Scientific article

Surveillance of extended-spectrum-beta-lactamase-producing Enterobacteriaceae in a Swiss Tertiary Care Hospital

Published inSchweizerische medizinische Wochenschrift, vol. 139, no. 51-52, p. 747-751
Publication date2009

BACKGROUND: Extended spectrum beta-lactamase producing enterobacteriaceae (ESBL-E) are increasing worldwide, but there is sparse data on patient-to-patient transmission and the prevalence among risk groups in Switzerland. A prospective, observational cohort study was performed to: 1) assess the prevalence of ESBL-E at admission among at-risk groups; 2) evaluate nosocomial cross-transmission in acute care (ACF) versus long-term care facilities (LTCF); and 3) evaluate prevalent mutations of the detected beta-lactamase genes. METHODS: Predefined risk groups were screened either on admission or after having been in contact with index patients diagnosed with ESBL-E by clinical cultures. Three patient categories were distinguished: patients previously known to be ESBL-E carrier (category I); patients transferred from countries with known high ESBL-E prevalence and thus at risk for ESBL-E carriage (category II); and roommates of index patients (category III). RESULTS: A total of 93 patients with ESBL-E were identified: Sixty-two percent (31/50) of category I patients were positive when screened upon rehospitalisation (category I); eighteen percent (22/124) of category II patients; and eight out of 177 category III patients (4.5%) of which five showed identical ESBL-E strains or shared the same beta-lactamase gene as their index cases. The incidence density of transmission was 0.9/1000 exposure-days, with more transmissions in ACF than in LTCF (4.2 vs 0.4/1000 exposure days). CTX-M-15 was the predominant beta-lactamase gene (60%) among the index patients. CONCLUSIONS: The prevalence of ESBL-E carriage among patients coming from regions with endemic rates or those previously identified as carriers is high; on-admission screening should be considered for these high risk populations. Documented nosocomial ESBL-E transmission was low.

  • Academic Medical Centers
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteremia/epidemiology
  • Cohort Studies
  • Enterobacteriaceae/drug effects/enzymology/ pathogenicity
  • Enterobacteriaceae Infections/epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Population Surveillance
  • Retrospective Studies
  • Switzerland
  • Young Adult
  • Beta-Lactam Resistance
  • Beta-Lactamases/ metabolism
Citation (ISO format)
FANKHAUSER, C. et al. Surveillance of extended-spectrum-beta-lactamase-producing Enterobacteriaceae in a Swiss Tertiary Care Hospital. In: Schweizerische medizinische Wochenschrift, 2009, vol. 139, n° 51-52, p. 747–751.
Updates (1)
ISSN of the journal0036-7672

Technical informations

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First validation06/21/2010 10:23:56 AM
Update time03/14/2023 3:43:25 PM
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