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Journal of Clinical Microbiology, June 2001, p. 2184-2190, Vol. 39, No. 6
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.6.2184-2190.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Coexistence of SHV-4- and TEM-24-Producing Enterobacter aerogenes Strains before a Large Outbreak of TEM-24-Producing Strains in a French Hospital

H. Mammeri,1,* G. Laurans,1 M. Eveillard,1 S. Castelain,2 and F. Eb1

Laboratories of Bacteriology-Hygiene1 and Virology,2 University Hospital, Amiens, France

Received 23 October 2000/Returned for modification 30 December 2000/Accepted 9 April 2001

In 1996, a monitoring program was initiated at the teaching hospital of Amiens, France, and carried out for 3 years. All extended-spectrum beta -lactamase (ESBL)-producing Enterobacter aerogenes isolates recovered from clinical specimens were collected for investigation of their epidemiological relatedness by pulsed-field gel electrophoresis and enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) and determination of the type of ESBL harbored by isoelectric focusing and DNA sequencing. Molecular typing revealed the endemic coexistence, during the first 2 years, of two clones expressing, respectively, SHV-4 and TEM-24 ESBLs, while an outbreak of the TEM-24-producing strain raged in the hospital during the third year, causing the infection or colonization of 165 patients. Furthermore, this strain was identified as the prevalent clone responsible for outbreaks in many French hospitals since 1996. This study shows that TEM-24-producing E. aerogenes is an epidemic clone that is well established in the hospital's ecology and able to spread throughout wards. The management of the outbreak at the teaching hospital of Amiens, which included the reinforcement of infection control measures, failed to obtain complete eradication of the clone, which has become an endemic pathogen.

* Corresponding author. Mailing address: Laboratoire de Bactériologie-Hygiène, C.H.U. Nord, 80054 Amiens Cédex 01, France. Phone: 03.22.66.84.30. Fax: 03.22.66.84.98. E-mail: bacteriologie{at}chu-amiens.fr.

Journal of Clinical Microbiology, June 2001, p. 2184-2190, Vol. 39, No. 6
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.6.2184-2190.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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