Meningitis Caused by Escherichia coli Producing TEM-52 Extended-Spectrum β-Lactamase within an Extensive Outbreak in a Neonatal Ward: Epidemiological Investigation and Characterization of the Strain

摘要: Outbreaks caused by Enterobacteriaceae isolates producing extended-spectrum -lactamases (ESBL) in neonatal wards can be difficult to control. We report here an extensive outbreak a ward with case of meningitis ESBL-producing Escherichia coli strain. Between 24 March and 29 April 2009, among the 59 neonates present ward, 26 E. rectal colonization were detected (44%). One colonized developed favorable outcome after treatment combining imipenem, gentamicin, ciprofloxacin. Despite strict intensification hygiene isolation procedures for more than 1 month, closure new admissions was necessary control outbreak. Randomly amplified polymorphic DNA pulsed-field gel electrophoresis analysis performed on 31 recovered from two mother’s milk samples showed clonal ESBL PCR assays indicated that strain harbored TEM-52 encoded IncI1 replicon. Phylogenetic multilocus sequence typing belonged rare phylogenetic group C, which is closely related B1 but appears as A triplex phylogrouping method. The virulence genes fuyA, aer, iroN virulent mouse model septicemia. This work indicates high potential colonization, transmission, some clones.