Influx of Extended-Spectrum  -Lactamase--Producing Enterobacteriaceae into the Hospital

Abstract

We report high rates of bacteremia and colonization with ESBL-producing Enterobacteriaceae at admission to our institution, which may undermine infection-control measures and complicate the selection of empirical treatment.

Bloodstream infections in older patients

“…42,51 In these institutions antibiotic resistance is a growing problem and outbreaks of infection with multidrug resistant organisms (MDROs) are frequently reported. 6,42 Long-term care facilities may play an important role in the spread of resistant organisms, including Klebsiella pneumonia carbapenemase (KPC)-producing Enterobacteriaceae, 52 extended spectrum b-lactamase (ESBL) producing organisms, 53 metallo-b-lactamase (MBL) producing, 54 MRSA, 55 VRE and MDR Acinetobacter baumanii. 56 March et al found that among LTCF residents in 2012, 54% were colonized with 1 resistant organism.…”

Diffusion communautaire des entérobactéries sécrétrices de β-lactamase à spectre élargi (EBLSE)

“…Une étude israélienne récente a mis en évidence que 13,7 % des souches d'entérobactéries isolées d'hémocultures pré-levées au moment de l'admission des patients à l'hôpital possédaient une -lactamase à spectre élargi. De même, 10,8 % des 241 patients dépistés étaient porteurs de EBLSE [14]. Plus récemment, une étude réalisée en Arabie saoudite [15] à partir de coprocultures a identifé un taux de portage d'EBLSE de 13,5 % chez les sujets sains et de 26,1 % chez les sujets hospitalisés.…”

Should We Screen Patients for Extended-Spectrum β-Lactamase–Producing Enterobacteriaceae in Intensive Care Units?

“…2 We mentioned the factors that might increase the risk of irritation of oral mucosa and warned the healthcare workers who wanted to implement this intervention for their patients. However, we considered that the benefit of VAP prevention outweighed the risk of adverse effects.…”

“…Data from Israel and Saudi Arabia indicate colonization rates in excess of 10% and even 26%. 2,3 Rectal colonization is a known risk factor for infection due to ESBL-producing Enterobacteriaceae. 2 Reddy et al 1 reported that 35 (8.5%) of 413 patients colonized with ESBLproducing Enterobacteriaceae developed a subsequent bloodstream infection.…”

“…2,3 Rectal colonization is a known risk factor for infection due to ESBL-producing Enterobacteriaceae. 2 Reddy et al 1 reported that 35 (8.5%) of 413 patients colonized with ESBLproducing Enterobacteriaceae developed a subsequent bloodstream infection. 1 In our study, every fourth colonized patient suffered from an infection caused by an ESBL-producing organism during the course of their hospital stay.…”