title: No evidence so far for the dissemination of carbapenemase-producing Enterobactericeae in the community in Switzerland.
abstract: BACKGROUND
  Carbapenemase-producing Enterobacteriaceae represent an increasing threat to public health and to the treatment of serious nosocomial infections. The aim of this study was to screen for the presence of carbapenemase-producing Enterobacteriaceae in human carriers in community settings in Switzerland, a country representative of central Europe.
  
  
  RESULTS
  Three hundred and fourteen stool samples of healthy staff members of a meat-processing company and 291 fecal swabs from primary care patients were recovered in Switzerland between April 2012 and July 2012 and were tested for carbapenemase-producing Enterobacteriaceae isolates by selecting for growth on a carbapenem-containing selective medium. Six resulting isolates (5 Escherichia coli and 1 Citrobacter youngae) were subjected to antimicrobial susceptibility tests and PCR analysis by screening for the carbapenemase genes bla OXA-48, bla VIM, bla NDM-1, and bla KPC as well as for the extended-spectrum ß-lactamase genes bla TEM, bla SHV, bla CTX-M and bla CMY-2. No carbapenemase genes were detected. Resistance to ß-lactam antibiotics was due to carriage of the extended-spectrum ß-lactamase CTX-M-15 in 4 isolates, to CTX-M-14 in one further isolate and to the plasmidic AmpC-ß-lactamase CMY-2 in one isolate.
  
  
  CONCLUSIONS
  These results show that carbapenemase-producing Enterobacteriaceae are as yet not present in the community. Continuous surveillance is necessary to anticipate future trends in the prevalence and dissemination of carbapenem resistant isolates in the population.
authors.affiliation: National Centre for Enteropathogenic Bacteria and Listeria, Institute for Food Safety and Hygiene, Vetsuisse Faculty University of Zurich, Winterthurerstrasse 272, 8057 Zurich, Switzerland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Nüesch-Inderbinen
authors.affiliation: National Centre for Enteropathogenic Bacteria and Listeria, Institute for Food Safety and Hygiene, Vetsuisse Faculty University of Zurich, Winterthurerstrasse 272, 8057 Zurich, Switzerland.
authors.forename: Katrin
authors.initials: K
authors.lastname: Zurfluh
authors.affiliation: National Centre for Enteropathogenic Bacteria and Listeria, Institute for Food Safety and Hygiene, Vetsuisse Faculty University of Zurich, Winterthurerstrasse 272, 8057 Zurich, Switzerland.
authors.forename: Herbert
authors.initials: H
authors.lastname: Hächler
authors.affiliation: National Centre for Enteropathogenic Bacteria and Listeria, Institute for Food Safety and Hygiene, Vetsuisse Faculty University of Zurich, Winterthurerstrasse 272, 8057 Zurich, Switzerland.
authors.forename: Roger
authors.initials: R
authors.lastname: Stephan
keywords: Carbapenemase; Dissemination; Enterobacteriaceae; Healthy carriers