Abstract
Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) infections are a growing threat to children, and the treatment of these infections becomes more and more challenging. A huge reservoir for ESBLs in the community is the fecal flora of children. This study investigates the rectal colonization, associated risk factors, antimicrobial susceptibility, and molecular characterization of ESBL-PE in Lebanese community infants. A total of 117 rectal swabs were taken from healthy infants between 1 and 12 months of age. Detection of ESBLs was carried out using the double-disk synergy test, combination-disk method, and multiplex polymerase chain reaction (PCR). A questionnaire about the infant's history and risk factors for carrying ESBL-PE was administered. In total, 58 (49.6%) of 117 participants were ESBL-PE carriers. Some significant important risk factors for colonization in this study were male gender, hospital birth, caesarean delivery, and being formula-fed. Observed decrease in colonization rate was associated with intimate hygiene habits. Carriers of multiple bla genes were the most common. CTX-M type was the major harbored, gene and CTX-M-9 was the most predominant, followed by CTX-M-15 type. To the best of our knowledge, this is the first available data about the carriage rate of ESBL-PE in community infants in Lebanon and the Middle East, the first study showing that birth in hospital, caesarean delivery, and being formula-fed are all significantly associated risk factors for the high colonization rates in community - not hospitalized - infants, and showing the dominance of multiple resistance gene carriage and wide dissemination of CTX-M-9 ESBL.
Highlights
Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) infections are a growing threat to children, and the treatment of these infections becomes more and more challenging
A significantly high carriage rate was found among infants who were born in hospitals (52.3%) compared with 0% for those who were born at home (p = 0.027)
Formula-fed infants were found to be significantly associated with a higher ESBL-PE carriage rate (60.5%) than those who were breast-fed (p = 0.034)
Summary
Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) infections are a growing threat to children, and the treatment of these infections becomes more and more challenging. This study investigates the rectal colonization, associated risk factors, antimicrobial susceptibility, and molecular characterization of ESBL-PE in Lebanese community infants. Conclusions: To the best of our knowledge, this is the first available data about the carriage rate of ESBL-PE in community infants in Lebanon and the Middle East, the first study showing that birth in hospital, caesarean delivery, and being formula-fed are all significantly associated risk factors for the high colonization rates in community – not hospitalized – infants, and showing the dominance of multiple resistance gene carriage and wide dissemination of CTX-M-9 ESBL. TEM- and SHV-type beta-lactamases, mainly produced by K. pneumoniae, have spread throughout hospital settings, and CTX-M enzymes, mainly produced by E. coli, have become predominant in the community [9]. Plasmids encoding blaCTX-M-15 are found mainly in Hijazi et al – Rectal carriage of ESBL-PE in Lebanese infants
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
