Epidemiology of infections due to multiresistantEnterobacter aerogenes in a University Hospital

Allerberger, Franz; Koeuth, Thearith; Lass‐Flörl, Cornelia; Mp, Dierich; Putensen, Christian; Scmutzhard, E; Mohsenipour, I; Grundmann, H.; Hartung, Doris; Bauernfeind, A.; Eberlein, E.; Lupski,

doi:10.1007/bf01691323

Cited by 17 publications

(15 citation statements)

References 7 publications

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“…In our study, we used two molecular typing methods, PFGE and ERIC-PCR, already successfully used in previous studies (2,8,13,15,21,24), to analyze all of the ESBL-EA strains isolated from clinical specimens at the Amiens teaching hospital during a 3-year study. The results provided by the two techniques were concordant for all of the strains, which indicates that ERIC-PCR is not only an easy and rapid method with which to test E. aerogenes strains but also a reproducible and discriminatory method.…”

Section: Discussionmentioning

confidence: 99%

“…The spread of epidemic strains from nursing homes to other units, especially surgical units and ICUs, can be suspected. ICUs, where patients have predisposing factors such as foreign devices, compromised immunity, and broad-spectrum antibiotic treatment, are considered to serve as breeding grounds for epidemic multidrug-resistant bacteria leading to outbreaks (2,4,12,13,15,21,23). The predominance of TEM-24-producing E. aerogenes among all of the ESBL-EA isolates found is probably due to virulence determinants such as antibiotic resistance or surface factors involved in epithelial cell surface adherence.…”

Section: Discussionmentioning

confidence: 99%

“…They were investigated by using molecular typing methods such as pulsed-field gel electrophoresis (PFGE) (2,15,24,32), random amplified polymorphic DNA analysis (4,8,12,13,23), enterobacterial repetitive intergenic consensus sequence PCR (ERIC-PCR) (8,13,15,21), and ribotyping (4,21,23). In some studies, the ␤-lactam resistance was characterized, giving ESBL identification (4,8,11,14,32,35).…”

mentioning

confidence: 99%

“…In some studies, the ␤-lactam resistance was characterized, giving ESBL identification (4,8,11,14,32,35). The outbreaks occurred in the United States (21,31,35), Belgium (15,24), and Austria (2). In France, ESBL-producing E. aerogenes (ESBL-EA) has become a threat since an epidemic clone producing TEM-24 ESBL has spread to nearly all French teaching hospitals, including the hospital of Amiens (8).…”

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confidence: 99%

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Coexistence of SHV-4- and TEM-24-Producing Enterobacter aerogenes Strains before a Large Outbreak of TEM-24-Producing Strains in a French Hospital

Mammeri¹,

Laurans²,

Eveillard³

et al. 2001

J Clin Microbiol

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In 1996, a monitoring program was initiated at the teaching hospital of Amiens, France, and carried out for 3 years. All extended-spectrum ␤-lactamase (ESBL)-producing Enterobacter aerogenes isolates recovered from clinical specimens were collected for investigation of their epidemiological relatedness by pulsed-field gel electrophoresis and enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) and determination of the type of ESBL harbored by isoelectric focusing and DNA sequencing. Molecular typing revealed the endemic coexistence, during the first 2 years, of two clones expressing, respectively, SHV-4 and TEM-24 ESBLs, while an outbreak of the TEM-24-producing strain raged in the hospital during the third year, causing the infection or colonization of 165 patients. Furthermore, this strain was identified as the prevalent clone responsible for outbreaks in many French hospitals since 1996. This study shows that TEM-24-producing E. aerogenes is an epidemic clone that is well established in the hospital's ecology and able to spread throughout wards. The management of the outbreak at the teaching hospital of Amiens, which included the reinforcement of infection control measures, failed to obtain complete eradication of the clone, which has become an endemic pathogen.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Coexistence of SHV-4- and TEM-24-Producing Enterobacter aerogenes Strains before a Large Outbreak of TEM-24-Producing Strains in a French Hospital

Mammeri¹,

Laurans²,

Eveillard³

et al. 2001

J Clin Microbiol

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“…Until recently, E. cloacae was the species most frequently reported in nosocomial infections. Over the last 5 years, E. aerogenes has emerged as an agent of nosocomial infection, and multiresistant strains have caused outbreaks in intensive care units (ICUs) in Belgium (9, 13), France (2,6,7,12,19), Austria (1), and the United States (11). Recent national surveys have described the epidemiology of E. aerogenes in Belgium (23) and France (4,10).…”

Section: Among the Enterobacter Genus Enterobacter Cloacae Andmentioning

confidence: 99%

National Epidemiologic Surveys of Enterobacter aerogenes in Belgian Hospitals from 1996 to 1998

et al. 2001

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Two national surveys were conducted to describe the incidence and prevalence of Enterobacter aerogenes in 21 Belgian hospitals in 1996 and 1997 and to characterize the genotypic diversity and the antimicrobial resistance profiles of clinical strains of E. aerogenes isolated from hospitalized patients in Belgium in 1997 and 1998. Twenty-nine hospitals collected 10 isolates of E. aerogenes, which were typed by arbitrarily primed PCR (AP-PCR) using two primers and pulsed-field gel electrophoresis. MICs of 10 antimicrobial agents were determined by the agar dilution method. Beta-lactamases were detected by the double-disk diffusion test and characterized by isoelectric point. The median incidence of E. aerogenes colonization or infection increased from 3.3 per 1,000 admissions in 1996 to 4.2 per 1000 admissions in the first half of 1997 (P < 0.01). E. aerogenes strains (n ‫؍‬ 260) clustered in 25 AP-PCR types. Two major types, BE1 and BE2, included 36 and 38% of strains and were found in 21 and 25 hospitals, respectively. The BE1 type was indistinguishable from a previously described epidemic strain in France. Half of the strains produced an extended-spectrum betalactamase, either TEM-24 (in 86% of the strains) or TEM-3 (in 14% of the strains). Over 75% of the isolates were resistant to ceftazidime, piperacillin-tazobactam, and ciprofloxacin. Over 90% of the strains were susceptible to cefepime, carbapenems, and aminoglycosides. In conclusion, these data suggest a nationwide dissemination of two epidemic multiresistant E. aerogenes strains in Belgian hospitals. TEM-24 beta-lactamase was frequently harbored by one of these epidemic strains, which appeared to be genotypically related to a TEM-24-producing epidemic strain from France, suggesting international dissemination.

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In Vivo Modification of Porin Activity Conferring Antibiotic Resistance to Enterobacter aerogenes

Chevalier

Pagès

Malléa

1999

Biochemical and Biophysical Research Communications

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Epidemiology of infections due to multiresistantEnterobacter aerogenes in a University Hospital

Cited by 17 publications

References 7 publications

Coexistence of SHV-4- and TEM-24-Producing Enterobacter aerogenes Strains before a Large Outbreak of TEM-24-Producing Strains in a French Hospital

Coexistence of SHV-4- and TEM-24-Producing Enterobacter aerogenes Strains before a Large Outbreak of TEM-24-Producing Strains in a French Hospital

National Epidemiologic Surveys of Enterobacter aerogenes in Belgian Hospitals from 1996 to 1998

In Vivo Modification of Porin Activity Conferring Antibiotic Resistance to Enterobacter aerogenes

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