Emergence of Ges-type extended-spectrum beta-lactamase producing enterobacteriaceae in a pediatric liver transplantation unit
(2009) 27th Annual Meeting of the European Society for Paediatric Infectious Diseases — Location: Brussels (9.June.2009)
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- Backgrounds and aims: Extended-spectrum beta-lactamases (ESBL) producing gram-negative bacteria are isolated with increasing frequency in pediatric populations. We report here for the first time in Belgium the emergence of Enterobacteriaceae carrying GES-type ESBL enzymes in a pediatric ward. Methods: All patients admitted to this 14-bed ward mainly occupied by children hospitalized for liver transplantation were screened for multi-resistant gram negative bacteria in stools additionally to clinical samples. Identification and susceptibility testing of isolates were performed by BD Phoenix® automate and ESBL production was confirmed by double discs synergy test using Rosco® tablets. All phenotypic ESBL-producing strains were characterized by PCR targeting various ESBL genes. Results: From January 2007 to January 2009, of the 2424 samples (562 stools) collected in 520 children, 50 ESBL-producing isolates (prevalence of 9.5%) were recovered including 10 GES-producing strains from 7 patients (6 fecal carriers). The GES ESBLs were found in 6 different Enterobacteriaceae species (two patients were colonized by more than one species) ; all isolates displayed identical resistance patterns. All patients but one were admitted for liver transplantation and originated from different countries of Eastern Europe. Patients and their families also stayed in the same hospital linked residency. Conclusions: The diversity of the species, the multiple origins of the patients and the local clustering together highly suggest both cross-transmission and horizontal gene transfer of these GES plasmid-borne ESBL enzymes. Although no infection was diagnosed, GES ESBL-producing isolates may lead to outbreaks and represent a threat for fragile immunosuppressed patients such as liver transplanted children.
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Huang, T.-D., Bogaerts, P., André, E., Van der Linden, D., Sokal, E., & Glupczynski, G. (2009). Emergence of Ges-type extended-spectrum beta-lactamase producing enterobacteriaceae in a pediatric liver transplantation unit. The Pediatric Infectious Disease Journal, 28(6), 560-e258. https://doi.org/10.1097/INF.0b013e3181a51c24 (Original work published 2009)