BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae pose an increasing challenge in hospitals. AIM: To describe the benefits of using molecular techniques to investigate the spread of ESBL-producing @entity3274 (ESBL-KP) within a tertiary referral centre. METHODS: Following the identification of a cluster of five ESBL-KP on one ward, a hospital-wide retrospective epidemiological investigation was undertaken into the incidence and spread of these organisms. @entity13974 tandem repeat (VNTR) profiles were used to assign @entity1 to possible clusters. @entity1 outcome and length of hospital stay were reviewed. Locations of @entity1 assigned to each cluster were investigated as possible sources of spread. Antimicrobial prescribing practices and hand hygiene compliance on affected wards were also reviewed. FINDINGS: Twenty-four ESBL-KP isolates were characterized by VNTR. The mean length of stay was 102.5 days for @entity1 with ESBL-KP, which was significantly longer compared with the mean length of stay for all @entity1 (10.1 days, P  <  0.01). Nineteen @entity1 were assigned to clusters with shared VNTR profiles. Review of @entity1 transfer histories identified two instances where cross-transmission may have occurred. In both cases, compliance with good hand hygiene practice and antimicrobial prescribing was suboptimal. CONCLUSION: Molecular typing provided a valuable insight into the clones of ESBL-KP circulating within the study institution. Increased surveillance to identify colonization among @entity1 and routine typing of isolates should be considered, but the resource implications for @entity1 isolation are considerable.

What may be lurking in the hospital undergrowth? Inapparent cross-transmission of extended-spectrum beta-lactamase-producing XXXX .

@entity3274 :: ('573', 'Species') :: ['Klebsiella pneumoniae'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'Patient'] @entity13974 :: ('MESH:C537362', 'Disease') :: ['Variable number']
@entity3274 :: (573,Species) :: ['Klebsiella pneumoniae']
