DISSEMINATION OF EXTENDED-SPECTRUM BETA-LACTAMASE PRODUCING ENTEROBACTERIACEAE IN CHILDREN

Extended -spectrum beta-lactamase producing Enterobacteriaceae (EESBL), have been considered important nosocomial pathogens during the last decades. Nowadays community dissemination of this resistance threat is a reality, namely, in particular niches, as old people care settings. Fecal colonization of healthy people is a reality that might compromise effective infection control in acute care hospitals and long term care facilities and in that way, screening of extended -spectrum beta-lactamase producing Enterobacteriaceae carriers on hospital admission, might be of importance in outbreak prevention in particular wards. Other resistance genes are also dispersed in parallel most of the times horizontally and multi -resistance is a reality in these isolates. Contribution of animals, domestic and wild, for dissemination is another link that has already been addressed, showing inter -species transmission of these multi- -resistant strains from human to animal and vice versa. Another contribution for dispersion might be food products. Fecal colonization of children with Extended -spectrum betalactamase producing Enterobacteriaceae, is a reality already reported in Portugal, that might compromise paediatric hospital admission and treatment of infection by these strains. This reality should be addressed in community clinical practice once it has consequences in terms of adequate empirical treatment, namely in urinary tract infections, by these strains, because of restriction of active antibiotics. Also, hospital admission of particular population settings should consider the possibility of extendedspectrum beta -lactamase producing Enterobacteriaceae fecal colonization, namely children. This is a new Public Health challenge for clinicians, microbiology laboratories, hospitals and the health care setting, in general