Environmental contamination with extended-spectrum β-lactamases: is there any difference between Escherichia coli and Klebsiella spp?

2012
Background The hospital environment contributes to the spread of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-PE) during outbreaks. We aimed to assess the rate of environmental contamination in rooms occupied by ESBL carriers or infected children and to identify risk factors associated with contamination. Methods Five environmental surface samples were systematically performed in rooms occupied by ESBL-PE carrier or infected children. Results Forty-six Escherichia coli and 48 Klebsiella infected/carrier patients were included in the study. Nineteen (4%) of the 470 environmental samples performed yielded ESBL-PE. Klebsiellaspp was the most frequent species isolated (16, 89%), whereas E coli and Citrobacter freundiiwere reported twice and once, respectively. Ten of the 19 (52%) isolates were identical to the corresponding strains isolated from children. Multivariate analysis highlighted ESBL-producing Klebsiellacarriage/infection as the only risk factor significantly associated with surface contamination ( P = .024 ) . Conclusion Our data suggest that hospital environmental contamination is more frequent in instances of fecal carriage or infection with ESBL-producing Klebsiellathan ESBL-producing E coli . Reinforcing hygiene measures around ESBL-producing Klebsiellamight be necessary to reduce the spread of ESBL-PE in hospital environments.
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