Fecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae in Korean community and hospital settings.
OBJECTIVE
The assessment and early recognition of risk factors for infections due to extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are important for infection control and proper treatment. The aim of the present study was to investigate the prevalence of fecal carriage of ESBL-E in healthy individuals and hospitalized high-risk patients in Korea and to compare the characteristics of ESBL-E in these two groups.


METHODS
A total of 384 samples from 290 healthy individuals and 94 high-risk patients were collected. The screening of ESBL-E was performed using a commercial chromogenic medium. Bacterial identification and antibiotic susceptibility testing were performed using the Vitek 2 system.


RESULTS
The prevalence of ESBL-E carriage was 20.3 % in healthy individuals and 42.5 % in high-risk patients. Escherichia coli comprised a large majority (96.6 %) of the isolates from healthy individuals, but Klebsiella pneumoniae was more commonly detected (45.0 %) in high-risk patients than in healthy individuals. K. pneumoniae isolates exhibited significantly higher resistance to ceftazidime, ampicillin, and carbapenem, and E. coli exhibited higher resistance to cefotaxime. E. coli from high-risk patients exhibited significantly higher resistance to levofloxacin and cefepime than that from healthy individuals.


CONCLUSIONS
We demonstrated the high prevalence of ESBL-E carriage in Korea and clarified the characteristics of ESBL-E carriage in healthy individuals and high-risk patients. The distribution and antibiotic susceptibility of colonizing ESBL-E were different between the group of healthy individuals and the high-risk patients. Active surveillance of ESBL-E carriage is suggested for infection control, and the use of chromogenic agar appears to be an efficient method.
Department of Laboratory Medicine, Konkuk University School of Medicine, Konkuk University Hospital, 4-12, Hwayang-dong, Seoul, 143-729, Korea.
Y J
YJ
Ko
H-W
HW
Moon
M
M
Hur
C-M
CM
Park
S E
SE
Cho
Y-M
YM
Yun
D000328:Adult; D000368:Aged; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000453:epidemiology; D004755:Enterobacteriaceae / Q000302:isolation & purification / Q000378:metabolism*; D004756:Enterobacteriaceae Infections / Q000175:diagnosis* / Q000453:epidemiology; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D001618:beta-Lactamases / Q000096:biosynthesis*
D001618:beta-Lactamases