title: Low-level antimicrobial resistance of Enterobacteriaceae isolated from the nares of pig-exposed persons.
abstract: Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) have recently emerged in livestock and humans. Therefore, this study assessed the carriage of Enterobacteriaceae in the anterior nares and associated antimicrobial resistance in pig-exposed persons. Nasal swabs were enriched in non-selective broth and then plated on MacConkey and ESBL-selective agars. Species was confirmed by matrix-assisted laser-desorption ionization-time-of-flight mass spectrometry (MALDI-ToF MS). Antimicrobial susceptibility testing was performed according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. Of 114 pig-exposed persons tested, Enterobacteriaceae were detected in the nares of 76 (66·7%) participants. The predominant species were Proteus mirabilis (n = 17, 14·9%), Pantoea agglomerans (n = 13, 11·4%), Morganella morganii (n = 9, 7·9%), Citrobacter koseri (n = 9, 7·9%), Klebsiella pneumoniae, Escherichia coli and Proteus vulgaris (each n = 8, 7·0%). ESBL-E were not detected. Of all isolates tested, 3·4% were resistant against ciprofloxacin, 2·3% against gentamicin, 23·9% against trimethoprim-sulfamethoxazole and 44·3% against tigecycline. Despite the high prevalence of ESBL-E in livestock, pig-exposed persons did not carry ESBL-E in their nares. This finding is important, because colonization of the nasal reservoir might cause endogenous infections or facilitate transmission of ESBL-E in the general population.
authors.affiliation: Institute of Hygiene,University Hospital Münster,Münster,Germany.
authors.forename: J
authors.initials: J
authors.lastname: Fischer
authors.affiliation: Department of Biometry, Epidemiology and Information Processing,University of Veterinary Medicine Hannover,Hannover,Germany.
authors.forename: K
authors.initials: K
authors.lastname: Hille
authors.affiliation: Institute of Hygiene,University Hospital Münster,Münster,Germany.
authors.forename: A
authors.initials: A
authors.lastname: Mellmann
authors.affiliation: Institute of Medical Microbiology,University Hospital Münster,Münster,Germany.
authors.forename: F
authors.initials: F
authors.lastname: Schaumburg
authors.affiliation: Department of Biometry, Epidemiology and Information Processing,University of Veterinary Medicine Hannover,Hannover,Germany.
authors.forename: L
authors.initials: L
authors.lastname: Kreienbrock
authors.affiliation: Institute of Hygiene,University Hospital Münster,Münster,Germany.
authors.forename: R
authors.initials: R
authors.lastname: Köck
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D004755:Enterobacteriaceae / Q000145:classification / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D055815:Young Adult; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents
keywords: ESBL; Escherichia coli; Germany; farmers; livestock