High prevalence of faecal carriage of ESBL-producing Enterobacteriaceae in Norwegian patients with gastroenteritis.
We conducted a cross-sectional study to examine the prevalence of faecal carriage of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in patients with gastroenteritis. During April 2011, all faecal samples submitted to our hospital laboratory were examined for ESBL-producing Enterobacteriaceae. Isolates expressing an ESBL phenotype were investigated for the presence of genes encoding broad-spectrum beta-lactamases, ESBLs, carbapenemases, and plasmid-mediated AmpC. Information on age, gender, and travel history was extracted from the laboratory records. In total 273 faecal samples were included. The overall carrier rate in the study population was 15.8%. The ESBL carrier rate among patients with no history of recent travel, or where this information was missing, was 10.3%. In contrast, the carrier rate was 56.3% (odds ratio 16.3, p < 0.001) among patients with a record of travel to Asia. Two ESBL-producing isolates were identified as enteropathogenic Escherichia coli. Co-resistance between third-generation cephalosporins, trimethoprim-sulfamethoxazole, and fluoroquinolones was seen in 49% of isolates. No carbapenemase-producers were found.
From the 1 Department of Microbiology and Infection Control, Akershus University Hospital , Lørenskog.
Silje Bakken
SB
Jørgensen
Orjan
O
Samuelsen
Arnfinn
A
Sundsfjord
Sidra Ahmad
SA
Bhatti
Ingvild
I
Jørgensen
Thusanth
T
Sivapathasundaram
Truls Michael
TM
Leegaard
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D055815:Young Adult; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis
D000900:Anti-Bacterial Agents; D001618:beta-Lactamases
CTX-M; EPEC; ESBL; Escherichia coli; gastroenteritis; multidrug resistance