Extended-spectrum beta-lactamase-producing bacteria in a tertiary care hospital in Madrid: epidemiology, risk factors and antimicrobial susceptibility patterns.

Abstract

Introduction: Extended-spectrum beta-lactamase (ESBL) producing bacteria have been increasingly reported as causal agents of nosocomial infection worldwide. Resistance patterns vary internationally, and even locally, from one institution to the other. We investigated the clinical isolates positive for ESBL-producing bacteria in our institution, a tertiary care hospital in Madrid (Spain), during a 2-year period (2007-2008).

Methods: Clinical and microbiological data were retrospectively reviewed. Two hundred and nineteen patients were included in the study.

Results: Advanced age, diabetes, use of catheters, previous hospitalization and previous antibiotic treatment were some of the risk factors found among patients. Escherichia coli was the most frequent isolate, and urinary tract the most common site of isolation. Internal Medicine, Intensive Care Unit (ICU) and General Surgery presented the highest number of isolates. There were no outbreaks during the study period. Antibiotic patterns showed high resistance rates to quinolones in all isolates. There was 100% sensitivity to carbapenems.

Conclusion: Carbapenems continue to be the treatment of choice for ESBL-producing bacteria. Infection control measures are of great importance to avoid the spread of these nosocomial infections.