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Multiresistant CTX-M-15 ESBL-producing Escherichia coli in southern Sweden: Description of an outbreak

Rolf Alsterlund1, Barbro Carlsson, Lena Gezelius

  • 1Department of Infectious Diseases, Central Hospital, Kristianstad, Sweden. rolf.alsterlund@skane.se

Scandinavian Journal of Infectious Diseases
|April 28, 2009
PubMed

Insights

A 2005-2006 outbreak of multiresistant Escherichia coli producing CTX-M-15 ESBL in Sweden highlighted prolonged patient carriage. Strict infection control is crucial to prevent future outbreaks of these resistant bacteria.

Area of Science:

  • Microbiology
  • Epidemiology
  • Infectious Diseases

Background:

  • An outbreak of multiresistant Escherichia coli producing CTX-M-15 extended-spectrum beta-lactamase (ESBL) occurred in southern Sweden (2005-2006).
  • The outbreak involved 27 cases linked to an infectious diseases ward and a long-term care facility.

Purpose of the Study:

  • To investigate the epidemiology of the ESBL-producing Escherichia coli outbreak for control.
  • To determine the duration of carriage of multiresistant ESBL-producing Escherichia coli in affected patients.
  • To measure the prevalence of ESBL-producing bacteria in patients admitted to the infectious diseases ward.

Main Methods:

  • Epidemiological investigation and microbiological analysis, including PFGE typing.
  • Follow-up sampling to assess the duration of bacterial carriage.
  • Surveillance of patients admitted to the infectious diseases ward.

Main Results:

  • The source of the outbreak was not identified.
  • Carriage time of multiresistant Escherichia coli was longer than previously reported, with one patient carrying for 33 months.
  • 2.5% of patients admitted to the ward in autumn 2006 carried ESBL-producing enterobacteria.

Conclusions:

  • Prolonged carriage of ESBL-producing Escherichia coli poses a significant risk for recurrent outbreaks.
  • Reinforced infection control measures are essential to mitigate the spread of these resistant bacteria.
  • The study identified a notable prevalence of ESBL-producing enterobacteria in a hospital setting.

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