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

Am J Infect Control. 2012 Nov;40(9):845-8. doi: 10.1016/j.ajic.2011.10.007. Epub 2012 Feb 9.

Abstract

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. Klebsiella spp was the most frequent species isolated (16, 89%), whereas E coli and Citrobacter freundii were 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 Klebsiella carriage/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 Klebsiella than ESBL-producing E coli. Reinforcing hygiene measures around ESBL-producing Klebsiella might be necessary to reduce the spread of ESBL-PE in hospital environments.

MeSH terms

  • Carrier State / microbiology
  • Child
  • Child, Preschool
  • Citrobacter freundii / enzymology
  • Citrobacter freundii / isolation & purification
  • Enterobacteriaceae Infections / microbiology*
  • Environmental Microbiology*
  • Escherichia coli / enzymology*
  • Escherichia coli / isolation & purification*
  • Humans
  • Klebsiella / enzymology*
  • Klebsiella / isolation & purification*
  • Patients' Rooms
  • Prospective Studies
  • beta-Lactamases / metabolism*

Substances

  • beta-Lactamases