Enterobacteria Producing Extended Spectrum Beta- Lactamases : 74 Cases in a General Hospital in France

Abstract

Antibiotics used to treat zoonoses, such as campylobacteriosis and salmonellosis become less effective, new data from the European center for Disease Prevention and Control (ECDC) confirm this observation. Enterobacteria are the most common causes of community or nosocomial infections. Some of them produce beta-lactamases extended spectrum (ESBL) frequently associated with resistance to antibiotics. We conduct a retrospective study from positive levies of enterobacteria ESBL identified in adult patients hospitalized at the Quimper hospital, during the year 2016. 74 patients (48women) median age 80 years were included. 30% lifed in an institution, 21% had an history of infection of EBLSE, 62% had urinary tract infection, 12% intraabdominal infection, 9% respiratory infections. Distribution of Enterobacteriaceae was: E. coli (73%), E.cloacae complex (16%), K.pneumoniae (5.4%), Citrobacter freundii (2.7%), Citrobacter koseri(1.4%), Salmonella enterica (1.4%). Sensitivity profiles of antibiotics strains are presented. The strategies of antibiotic therapy are detailed and discussed. The most used molecule was ceftriaxone for probalistic treatment then fluoroquinolone, carbapenems and amoxicillinclavulanate for second line. The evolution was favorable for 64 patients, 8 deaths, 6 serious complications were notified.