title: Fecal carriage of extended-spectrum β-lactamase- and AmpC- producing Escherichia coli among healthcare workers.
abstract: BACKGROUND
  Commensal E. coli can be considered a reservoir of genes coding for antibiotic resistance that may be transmitted in hospitals by healthcare workers (HCWs). This study aimed to determine the fecal carriage rate of extended-spectrum β-lactamase (ESBL)-producing E. coli among HCWs.
  
  
  METHODS
  Stool samples were collected from 200 HCWs. Phenotypic screening for ESBL and AmpC β-lactamases was performed using disk diffusion and minimum inhibitory concentration methods followed by the combined disks test and double synergy differential test for confirmation. Multiplex polymerase chain reaction (PCR) was used to detect blaSHV, blaTEM, blaCTX-M, and CIT groups for AmpC genes.
  
  
  RESULTS
  Of 200 E. coli isolates, 100% were susceptible to imipenem, and 59 (29.5%) were resistant to one or more third-generation cephalosporins. By molecular analysis, 21% (42/200) were colonized by ESBL-producing E. coli, and 3% (6/200) were colonized by AmpC-producing E. coli. The blaSHV gene was the predominant ESBL gene, detected in 81.8% of the resistant E. coli isolates.
  
  
  CONCLUSIONS
  These findings highlight the increase in fecal carriage of E. coli carrying ESBL and AmpC genes among HCWs, which may be one of the causes of the spread of ESBL-producing bacteria in hospitals and requires sound infection control measures. This is the first study of the fecal carriage rate of E. coli carrying AmpC genes in HCWs.
authors.affiliation: Faculty of Medicine, Fayoum University, Fayoum, Egypt. rhb00@fayoum.edu.eg.
authors.forename: Rasha H
authors.initials: RH
authors.lastname: Bassyouni
authors.forename: Sylvana Nady
authors.initials: SN
authors.lastname: Gaber
authors.forename: Ahmed Ashraf
authors.initials: AA
authors.lastname: Wegdan
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D005243:Feces / Q000382:microbiology*; D006282:Health Personnel; D006801:Humans; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction; D015995:Prevalence; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D001618:beta-Lactamases