title: Extended-spectrum beta-lactamase-producing Enterobacteriaceae in different environments (humans, food, animal farms and sewage).
abstract: OBJECTIVE
  This study aimed to determine the presence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in different environments.
  
  
  METHODS
  Clinical samples and stool samples from animal farms, sewage, human faecal carriers attending the emergency room and faecal carriers in the context of food-borne disease outbreaks were subcultured onto MacConkey agar supplemented with cefotaxime for the detection of ESBL-producing Enterobacteriaceae. Identification, susceptibility pattern and ERIC-PCR were used for clone delineation in each sample. Community consumption of antibiotics was also recorded.
  
  
  RESULTS
  An ESBL-producing Enterobacteriaceae prevalence of 1.9% was observed in human infections. A cross-sectional survey of human faecal carriers in the community showed a general prevalence of 6.6% with a temporal distribution. High use of antibiotics in winter coincided with a lower prevalence in carriers. ESBL-producing Enterobacteriaceae were detected in the five samples of human sewage, in samples from 8 of 10 pig farms, 2 of 10 rabbit farms, from all 10 poultry farms and in 3 of 738 food samples studied. Faecal carriage of ESBL-producing Enterobacteriaceae was detected in samples from 19 of 61 food-borne outbreaks evaluated. All food-borne outbreaks were due to enteropathogens. The prevalence of carriers in these outbreaks ranged from 4.4% to 66.6%.
  
  
  CONCLUSIONS
  This widespread occurrence of ESBL-producing Enterobacteriaceae suggests that the community could act as a reservoir and that food could contribute to the spread of these strains.
authors.affiliation: Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Spain.
authors.forename: Raúl Jesús
authors.initials: RJ
authors.lastname: Mesa
authors.forename: Vanessa
authors.initials: V
authors.lastname: Blanc
authors.forename: Anicet R
authors.initials: AR
authors.lastname: Blanch
authors.forename: Pilar
authors.initials: P
authors.lastname: Cortés
authors.forename: Juan José
authors.initials: JJ
authors.lastname: González
authors.forename: Susana
authors.initials: S
authors.lastname: Lavilla
authors.forename: Elisenda
authors.initials: E
authors.lastname: Miró
authors.forename: Maite
authors.initials: M
authors.lastname: Muniesa
authors.forename: Montserrat
authors.initials: M
authors.lastname: Saco
authors.forename: Ma Teresa
authors.initials: MT
authors.lastname: Tórtola
authors.forename: Beatriz
authors.initials: B
authors.lastname: Mirelis
authors.forename: Pere
authors.initials: P
authors.lastname: Coll
authors.forename: Montserrat
authors.initials: M
authors.lastname: Llagostera
authors.forename: Guillem
authors.initials: G
authors.lastname: Prats
authors.forename: Ferran
authors.initials: F
authors.lastname: Navarro
mesh_terms: D000383:Agriculture; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D005516:Food Microbiology; D006801:Humans; D011200:Poultry / Q000382:microbiology; D011817:Rabbits / Q000382:microbiology; D012621:Seasons; D012722:Sewage / Q000382:microbiology*; D013030:Spain / Q000453:epidemiology; D013552:Swine / Q000382:microbiology; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D012722:Sewage; D001618:beta-Lactamases