Multiple antibiotic-resistant Klebsiella and Escherichia coil in nursing homes.
Context Infections caused by ceftazidime sodium--resistant gram-negative bacteria that harbor extended-spectrum bêta-lactamases (ESBLs) are increasing in frequency in hospitals in the United States.
Objectives To report a citywide nursing home-centered outbreak of infections caused by ESBL-producing gram-negative bacilli and to describe the clinical and molecular epidemiology of the outbreak.
Design Hospital-based case-control study and a nursing home point-prevalence survey.
Molecular epidemiological techniques were applied to resistant strains.
Settings A 400-bed tertiary care hospital and a community nursing home.
Patients Patients who were infected and/or colonized with ceftazidime-resistant Escherichia coil, Klebsiella pneumoniae, or both and controls who were admitted from nursing homes between November 1990 and July 1992.
Main Outcome Measures Clinical and epidemiological factors associated with colonization or infection by ceftazidime-resistant E coil or K pneumoniae ; molecular genetic characteristics of plasmid-mediated ceftazidime resistance.
Results Between November 1990 and October 1992,55 hospital patients infected or colonized with ceftazidime-resistant E coli, Kpneumoniae, or both were identified.
Of the 35 admitted from 8 nursing homes, 31 harbored the resistant strain on admission.
All strains were resistant to ceftazidime, gentamicin, and tobramycin ; 96% were resistant to trimethoprim-sulfamethoxazole and 41% to ciprofloxacin hydrochloride. (...)
Mots-clés Pascal : Klebsiella pneumoniae, Enterobacteriaceae, Bactérie, Escherichia coli, Bactériose, Infection, Hôpital, Colonisation, Exploration, Ceftazidime, Résistance microorganisme, Epidémiologie, Plasmide, Antibiotique, Chimiothérapie, Traitement, Efficacité traitement, Homme, Etats Unis, Amérique du Nord, Amérique, Céphalosporine dérivé, bêta-Lactamines, Maison médicalisée
Mots-clés Pascal anglais : Klebsiella pneumoniae, Enterobacteriaceae, Bacteria, Escherichia coli, Bacteriosis, Infection, Hospital, Colonization, Exploration, Ceftazidime, Microorganism resistance, Epidemiology, Plasmid, Antibiotic, Chemotherapy, Treatment, Treatment efficiency, Human, United States, North America, America, Cephalosporin derivatives, bêta-Lactams
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0130311
Code Inist : 002B02S07. Création : 16/11/1999.