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Title: Clinical and molecular epidemiology of extended-spectrum beta-lactamase-producing Escherichia coli as a cause of nosocomial infection or colonization: implications for control.
Authors: Rodríguez-Baño, Jesús
Navarro, Maria D.
Romero, Luisa
Muniain, Miguel A.
Perea, Evelio J.
Pérez-Cano, Ramón
Hernández, José R.
Pascual, Alvaro
metadata.dc.contributor.authoraffiliation: [Navarro,MD; Muniain,MA; Pérez-Cano,R] Sección de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Seville, Spain.[Romero,L;Perea,EJ;Pascual,A] Servicio de Microbiología, Hospital Universitario Virgen Macarena, Seville, Spain. [Rodríguez-Baño,J; Muniain,MA; Pérez-Cano,R] Departamento de Medicina, Universidad de Sevilla, Seville, Spain. [Perea,EJ; Hernández,JR; Pascual,A] Departamento de Microbiología, Universidad de Sevilla, Seville, Spain
Keywords: Molecular Epidemiology;Escherichia coli;Cross Infection;Epidemiología Molecular;Escherichia coli;infección hospitalaria
metadata.dc.subject.mesh: 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
Issue Date: 1-Jan-2006
Publisher: University of Chicago Press
Citation: 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
Abstract: 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.
Description: Major article
metadata.dc.identifier.doi: 10.1086/498519
ISSN: 1058-4838
Appears in Collections:01- Artículos - Hospital Virgen Macarena

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