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Prospective survey of colonization and infection caused by SHV-4 producing Klebsiella pneumoniae in a neurosurgical intensive care unit

Published online by Cambridge University Press:  01 June 2000

C. ARPIN ,
A. M. ROGUES ,
S. KABOUCHE ,
G. BOULARD ,
C. QUESNEL ,
J. P. GACHIE  and
C. QUENTIN
C. ARPIN
Affiliation:
Laboratoire de Microbiologie, Université de Bordeaux 2, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France
A. M. ROGUES
Affiliation:
Service d'Hygiène Hospitalière, Hôpital Pellegrin, 1 place Amélie Raba Léon, 33076 Bordeaux Cedex, France
S. KABOUCHE
Affiliation:
Laboratoire de Microbiologie, Université de Bordeaux 2, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France
G. BOULARD
Affiliation:
Service de Neurochirurgie, Hôpital Pellegrin, 1 place Amélie Raba Léon, 33076 Bordeaux Cedex, France
C. QUESNEL
Affiliation:
Service d'Hygiène Hospitalière, Hôpital Pellegrin, 1 place Amélie Raba Léon, 33076 Bordeaux Cedex, France
J. P. GACHIE
Affiliation:
Service d'Hygiène Hospitalière, Hôpital Pellegrin, 1 place Amélie Raba Léon, 33076 Bordeaux Cedex, France
C. QUENTIN
Affiliation:
Laboratoire de Microbiologie, Université de Bordeaux 2, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France
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Abstract

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The occurrence of extended-spectrum β-lactamase producing enterobacteria (ESBLE) has been prospectively surveyed in a neurosurgical intensive care unit (ICU). Of the 47 patients examined, 8 were identified as faecal carriers, and 2 of them developed a subsequent urinary tract infection. ESBLE were also detected in the immediate environment of five colonized and/or infected patients. All isolates were Klebsiella pneumoniae of a particular biotype which exhibited a similar antibiotype and produced an SHV-4 type β-lactamase. However, plasmid profiling and ribotyping revealed that strains isolated from seven patients of hall A were a single epidemic clone, whereas strains isolated from the eighth patient of hall B were different. Comparison between the characteristics of patients who carried an ESBLE during the surveillance period, and control patients who did not, showed that a recent surgery, and the length of ICU stay were significantly associated with the acquisition of ESBLE.

Type
Research Article
Information
Epidemiology & Infection , Volume 124 , Issue 3 , June 2000 , pp. 401 - 408
Copyright
© 2000 Cambridge University Press