Prevalence and genetic diversity of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli in nursing homes in Bavaria, Germany.
Main goal of this study was to determine the prevalence and molecular epidemiology of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae among 156 nursing home residents in Bavaria and to compare the results with healthy individuals from the Bavarian community. Intestinal colonisation by ESBL-producing Escherichia coli was detected in 23 nursing home residents (14.7%) using MacConkey agar supplemented with cefotaxime (1mg/L) for screening and the combined disc method for ESBL confirmation. Antimicrobial susceptibility testing revealed co-resistance to ciprofloxacin in 86.9% of the ESBL-producers. All isolates harboured CTX-M-ESBL with CTX-M-15 (65.2%) and CTX-M-27 (21.7%) as the most common types. Moreover, 16 isolates (69.6%) could be assigned by PCR-typing to the epidemic clonal lineage E. coli O25b-ST131. Further typing by rep-PCR and XbaI-macrorestriction with subsequent pulsed-field gel electrophoresis, respectively, revealed that two or more residents shared the same ESBL-producing E. coli clone in four nursing homes. In conclusion, we could show a high prevalence of ESBL-producing E. coli in Bavarian nursing homes (14.7%) compared to the healthy population (6.3%). Although the prevalence of ESBL-type CTX-M-15 in E. coli was similar in nursing home residents (65.2%) and healthy individuals (46%) the presence of E. coli O25b-ST131 clones differed substantially (69.6% and 14.2%, respectively). Furthermore, this study demonstrates that a person-to-person transmission or a common source of infection for ESBL-producing microorganisms may occur in these facilities. Therefore, basic hygiene measures should be assiduously implemented to prevent the further spread of these multidrug-resistant bacteria.
Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany. Electronic address: giuseppe.valenza@lgl.bayern.de.
Giuseppe
G
Valenza
Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany.
Silke
S
Nickel
Robert Koch Institute, FG13 Nosocomial Pathogens and Antibiotic Resistance, Burgstraße 37, 38855 Wernigerode, Germany.
Yvonne
Y
Pfeifer
Robert Koch Institute, FG13 Nosocomial Pathogens and Antibiotic Resistance, Burgstraße 37, 38855 Wernigerode, Germany.
Michael
M
Pietsch
Bavarian Health and Food Safety Authority, Schweinauer Hauptstr. 80, 90441 Nuremberg, Germany.
Elzbieta
E
Voigtländer
Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany.
Verena
V
Lehner-Reindl
Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764 Oberschleißheim, Germany.
Christiane
C
Höller
D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004755:Enterobacteriaceae / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology*; D004926:Escherichia coli / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D014644:Genetic Variation; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D058889:Molecular Typing; D009735:Nursing Homes; D015995:Prevalence; D012307:Risk Factors; D001618:beta-Lactamases / Q000235:genetics*
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases
Antibiotic resistance; CTX-M-15; Colonisation; ST131