Fecal carriage of extended-spectrum beta-lactamase and ampc beta-lactamase-producing enterobacteriaceae in a turkish community.

Abstract

Community-acquired infection caused by extended-spectrum beta-lactamase (ESBL)-producing microorganisms has an increasing frequency. The aim of this study was to determine the fecal carriage of ESBL and AmpC beta-lactamase-producing Enterobacteriaceae in community and to investigate cefotaxime-M (CTX-M) genes among ESBL isolates. A total of 1402 fecal specimens which were collected from outpatients included in the study. ESBL screening, ESBL production, and AmpC beta-lactamase detection were performed. Matrix-assisted laser desorption ionization-time-of-flight (MALDI-TOF) was used for identification of species. Antibiotic susceptibilities of the isolates were detected by disk diffusion method. CTX-M beta-lactamase genes were investigated by polymerase chain reaction. During the study period, a total of 1402 fecal samples were analysed with ESBL screening test and 490 Enterobacteriaceae strains isolated from these samples (Escherichia coli [n = 461, 94.1%], Klebsiella pneumoniae [n = 25, 5.1%], and Enterobacter cloacae [n = 4, 0.8%]). Fecal carriage of ESBL-producing Enterobacteriaceae in the community was 34.3%. AmpC beta-lactamases were detected in 26 (5.3%), and the frequency of CTX-M was found as 96.9%. The resistance rates of the E. coli strains to fluoroquinolones, trimethoprim-sulfamethoxazole, and carbapenems were 31.2%, 33.3%, and 0%, respectively. The relative high prevalence of fecal carriage of ESBL-producing bacteria in community warrants further study in this field including developing policies about antimicrobial use and close monitoring of resistance patterns.