a Bavarian Health and Food Safety Authority , Erlangen , Germany.
b Microbiology Institute - Clinical Microbiology, Immunology and Hygiene , University Hospital of Erlangen , Erlangen , Germany.
Infect Dis (Lond). 2017 May;49(5):405-409. doi: 10.1080/23744235.2016.1274420. Epub 2017 Jan 10.
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.
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.
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.
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.
产超广谱β-内酰胺酶肠杆菌科（ESBL-E）在医院和社区环境中在全球范围内传播。本研究调查了重症监护和骨髓移植中 ESBL-E 的分子流行病学和传播方式。
所有纳入本研究的患者在入院时和每周进行一次 ESBL-E 筛查。通过 PCR 和测序鉴定相关β-内酰胺酶基因。
本研究共纳入 669 例患者。入院时，49 例（7.3%）患者产 ESBL 大肠埃希菌，1 例患者产 ESBL 肺炎克雷伯菌。产 ESBL 大肠埃希菌分离株中最常见的 ESBL 类型为 CTX-M-15（38.8%）和 CTX-M-1（38.8%）。此外，49 株产 ESBL 大肠埃希菌中 12 株（24.5%）可归属于流行克隆 ST131。仅有 1 例患者在住院期间获得产 ESBL 大肠埃希菌，但未能证明存在交叉传播。在 1095 份环境样本中均未发现 ESBL。
我们的研究结果表明，早期检测产 ESBL 肠杆菌科并采取基本的卫生措施和接触隔离可能会降低住院期间的传播率。
