title: Prevalence and characterization of extended-spectrum beta-lactamases producing Enterobacteriaceae in healthy children and associated risk factors.
abstract: BACKGROUND
  Community acquired infections due to extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) had been increased. The fecal flora of children in the community represents a huge potential reservoir for ESBLs which are located on highly transmissible plasmids. This study examined the prevalence of ESBL-PE fecal carriage, antimicrobial susceptibility pattern, possible risk factors, and characterized the genes encoding these ESBL enzymes in Lebanese children community.
  
  
  METHODS
  A total of 125 rectal swabs were taken from healthy children aged from 1 to 5 years. Detection of ESBLs was carried out using combination-disc method test and multiplex PCR. A questionnaire concerning child's lifestyle and risk factors for ESBL carriage was illustrated.
  
  
  RESULTS
  Thirty-one of 125 participants (24.8 %) carried ESBL-PE. Regular consumption of meat, and chicken were significantly associated with high carriage rate of ESBL-PE, while dairy products (milk, yogurt, cheese) association was non-significant. Intimate hygiene habits were found also affecting the carriage rate. Multiple bla genes were the most common, 48.4 % (15/31) of ESBL-PE carried both bla CTX-M and bla TEM, and 22.6 % (7/31) carried bla CTX-M, bla SHV, and bla TEM, 29 % (9) carried bla CTX-M only. Concerning CTX-M-types, CTX-M-9 was the most predominant (24/31) and mostly in combination with CTX-M-15 type.
  
  
  CONCLUSIONS
  High rate of colonization in healthy children with ESBL-PE was observed, regular consumption of dietary products from animal source (meat or chicken) were associated with this colonization in the community in non-hospitalized children. To our best knowledge it is the first study about regular consumption of dairy product as a risk factor for ESBL-PE community carriage, the first data about the carriage rate of ESBL-PE in community children in Lebanon and Middle East, and for the wide dissemination of CTX-M-9 type in this population.
authors.affiliation: Department of Pharmaceutical Sciences (Pharmaceutical Microbiology), Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon. somayahijazi@yahoo.com.
authors.forename: S M
authors.initials: SM
authors.lastname: Hijazi
authors.affiliation: Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt. ersbfawzi@hotmail.com.
authors.forename: M A
authors.initials: MA
authors.lastname: Fawzi
authors.affiliation: Department of Microbiology and Immunology, Infection Control, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Fatenmostafa_6@hotmail.com.
authors.forename: F M
authors.initials: FM
authors.lastname: Ali
authors.affiliation: Department of Pharmaceutical Sciences (Pharmaceutical Microbiology), Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon. kelgalil@hotmail.com.|Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt. kelgalil@hotmail.com.
authors.forename: K H
authors.initials: KH
authors.lastname: Abd El Galil
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism*; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D002675:Child, Preschool; D004755:Enterobacteriaceae / Q000145:classification / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D006920:Hygiene; D007223:Infant; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D010957:Plasmids / Q000235:genetics / Q000378:metabolism; D015995:Prevalence; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D001426:Bacterial Proteins; D001618:beta-Lactamases
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