Razazi et al reported a number of risk factors associated with a patient in the intensive care unit (ICU) being colonized with an extended-spectrum beta-lactamase (ESBL) producing Enterobacteria. These can help to identify a patient who may benefit from surveillance and targeted therapy. The authors are from CHU Henri Mondor and Institut Pasteur in France.

Patient selection: adults admitted to medical ICU


Method of detection of ESBL producing Enterobacteria: rectal swab on admission


Risk factors for colonization:

(1) transfer from another ICU

(2) history of hospital admission in another country

(3) history of surgery within the past year

(4) history of prior therapy with a third generation cephalosporin within the 3 to 12 months prior to ICU admission

(5) history of neurologic disease


While 15% of patients were found to be colonized with ESBL-producing Enterobacteria on admission to the ICU, relatively few developed an infection by an ESBL-producing bacteria. These patients can serve to contaminate the ICU and other patients.

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