Abstract
Nosocomial infections are frequent complications of hospitalization, caused by opportunistic pathogens that gain access to hosts undergoing invasive procedures, such as surgery, intubation, and placement of deep vein lines. Nosocomial infections in animal hospitals can infect other animals, as well as be transmitted to human personnel. Enterobacter is a genus of common gram-negative bacteria, which can be associated with antibiotic resistant hospital infections. Because of an outbreak in antibiotic resistance in the genus, we decided to investigate five years of Enterobacter infections in the Large Animal Services of the Lois Bates Acheson Veterinary Teaching Hospital (LBAVTH) at Oregon State University. The demographics from 37 Enterobacter-infected patients of the LBAVTH were obtained from charts and analyzed. The identified clusters of infections suggested possible patient-environment sources of infection. The environment of the hospital was sampled in an attempt to determine the source of infection. Although Enterobacter was not isolated, three of the collected samples contained bacteria with resistance to third-generation cephalosporins. Enterobacter isolates from six of the 37 patients were further analyzed for presence of specific ESBL resistance genes. All six of the isolates harbored multiple extended-spectrum beta-lactamase genes, i.e., CTX-M-15, TEM-80, SHV-2 and AmpC. In summary, Enterobacter infection in the veterinary hospital was caused by beta-lactam-resistant strains, carrying ESBL-resistant genes. Veterinary hospital personnel should be aware of the potential for transmission, to both humans and animals, of ESBL-gene-containing bacteria.
Highlights
In the 1970s, Enterobacter was first noted as a common cause of nosocomial infections in immuno-compromised hosts [1,2,3,4]; with respiratory, urinary, and gastrointestinal tracts being the most common sites of infection [3]
Enterobacter is a genus of common gram-negative bacteria, which can be associated with antibiotic resistant hospital infections
During the period of October 2003 to March 2010, sixty cultures were positive for Enterobacter, from which thirty-seven of patients admitted in Large Animal Services of the Lois Bates Acheson Veterinary Teaching Hospital (LBAVTH) were reviewed
Summary
In the 1970s, Enterobacter was first noted as a common cause of nosocomial infections in immuno-compromised hosts [1,2,3,4]; with respiratory, urinary, and gastrointestinal tracts being the most common sites of infection [3]. According to the National Nosocomial Infections Surveillance System (NNIS), Enterobacter spp. accounted for 5% to 7% of hospital-acquired human infections in the United States from 1976 to 1989 [4]. Enterobacter become resistant to beta lactam antibiotics by producing an extended-spectrum beta-lactamase (ESBL) protein, which breaks the beta lactam ring of the antibiotic and inactivating it. The first ESBL isolate resistant to extended-spectrum cephalosporins, SHV-beta-lactamase, was reported in 1983, in Germany [5]. Over the past five years, the frequency of Enterobacter resistance to third-generation cephalosporins has increased worldwide [1]
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