High prevalence of fecal carriage of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a pediatric unit in Madagascar

BMC Infectious Diseases

Research Article

Honoré Raobijaona¹  Todisoa Andriatahina¹  Vincent Richard²  Antoine Talarmin²  Eliosa Ratsima Hariniana²  Frédérique Randrianirina²  Yves Buisson³ 

[1] Hôpital Joseph Raseta Befelatanana, Antananarivo, Madagascar;Institut Pasteur, Antananarivo, Madagascar;Institut de la Francophonie pour la Médecine Tropicale, Ventiane, Laos;

关键词: Nosocomial Infection;    Amikacin;    Imipenem;    Clavulanic Acid;    Gram Negative Bacillus;   

DOI  :  10.1186/1471-2334-10-204

 received in 2009-07-02, accepted in 2010-07-12,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundExtended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae have spread worldwide but there are few reports on carriage in hospitals in low-income countries. ESBL-producing Enterobacteriaceae (ESBL-PE) have been increasingly isolated from nosocomial infections in Antananarivo, Madagascar.Methodswe conducted a prevalence survey in a pediatric unit from March to April 2008 Patient rectal swabs were sampled on the first and the last day of hospitalization. Medical staff and environment were also sampled. Rectal and environmental swabs were immediately plated onto Drigalski agar supplemented with 3 mg/liter of ceftriaxon.ResultsFecal carriage was detected in 21.2% of 244 infants on admission and 57.1% of 154 on discharge, after more than 48 hours of hospitalization (p < 0.001). The species most frequently detected on admission were Escherichia coli and Klebsiella pneumoniae (36.9%), whereas, on discharge, K. pneumoniae was the species most frequently detected (52.7%). ESBL-associated resistances were related to trimethoprim-sulfamethoxazole (91.3%), gentamicin (76.1%), ciprofloxacin (50.0%), but not to amikacin and imipenem. The increased prevalence of carriage during hospitalization was related to standard antimicrobial therapy.ConclusionThe significant emergence of multidrug-resistant enteric pathogens in Malagasy hospitals poses a serious health threat requiring the implementation of surveillance and control measures for nosocomial infections.

【 授权许可】

Unknown   
© Andriatahina et al; licensee BioMed Central Ltd. 2010. 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.