• Gloria Concepción Huerta-García, Guadalupe Miranda-Novales, Rita Díaz-Ramos, Guillermo Vázquez-Rosales, and Fortino Solórzano-Santos.
• Department of Infectious Diseases, Hospital de Pediatría, Centro Medico Nacional Siglo XXI, IMSS, México D.F, México.
• Rev Invest Clin. 2015 Sep 1; 67 (5): 313-7.

BackgroundMembers of the Enterobacteriaceae family are common agents of nosocomial infections. Intestinal colonization by these microorganisms represents a major step in the development of systemic infection. Extended-spectrum b-lactamase-producing bacteria are usually associated with outbreaks, but endemic infections are common in intensive care units.ObjectiveTo determine the frequency of intestinal colonization with extended-spectrum b-lactamase-producing Enterobacteriaceae in newborns.Patients And MethodsThis was a descriptive cohort study. Newborns from two general hospitals (A and B) in Mexico City were included during a five-month period; those with a hospital stay > 7 days were selected. Fecal samples were obtained by rectal swab on day 7 and every week until discharge. Extended-spectrum b-lactamase production was confirmed in enterobacteria by the Etest. Clonal relatedness was established by pulsed-field gel electrophoresis.Results102 newborns were included; 63/102 (61.7%) were colonized by extended-spectrum b-lactamase-producing Enterobacteriaceae on day 7, 17/21 (81%) on day 14, and 6/8 (75%) on day 21 of hospitalization. Klebsiella pneumoniae was recovered most frequently (75.4%). A predominant clone (95%) was found in hospital B, and a major clone (75%) in Hospital A. Other extended-spectrum b-lactamase-producing Enterobacteriaceae isolates were Enterobacter spp. (16%) and Escherichia coli (7.6%).ConclusionsHigh rates of colonization and horizontal transmission of extended-spectrum b-lactamase-producing Enterobacteriaceae were found in the newborn care units of two general hospitals. Clonal relatedness was identified. Lack of adherence to standard precautions and hand hygiene were determining factors.

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