Local prevalence of extended-spectrum beta-lactamase (ESBL) producing intestinal carriers at admission and co-expression of ESBL and OXA-48 carbapenemase in : a prevalence survey in a Spanish University Hospital.

OBJECTIVE

To assess the prevalence of extended-spectrum beta-lactamase (ESBL)-producing (ESBL-E) faecal carriers at admission in a University Hospital in Spain.

DESIGN

Prevalence survey.

SETTING

Pneumology, gastroenterology, urology and neurosurgery units at a university tertiary hospital in Madrid (Spain).

PARTICIPANTS

A total of 10 643 patients aged 18 and older admitted from March 2014 to April 2016 with a rectal swab taken at admission or as soon as possible within the first 48 hours.

PRIMARY AND SECONDARY OUTCOME MEASURES

Prevalence of ESBL-E faecal carriers and prevalence of ESBL-E infections at admission.

RESULTS

The prevalance of ESBL-E carriers at admission was 7.69% (CI 95% 7.18 to 8.19). Most of the isolates were (77.51%), followed by (20.71%). Eighty-eight (10.41%) of ESBL-E were simultaneous ESBL and carbapenemase (CP) producers, 1.83% in the case of and 42.86% among isolates. Of the ESBL typed, 52.15% belonged to the cefotaximases (CTX-M-15) type and 91.38% of the CP were oxacillinase (OXA-48) type. Only 0.43% patients presented an active infection by ESBL-E at admission.

CONCLUSIONS

The prevalence found in our study is very similar to that found in literature. However, we found a high percentage of simultaneous ESBL and CP producers, particularly in . Despite the high prevalence of colonised patients, the ESBL-infection rate at admission was very low.