title: Fecal Carriage of Extended-Spectrum β-Lactamases in Healthy Humans, Poultry, and Wild Birds in León, Nicaragua-A Shared Pool of blaCTX-MGenes and Possible Interspecies Clonal Spread of Extended-Spectrum β-Lactamases-Producing Escherichia coli.
abstract: Antibiotic-resistant bacteria are a major concern in the healthcare of today, especially the increasing number of gram-negative bacteria producing β-lactamases such as extended-spectrum β-lactamases (ESBLs). However, little is known about the relationship of ESBL producers in humans and domestic and wild birds, especially in a low-income setting. Therefore, we studied the fecal carriage of ESBL-producing Escherichia coli and Klebsiella pneumoniae in healthy humans, poultry, and wild birds in the vicinity of León, Nicaragua. Three hundred fecal samples were collected during December 2012 from humans (n = 100), poultry (n = 100) and wild birds (n = 100). The samples were examined for ESBL-producing E. coli and K. pneumoniae, revealing the prevalence of 27% in humans, 13% in poultry, and 8% in wild birds. Further characterization of the ESBL-producing isolates was performed through polymerase chain reaction (PCR) (NDM, CTX-M), epidemiological typing (ERIC2-PCR), multilocus sequence typing, and sequencing. ESBL producers harbored blaCTX-M-2, blaCTX-M-15, blaCTX-M-22, and blaCTX-M-3genotypes. The blaCTX-M-15constituted the absolute majority of ESBL genes among all samples. ERIC-PCR demonstrated highly related E. coli clones among humans, poultry, and wild birds. Clinically relevant E. coli clone ST648 was found in humans and poultry. There is a shared pool of blaCTX-Mgenes between humans and domesticated and wild birds in Nicaragua, and the results suggest shared clones of ESBL-producing E. coli. The study adds to the notion that wild birds and poultry can pick up antibiotic-resistant bacteria of human origin and function as a melting pot of resistance. Structured surveillance programs of antimicrobial resistance and a more regulated prescription of antibiotics are warranted in Nicaragua.
authors.affiliation: 1 Section for Infectious Diseases, Department of Medical Sciences, Uppsala University , Uppsala, Sweden .|2 Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University , Uppsala, Sweden .
authors.forename: Badrul
authors.initials: B
authors.lastname: Hasan
authors.affiliation: 1 Section for Infectious Diseases, Department of Medical Sciences, Uppsala University , Uppsala, Sweden .
authors.forename: Karl
authors.initials: K
authors.lastname: Laurell
authors.affiliation: 1 Section for Infectious Diseases, Department of Medical Sciences, Uppsala University , Uppsala, Sweden .
authors.forename: Mufti Mahmud
authors.initials: MM
authors.lastname: Rakib
authors.affiliation: 1 Section for Infectious Diseases, Department of Medical Sciences, Uppsala University , Uppsala, Sweden .
authors.forename: Erik
authors.initials: E
authors.lastname: Ahlstedt
authors.affiliation: 1 Section for Infectious Diseases, Department of Medical Sciences, Uppsala University , Uppsala, Sweden .|3 School of Natural Sciences, Linnaeus University , Kalmar, Sweden .|4 Kalmar County Hospital , Clinic of Microbiology, Kalmar, Sweden .
authors.forename: Jorge
authors.initials: J
authors.lastname: Hernandez
authors.affiliation: 5 Department of Microbiology, Medical Science Faculty, National Autonomous University of León (UNAN-León) , León, Nicaragua .
authors.forename: Mercedes
authors.initials: M
authors.lastname: Caceres
authors.affiliation: 1 Section for Infectious Diseases, Department of Medical Sciences, Uppsala University , Uppsala, Sweden .|2 Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University , Uppsala, Sweden .
authors.forename: Josef D
authors.initials: JD
authors.lastname: Järhult
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015780:Carbapenems / Q000494:pharmacology; D002353:Carrier State; D002999:Clone Cells; D010856:Columbidae / Q000382:microbiology; D062665:Epidemiological Monitoring; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission / Q000662:veterinary*; D029968:Escherichia coli Proteins / Q000145:classification / Q000235:genetics* / Q000378:metabolism; D046093:Falconiformes / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D015964:Gene Expression Regulation, Bacterial; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission / Q000662:veterinary*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D058885:Multilocus Sequence Typing; D009527:Nicaragua / Q000453:epidemiology; D011200:Poultry / Q000382:microbiology; D017422:Sequence Analysis, DNA; D018440:beta-Lactam Resistance / Q000235:genetics*; D001618:beta-Lactamases / Q000145:classification / Q000235:genetics* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D029968:Escherichia coli Proteins; D001618:beta-Lactamases; C000602253:beta-lactamase CTX-M, E coli
keywords: CTX-M-15; E. coli; ESBL; Nicaragua; environment; wild birds