Epidemiology of extended spectrum beta-lactamases (ESBL) Enterobacteriaceae in a General Hospital, South of France, 1999-2007

Purpose of the study. - The global epidemiology of extended spectrum betalactamases (ESBL) producing Enterobacteriaceae has evolved in recent years with the emergence of a new type of ESBL: CTX-M, mainly in Escherichia coli. These CTX-M type producing Enterobacteriaceae are responsible for both nosocomial and, more recently, community infections, including urinary tract infections. The aim of our work is to study ESBL producing Enterobacteriaceae evolution between 1999 and 2007 in the population from the Centre Hospitaller du Pays-d'Aix (CHPA), a general hospital from South of France. Patients and methods. - ESBL producing strains of Enterobacteriaceae isolated in odd years between 1999 and 2007 from clinical isolates of all origins have been phenotypically identified and their ESBL genotyped. Molecular and epidemiological data from our hospital health-care associated infection committee were analyzed. Results. - Two hundred and sixty-two ESBL producing isolates were studied. Within ESBL producing Enterobacteriaceae, Enterobacter aerogenes was predominant in 1999 (48.7% of isolates), and decreased to 18.8% of isolates in 2007. On the other hand, E. coli, which represented 10.5% of ESBL isolates in 1999,. grew up to 37.5% of the isolates in 2007. ESBL prevalence in E. coli increased during this period from 0.3 to 2.5%. Simultaneously, ESBL, predominantly TEM-24 in 1999, were replaced by CTX-M in 2007, among which CTX-M-15 is predominant (88% of CTX-M). Conclusion. - Our study confirms a major change in ESBL epidemiology in CHPA, with the emergence of CTX-M type ESBL, mainly CTX-M 15, and an increase of ESBL prevalence in E. coli. (C) 2012 Elsevier Masson SAS. All rights reserved.