Extended-spectrum beta-lactamases in long-term-care facilities.

Although the first reports on extended-spectrum beta-lactamase (ESBL)-producing isolates in long-term-care facilities (LTCFs) appeared 10 years ago, there are still scanty data on this topic. A long-term survey starting in 1993 by the microbial laboratories of the Assistance Publique Hopitaux de Paris and covering 21,000 beds, 7000 of them in LTCFs, indicated that the incidence of ESBL-producing isolates/1000 hospitalisation days in LTCFs increased from 0.07 in 1996 to 0.28 in 2005. Escherichia coli accounted for 80% of ESBL-positive isolates in 2005, whereas it accounted for <45% in 2001. This rise in E. coli with ESBLs reflected clonal spread, as found elsewhere, with CTX-M types now the predominant enzyme types.