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This article is part of the supplement: International Conference on Prevention & Infection Control (ICPIC 2011)

Open Access Poster presentation

Prevalence of carriage of ESBL producing enterobacteriaceae in a Dutch teaching hospital

G Moen*, I Willemsen, M Kluytmans, C Verhulst and J Kluytmans

  • * Corresponding author: G Moen

Author Affiliations

Amphia Ziekenhius, Breda, Netherlands

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BMC Proceedings 2011, 5(Suppl 6):P133  doi:10.1186/1753-6561-5-S6-P133

The electronic version of this article is the complete one and can be found online at:

Published:29 June 2011

© 2011 Moen et al; licensee BioMed Central Ltd.

This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction / objectives

The prevalence of Extended Spectrum Beta-Lactamase producing Enterobacteriaceae (ESBL-E) is rapidly increasing worldwide. This study aimed to determine the prevalence of ESBL-E carriage in hospitalised patients and the relative contribution of nosocomial acquisition.


In November 2010, a prevalence survey was performed in all patients that were hospitalised in a Dutch teaching hospital by taking rectal swabs. Swabs were placed in a selective broth and incubated overnight. A subculture on a selective agar (EbSA,Cepheid) was performed. Species identification and susceptiblity testing was performed for all isolates that grew on the EbSA agar using Vitek 2 (bioMérieux). For ESBL-suspected isolates (MIC ceftazidime and/or cefotaxime >1 ug/ml) the presence of ESBL was confirmed using the combined disk diffusion method for cefotaxime and ceftazidime, both with and without clavulanic acid (Rosco). Raman Spectroscopy (SpectraCell RA) was used to determine the similarity between the ESBL-E isolates.


Rectal swabs were obtained from 559 of 668 (84%) hospitalised patients. The prevalence of ESBL-E carriage was 4,5 % (25/559). E. coli was the predominant species (96%). Age, sex, stay on the ICU, and length of hospital stay were not statistical significantly associated with ESBL-E carriage. Raman Spectroscopy revealed that 88% (22/25) of ESBL-E were unique isolates. One cluster of three patients was identified, and two of these patients could be epidemiologically linked.


In conclusion, the observed prevalence of ESBL-E carriage of 4.5% in hospitalised patients is unexpectedly high considering the previously reported ESBL-E rates in the Netherlands. Only one case of nosocomial transmission was found, indicating the presence of an extensive and diverse reservoir of ESBL-E in the community.

Disclosure of interest

None declared.