Faecal carriage of multidrug-resistant Gram-negative bacilli during a non-outbreak situation in a French university hospital

J Antimicrob Chemother. 2010 Nov;65(11):2455-8. doi: 10.1093/jac/dkq333. Epub 2010 Sep 2.


Objectives: To determine the prevalence of multidrug-resistant (MDR) Gram-negative bacilli and extended spectrum β-lactamase (ESBL)-producing isolates in stool specimens obtained from patients hospitalized for acute diarrhoea in a French university hospital.

Methods: Bacteria in stool specimens were screened for ESBL production on Drigalski agar supplemented with ceftazidime, ESBL CHROMagar(®) and CTX CHROMagar(®) media and confirmed by the double-disc synergy test. Genetic detection was performed by PCR and sequencing with bacterial DNA extracted from isolates.

Results: The presence of MDR bacteria was markedly high (96 of 303 patients, 31.7%). The majority of MDR bacteria were Enterobacter cloacae (44, 38%) and Escherichia coli (32, 28%). Moreover, the prevalence of ESBL and CTX-M producers among all included patients was 15.8% and 5.9%, respectively. The clone E. coli O25b : H4-ST131 was detected in 63% of CTX-M strains. Surprisingly, 16 carbapenemases (5.3% of patients) were isolated.

Conclusions: The study revealed the wide dissemination of MDR bacteria, including carbapenemase producers, in a French hospital during a non-outbreak situation. Public health efforts to combat emergence and dissemination of MDR organisms need to be developed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carrier State / epidemiology*
  • Child
  • Child, Preschool
  • DNA, Bacterial / genetics
  • Diarrhea / microbiology
  • Drug Resistance, Multiple, Bacterial*
  • Feces / microbiology*
  • Female
  • France
  • Gram-Negative Bacteria / drug effects*
  • Gram-Negative Bacteria / enzymology
  • Gram-Negative Bacteria / isolation & purification*
  • Gram-Negative Bacterial Infections / epidemiology*
  • Hospitalization
  • Hospitals, University
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Microbial Sensitivity Tests / methods
  • Middle Aged
  • Polymerase Chain Reaction / methods
  • Young Adult
  • beta-Lactamases / biosynthesis*
  • beta-Lactamases / genetics


  • DNA, Bacterial
  • beta-Lactamases