CTX-M-producing Escherichia coli in a maternity ward: a likely community importation and evidence of mother-to-neonate transmission.
Langue
EN
Article de revue
Ce document a été publié dans
Journal of Antimicrobial Chemotherapy. 2010-07-01, vol. 65, n° 7, p. 1368-71
Résumé en anglais
To investigate the high prevalence of extended-spectrum beta-lactamase (ESBL)-producing strains of Escherichia coli (4%, 10/250 consecutive isolates) recovered during a 5 month period in the maternity ward of the University ...Lire la suite >
To investigate the high prevalence of extended-spectrum beta-lactamase (ESBL)-producing strains of Escherichia coli (4%, 10/250 consecutive isolates) recovered during a 5 month period in the maternity ward of the University Hospital of Bordeaux, France. beta-Lactam resistance transfer was analysed by conjugation and transformation. ESBLs were characterized by isoelectric focusing, PCR amplification and sequencing. The relatedness of the strains was examined by PFGE and phylogenetic group determination. Plasmids were characterized by incompatibility group and restriction analysis. Ten ESBL-producing E. coli were isolated from urinary or genital samples of eight mothers and from gastric fluids of two newborns of carrier mothers. The patients were hospitalized in five different units of the maternity ward. Transconjugants, obtained for 7 of the 10 strains, and wild-type strains exhibited various antibiotypes. Different CTX-M enzymes were characterized: CTX-M-1 (n = 4); CTX-M-14 (n = 3); CTX-M-32 (n = 2); and CTX-M-28 (n = 1). The strains recovered from two mothers and their respective babies were identical. All the other strains were epidemiologically unrelated. Furthermore, various plasmids were identified. Environmental samples from the common echographic and sampling rooms did not reveal the presence of ESBL-producing enterobacteria. The data argue against the occurrence of a nosocomial outbreak and support the hypothesis of an importation of community-acquired ESBL-producing strains into the hospital through colonized/infected patients. At present, not only patients transferred from other hospitals or long-term care facilities are at risk of carrying ESBL-producing enterobacteria on hospital admission, but also community patients.< Réduire
Mots clés en anglais
Adult
Anti-Bacterial Agents
Bacterial Typing Techniques
Community-Acquired Infections
DNA Fingerprinting
Electrophoresis
Gel
Pulsed-Field
Environmental Microbiology
Escherichia coli
Escherichia coli Infections
Escherichia coli Proteins
Female
France
Genotype
Hospitals
Maternity
Hospitals
University
Humans
Infant
Newborn
Infectious Disease Transmission
Vertical
Microbial Sensitivity Tests
Plasmids
Pregnancy
beta-Lactamases
beta-Lactams
Unités de recherche