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Background  Device-associated nosocomial infections (DA-NIs), due to MDR  Enterobacteriaceae , are a major threat to patient safety in ICUs. We investigated on Extended-spectrum β-lactamases (ESBL) producing  Enterobacteriaceae  and incidence of integrons in these bacteria isolated from ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infections (CAUTIs) in 18 governmental hospitals in the north of Iran.    Methods  In this cross-section study, the antibiotic susceptibility test was performed using the MIC method; also, phenotypically detection of ESBL-producing bacteria was carried out by the double-disk synergy (DDS) test. Presence of ESBL-related genes and integron Classes 1 and 2 was evaluated by the PCR method.    Results  Out of a total of 205 patients with DA-NIs,  Enterobacteriaceae  were responsible for (72.68%) of infections. The most common DA-NIs caused by  Enterobacteriaceae  were VAP (77.18%), CAUTI (19.46%), and sepsis due to VAP (3.35%). The most frequently  Enterobacteriaceae  were;  Klebsiella pneumoniae  75 (24; 32% ESBL positive),  E. coli  69 (6; 8.69% ESBL positive) and  Enterobacter spp . 5 (5; 100% ESBL positive). Distribution of ESBL-related genes was as follows: bla-SHV (94.3%), bla-CTX (48.6%), bla-VEB (22.9%) and bla-GES (17.14%). The incidence rate of integron class 1 and class 2 was (82.92%) and (2.9%) respectively. Eight types of ESBL-producing bacteria were observed.    Conclusions  Due to the fact that the emergence rate of ESBL  Enterobacteriaceae  is increasing in DA-NIs, co-incidence of different types of ESBL genes with integrons in 75–100% of strains in our study is alarming for clinicians and healthcare safety managers. Therefore, regional and local molecular level estimations of ESBLs that are agents of DA-NIs are critical for better management of empiric therapy, especially for patients in ICUs.    Electronic supplementary material  The online version of this article (doi:10.1186/s13756-016-0143-2) contains supplementary material, which is available to authorized users.

antimicrobial resistance and infection control

Assessment of extended-spectrum β-lactamases and integrons among Enterobacteriaceae in device-associated infections: multicenter study in north of Iran