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Volume 2 Supplement 1

Antimicrobial Resistance and Infection Control: Abstracts from the 2nd International Conference on Prevention and Infection Control (ICPIC 2013)

P078: Epidemiology of extended-spectrum beta-lactamase-producing enterobacteriaceae (ESBL-E) during an epidemic, with screening of patients and healthcare workers

Antimicrobial Resistance and Infection Control volume 2, Article number: P78 (2013) Cite this article

Objectives

To determine the nosocomial acquisition rate of ESBL-E among patients and healthcare workers (HCWs) during an epidemic (March 2009 to Nov 2010) in an orthopaedics ward at HUG.

Methods

Universal screening made by anal swab of all patients on admission and every 2 weeks if screening remained negative. 49 samples were collected from 41 HCW and 60 environmental samples were analysed. Molecular typing was performed on all ESBL-E isolates. If there was more than 97.5% similarity, strains were considered identical.

Results

Between March 2009 and November 2010, 1’531 admissions occurred to the orthopaedic ward (12’401 patient-days; length of stay of 27 days). Among 565 anal swabs, ESBL-E were detected in 204 samples from 45 patients.

The ESBL-E found were E. coli (n=39), Klebsiella pneumoniae (n=10), Enterobacter spp (n=8), Citrobacter spp (n=2), Morganella morganii (n=2), and Proteus vulgaris (n=1). Two different ESBL-E strains were detected in 6 patients, and 3 others carried three distinct isolates. The ESBL-E transmitted were E. coli (14 patients), K. pneumoniae (3 patients) and both in 2 patients.

Identical ESBL-E species with epidemiological links were found in 25 cases. Only 9 of these were attributable to the unit. Most positive patients (96% [43/45]) were colonized asymptomatically with ESBL-E.

Among HCWs, 6 samples (12%) were positive. Transmission was only observed between patients, not HCWs.

None of the environmental samples revealed presence of ESBL-E.

Conclusion

Transmission of ESBL-E strains was only observed between patients. No transmission between HCWs and patients occurred. HCW screening and environmental sampling is not useful during ESBL-E carriage outbreaks.

The main ESBL-E transmitted was E. coli.

ESBL-E transmission can occur in units with extended length of stay, questioning the new Swiss policy of abandoning contact precautions for E. coli-ESBL carriers.

Disclosure of interest

None declared

Author information

Authors and Affiliations

  1. Infection Control Program, Geneva University Hospitals, Geneva, Switzerland

    A Agostinho, S Harbarth & I Uçkay

  2. Orthopaedic Surgery, Geneva University Hospitals, Geneva, Switzerland

    G Jourdan & P Hoffmeyer

  3. Central Bacteriology Laboratory, Geneva University Hospitals, Geneva, Switzerland

    G Renzi

  4. Occupational Medicine Service, Geneva University Hospitals, Geneva, Switzerland

    C Bonfillon

Authors
  1. A Agostinho
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  2. G Jourdan
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  3. G Renzi
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  4. C Bonfillon
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  5. P Hoffmeyer
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  6. S Harbarth
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  7. I Uçkay
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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Cite this article

Agostinho, A., Jourdan, G., Renzi, G. et al. P078: Epidemiology of extended-spectrum beta-lactamase-producing enterobacteriaceae (ESBL-E) during an epidemic, with screening of patients and healthcare workers. Antimicrob Resist Infect Control 2 (Suppl 1), P78 (2013). https://doi.org/10.1186/2047-2994-2-S1-P78

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  • DOI: https://doi.org/10.1186/2047-2994-2-S1-P78

Keywords

  • Environmental Sample
  • Positive Patient
  • Healthcare Worker
  • Klebsiella Pneumoniae
  • Molecular Typing

Antimicrobial Resistance & Infection Control

ISSN: 2047-2994

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