Abstract
Strains of the Enterobacteriaceae family producing ESBL and AmpC broad-spectrum beta-lactamases that may survive in the hospital setting potentially cause infection in hospitalized patients due to contaminated objects or health care workers’ hands. Over a period of two months (November-December 2010), a single epidemiological study of microbial contamination of air, surfaces and health care workers (swabs from both nostrils and the right hand without a glove) was carried out at two intensive care units of the University Hospital Olomouc, Czech Republic. The bacteria were identified using standard microbiological methods. Phenotypic detection of ESBL and AmpC enzymes and basic genetic analysis of ESBL- and AmpC-positive isolates was performed. The same approach was used to identify and analyze bacteria isolated from clinical samples of patients hospitalized at the above departments over the study period. From a total of 140 environmental samples collected over the study period, 21 isolates of the Enterobacteriaceae family were identified, with ESBL and AmpC production being detected in 4 and 7 isolates, respectively. Among patients’ clinical samples, 10 ESBL- and 6 AmpC-positive isolates were detected. No similarity was found between environmental isolates and strains isolated from patients.
Highlights
Members of the Enterobacteriaceae family are feared nosocomial pathogens, especially in high-risk departments such as intensive care, neonatal and burn units
Strains of the Enterobacteriaceae family producing ESBL and AmpC broad-spectrum beta-lactamases that may survive in the hospital setting potentially cause infection in hospitalized patients due to contaminated objects or health care workers’ hands
The study documented the presence of ESBL- and AmpC-positive Enterobacteriaceae in two intensive care units of the University Hospital Olomouc (UHO)
Summary
Members of the Enterobacteriaceae family are feared nosocomial pathogens, especially in high-risk departments such as intensive care, neonatal and burn units. The risk stems mainly from an increasing prevalence of ESBL- and AmpC-positive strains and the associated higher risk of failure of antibiotic therapy [1,2]. The growing number of Enterobacteriaceae spp. was confirmed by data from the University Hospital Olomouc (UHO), Czech Republic. The percentage of Klebsiella pneumoniae isolates resistant to ceftazidime rose from 16% in 2005 to 40% in 2010 (unpublished data). The main mechanism of this resistance is production of broad-spectrum beta-lactamases, in particular ESBLs, that inhibit the effect of cephalosporin and penicillin antibiotics. In the UHO, fluroquinolone resistance of Klebsiella pneumoniae isolates increased from 12% in 2005 to 42% in 2010 (unpublished data). Besides Klebsiella pneumoniae strains, the common broad-spectrum beta-lactamase producers include Escherichia coli isolates and, less frequently, Enterobacter cloacae, Serratia marcescens, Citrobacter spp., Proteus spp. and others [5,6]
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