title: Beta-lactamase patterns and betalactam/clavulanic acid resistance in Escherichia coli isolated from fecal samples from healthy volunteers.
abstract: Fecal specimens from 50 healthy volunteers living in Izmir, Turkey, were examined for the presence of beta-lactamase producing Escherichia coli by selection on agar plates containing ampicillin (10 mg/L). Thirty-nine (78%) of the strains were ampicillin-resistant and ampicillin MIC50 values for these isolates were > or =1024 microg/ml (range 32- > or =1024 microg/ml). Ampicillin MIC values remained above 64 microg/ml in 16 (41%) strains despite addition of clavulanic acid (2 mg/L). Beta-lactamase production of the clavulanate-resistant strains was further investigated by analytical isoelectric focusing (pI). Enzymes with pIs of 5.4, 5.6, 7.4, 7.6 and >8.5 were detected. Sixty-nine percent of the isolates produced a pI 5.4 enzyme that cofocused with TEM-1. Beta-lactamase assays revealed that hyperproduction of these enzymes was the predominant mechanism for clavulanate resistance. Twelve (75%) of the isolates were able to transfer their ampicillin resistance. The ampicillin and ampicillin plus clavulanic acid MIC values of all transconjugants were above 256 microg/ml. Transferable ampicillin resistance was associated with resistance to other antibacterials at the following frequencies: tetracycline 92%, trimethoprim 83%, streptomycin 50%, gentamicin 25%, and chloramphenicol 8%. In conclusion, it has been suggested that commensal bacteria in normal populations make up the largest reservoir of antibiotic-resistant genes. Although the exact molecular mechanisms could not be determined, the current study shows that the incidence of ampicillin and clavulanic acid resistance is also high in commensal fecal flora.
authors.affiliation: Dokuz Eylül University, School of Medicine, Department of Microbiology and Clinical Microbiology, Inciralti, Izmir, Turkey.
authors.forename: Z
authors.initials: Z
authors.lastname: Gulay
authors.forename: M
authors.initials: M
authors.lastname: Bicmen
authors.forename: S G
authors.initials: SG
authors.lastname: Amyes
authors.forename: N
authors.initials: N
authors.lastname: Yulug
mesh_terms: D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D019818:Clavulanic Acid / Q000494:pharmacology*; D003227:Conjugation, Genetic / Q000235:genetics; D004926:Escherichia coli / Q000187:drug effects* / Q000201:enzymology* / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology; D006801:Humans; D007525:Isoelectric Focusing; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance / Q000235:genetics / Q000502:physiology; D010406:Penicillins / Q000494:pharmacology; D010641:Phenotype; D010957:Plasmids / Q000235:genetics; D018440:beta-Lactam Resistance / Q000235:genetics / Q000502:physiology*; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D019818:Clavulanic Acid; D000667:Ampicillin; D001618:beta-Lactamases