title: Analysis of risk factors for a high prevalence of extended-spectrum {beta}-lactamase-producing Enterobacteriaceae in asymptomatic individuals in rural Thailand.
abstract: The prevalence of and risk factors associated with extended-spectrum β-lactamase (ESBL)-producing micro-organisms have not been well studied in healthy individuals. The aim of this study was to determine this in healthy individuals in Thailand. Stool samples and questionnaires obtained from 445 participants from three provinces in Thailand were analysed. The antimicrobial susceptibility of the isolates was assessed using phenotypic and genotypic methods. PCR analysis was performed to detect and group the bla(CTX-M) genes. The prevalence of CTX-M-type ESBL-producing Enterobacteriaceae in the three provinces was as follows: 29.3 % in Nan (43/147), 29.9 % in Nakhon Si Thammarat (43/144) and 50.6 % in Kanchanaburi (78/154) (P<0.001). Of the 445 samples, 33 (7.4 %), 1 (0.2 %) and 127 (28.5 %) isolates belonged to the bla(CTX-M) gene groups I, III and IV, respectively. Escherichia coli was the predominant member of the Enterobacteriaceae producing CTX-M-type ESBLs (40/43, 39/43 and 70/78 isolates in Nan, Nakhon Si Thammarat and Kanchanaburi, respectively). No statistically significant association was observed between the presence of ESBL-producing bacteria and gender, age, education, food habits or antibiotic usage. However, the provinces that had the highest prevalence of ESBL-producing Enterobacteriaceae also had the highest prevalence of use and purchase of antibiotics without a prescription. Thus, this study revealed that faecal carriage of ESBL-producing Enterobacteriaceae is very high in asymptomatic individuals in Thailand, with some variations among the provinces. This high prevalence may be linked to antibiotic abuse.
authors.affiliation: Department of Bioinformatics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Ulzii-Orshikh
authors.initials: UO
authors.lastname: Luvsansharav
authors.affiliation: International Center for Medical Research and Treatment, Kobe University Graduate School of Medicine, Kobe, Japan.|Department of Bioinformatics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Itaru
authors.initials: I
authors.lastname: Hirai
authors.affiliation: Department of Bioinformatics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Marie
authors.initials: M
authors.lastname: Niki
authors.affiliation: Department of Bioinformatics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Department of Nursing, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Makimoto
authors.affiliation: Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: Chalit
authors.initials: C
authors.lastname: Komalamisra
authors.affiliation: Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: Wanna
authors.initials: W
authors.lastname: Maipanich
authors.affiliation: Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: Teera
authors.initials: T
authors.lastname: Kusolsuk
authors.affiliation: Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: Surapol
authors.initials: S
authors.lastname: Sa-Nguankiat
authors.affiliation: Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: Somchit
authors.initials: S
authors.lastname: Pubampen
authors.affiliation: International Center for Medical Research and Treatment, Kobe University Graduate School of Medicine, Kobe, Japan.|Department of Bioinformatics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D058345:Asymptomatic Infections / Q000453:epidemiology; D001483:Base Sequence; D004269:DNA, Bacterial / Q000235:genetics / Q000302:isolation & purification; D004755:Enterobacteriaceae / Q000145:classification / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D005260:Female; D005798:Genes, Bacterial; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D013785:Thailand / Q000453:epidemiology; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D001618:beta-Lactamases