Clinical and molecular epidemiology of extended-spectrum beta-lactamase-producing Escherichia coli as a cause of nosocomial infection or colonization: implications for control.


Autoria(s): Rodríguez-Baño, Jesús; Navarro, Maria D.; Romero, Luisa; Muniain, Miguel A.; Perea, Evelio J.; Pérez-Cano, Ramón; Hernández, José R.; Pascual, Alvaro
Data(s)

11/06/2012

11/06/2012

01/01/2006

Resumo

BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing members of the Enterobacteriaceae family are important nosocomial pathogens. Escherichia coli producing a specific family of ESBL (the CTX-M enzymes) are emerging worldwide. The epidemiology of these organisms as causes of nosocomial infection is poorly understood. The aims of this study were to investigate the clinical and molecular epidemiology of nosocomial infection or colonization due to ESBL-producing E. coli in hospitalized patients, consider the specific types of ESBLs produced, and identify the risk factors for infection and colonization with these organisms. METHODS: All patients with nosocomial colonization and/or infection due to ESBL-producing E. coli in 2 centers (a tertiary care hospital and a geriatric care center) identified between January 2001 and May 2002 were included. A double case-control study was performed. The clonal relatedness of the isolates was studied by repetitive extragenic palindromic-polymerase chain reaction and pulsed-field gel electrophoresis. ESBLs were characterized by isoelectric focusing, polymerase chain reaction, and sequencing. RESULTS: Forty-seven case patients were included. CTX-M-producing E. coli were clonally unrelated and more frequently susceptible to nonoxyimino-beta-lactams. Alternately, isolates producing SHV- and TEM-type ESBL were epidemic and multidrug resistant. Urinary catheterization was a risk factor for both CTX-M-producing and SHV-TEM-producing isolates. Previous oxyimino-beta-lactam use, diabetes, and ultimately fatal or nonfatal underlying diseases were independent risk factors for infection or colonization with CTX-M-producing isolates, whereas previous fluoroquinolone use was associated with infection or colonization with SHV-TEM-producing isolates. CONCLUSIONS: The epidemiology of ESBL-producing E. coli as a cause of nosocomial infection is complex. Sporadic CTX-M-producing isolates coexisted with epidemic multidrug-resistant SHV-TEM-producing isolates. These data should be taken into account for the design of control measures.

Major article

REIPI (Spanish Network for Research in Infectious Diseases), Instituto de Salud Carlos III, Ministerio de Salud y Consumo (C03/14); and Asociación Sanitaria Virgen Macarena (fellowship to M.D.N.).

Identificador

Rodríguez-Baño J, Navarro MD, Romero L, Muniain MA, Perea EJ, Pérez-Cano R, et al. Clinical and molecular epidemiology of extended-spectrum beta-lactamase-producing Escherichia coli as a cause of nosocomial infection or colonization: implications for control. Clin Infect Dis. 2006 Jan 1;42(1):37-45

1058-4838

http://hdl.handle.net/10668/405

16323089

10.1086/498519

Idioma(s)

en

Publicador

University of Chicago Press

Relação

Clinical Infectious Diseases

http://cid.oxfordjournals.org/content/42/1/37.long

Direitos

Acceso abierto

Palavras-Chave #Molecular Epidemiology #Escherichia coli #Cross Infection #Epidemiología Molecular #Escherichia coli #infección hospitalaria #Medical Subject Headings::Named Groups #Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged::Aged, 80 and over #Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection #Medical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Escherichia::Escherichia coli #Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans #Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Molecular Epidemiology #Medical Subject Headings::Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Hydrolases::Amidohydrolases::beta-Lactamases
Tipo

info:eu-repo/semantics/article

info:eu-repo/semantics/published

Artículo