Extended-spectrum beta-lactamases, what is the risk in pediatric oncology?

Extended-spectrum beta-lactamases producing Enterobacteriaceae (ESBLE-PE), first described in 1980, are now endemic worldwide. Commensalism and plasmidic borne resistance were key factors to allow this spread, which was accelerated by antibiotic consumptions (mainly 3rd generation cephalosporins and fluoroquinolones). Frequent co-resistance, broad-spectrum activity. against beta-lactamases, and high frequency of infections caused by Enterobacteriacae, make ESBLE-PE a terrible foe in healthcare settings. Any kind of setting is involved, in particular settings with patients requiring intensive care and high antibiotic consumptions. This mechanism of resistance is extremely worrying in oncology and haematology settings where immunosuppression exposes patients to an important risk of secondary infection. Through this manuscript, we aimed to review the historical aspects of ESBL-PE, present updated epidemiological data, and define risk factors for ESBL-PE colonisation and infection in paediatric onco-hematology settings. We also described preventive measures to control the spread of ESBL-PE and therapeutic options. (C) 2016 Elsevier Masson SAS. All rights reserved.