title: Fecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae in community setting in Casablanca.
abstract: BACKGROUND
  The importance of community-acquired infections due to extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) has been increasingly recognized in recent years. This study aimed to determine the prevalence of intestinal carriage of ESBL-PE in the community in Casablanca, Morocco.
  
  
  METHODS
  During 6 months (2013), 93 fecal samples were examined for ESBL-PE. Isolates expressing an ESBL phenotype were investigated for the presence of genes encoding β-lactamases and plasmid-mediated quinolone resistance. Conjugation experiments were done to determine the mobility of ESBL genes.
  
  
  RESULTS
  The prevalence of fecal carriage of ESBL-PE was 4.3% (4/93; 95% CI, 0.2-8.4). Klebsiella pneumoniae (n = 2), Enterobacter cloacae (n = 2), Escherichia coli (n = 1), and Serratia odorifera (n = 1) were the ESBL-producing species. Four (66.7%) of these isolates were multidrug-resistant. The blaSHV-12 (n = 5) was the most frequent ESBL gene detected, followed by blaCTX-M-15 (n = 3).The non-ESBL gene detected was blaTEM-1 (n = 5). One isolate harbored the qnrB1 variant. RESULTS of conjugation experiments indicated that blaSHV-12 + blaTEM-1 + qnrB1 and blaCTX-M-15 + blaTEM-1 genes were co-transferred and that these genes were carried by a conjugative plasmid of high molecular weight (125 kb).
  
  
  CONCLUSIONS
  Our results show the importance of the intestinal tract as a reservoir for ESBL-PE in the community in Morocco.
authors.affiliation: From the Molecular Bacteriology Laboratory, Pasteur Institute of Morocco , Casablanca.
authors.forename: Abouddihaj
authors.initials: A
authors.lastname: Barguigua
authors.forename: Hind
authors.initials: H
authors.lastname: Ouair
authors.forename: Fatima
authors.initials: F
authors.lastname: El Otmani
authors.forename: Rachid
authors.initials: R
authors.lastname: Saile
authors.forename: Naima
authors.initials: N
authors.lastname: El Mdaghri
authors.forename: Mohammed
authors.initials: M
authors.lastname: El Azhari
authors.forename: Mohammed
authors.initials: M
authors.lastname: Timinouni
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State / Q000453:epidemiology*; D002939:Ciprofloxacin / Q000494:pharmacology; D016972:Enterobacter cloacae / Q000187:drug effects / Q000201:enzymology / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000453:epidemiology*; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology / Q000235:genetics; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009018:Morocco; D009643:Norfloxacin / Q000494:pharmacology; D012705:Serratia / Q000187:drug effects / Q000201:enzymology / Q000235:genetics; D055815:Young Adult; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D001618:beta-Lactamases; D009643:Norfloxacin
keywords: Casablanca city; ESBL; Enterobacteriaceae; community; fecal carriage