-15 (38.8%) and CTX-M-1 (38.8%). Furthermore, 12 of 49 (24.5%) ESBL-producing E. coli could be assigned to the epidemic clone ST131. A single patient acquired ESBL-producing E. coli during the hospital stay but cross-transmission could not be demonstrated. Among 1095 environmental samples none revealed ESBL.
  
  
  CONCLUSIONS
  Our results suggest that early detection of ESBL-producing Enterobacteriaceae and consequent implementation of basic hygiene measures and contact isolation may reduce the transmission rate during the hospital stay.
authors.affiliation: a Bavarian Health and Food Safety Authority , Erlangen , Germany.|b Microbiology Institute - Clinical Microbiology, Immunology and Hygiene , University Hospital of Erlangen , Erlangen , Germany.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Valenza
authors.affiliation: c Department of Hygiene and Environmental Medicine , Central Hospital of Augsburg , Augsburg , Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Schulze
authors.affiliation: c Department of Hygiene and Environmental Medicine , Central Hospital of Augsburg , Augsburg , Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Friedrich
authors.affiliation: d Institute of Clinical Microbiology and Hygiene , University Hospital of Regensburg , Regensburg , Germany.
authors.forename: Wulf
authors.initials: W
authors.lastname: Schneider-Brachert
authors.affiliation: d Institute of Clinical Microbiology and Hygiene , University Hospital of Regensburg , Regensburg , Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Holzmann
authors.affiliation: a Bavarian Health and Food Safety Authority , Erlangen , Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Nickel
authors.affiliation: a Bavarian Health and Food Safety Authority , Erlangen , Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Lehner-Reindl
authors.affiliation: e Bavarian Health and Food Safety Authority , Oberschleißheim , Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Höller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology* / Q000635:transmission; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000635:transmission; D004926:Escherichia coli / Q000145:classification / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D005838:Genotype; D006801:Humans; D007362:Intensive Care Units; D007711:Klebsiella pneumoniae / Q000145:classification / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017720:Molecular Epidemiology; D058889:Molecular Typing; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D017422:Sequence Analysis, DNA; D055815:Young Adult; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D001618:beta-Lactamases
keywords: ESBL; Escherichia coli; ST131; carriage; hospital; transmission