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J Antimicrob Chemother. 2008 Nov;62(5):1142-9. doi: 10.1093/jac/dkn293. Epub 2008 Jul 18.

Faecal carriage of extended-spectrum beta-lactamase-producing Escherichia coli: prevalence, risk factors and molecular epidemiology.

Author information

1
Sección de Enfermedades Infecciosas, Hospital Universitario Virgen Macarena, Seville, Spain. jrb@nacom.es

Abstract

OBJECTIVES:

The aim of this study was to investigate the epidemiology of faecal carriage of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in the community.

PATIENTS AND METHODS:

Faecal carriage with ESBL-producing E. coli was studied in 53 outpatients with urinary tract infection (UTI) due to these organisms, 73 household members, 32 non-household relatives and 54 unrelated patients. Clonal relatedness of the isolates was investigated using repetitive extragenic palindromic-PCR and PFGE, and ESBLs were characterized by PCR and sequencing. Multivariate analysis was performed to investigate risk factors for faecal carriage.

RESULTS:

The prevalence of faecal carriage was 67.9% in patients with UTI, 27.4% in household members, 15.6% in non-household relatives and 7.4% in unrelated patients. Being a relative of a patient with UTI was independently associated with an increased risk of being a carrier. Among the relatives, multivariate analysis showed that those eating their main meal outside their own home >15 days during the previous month were less likely to be faecal carriers (OR = 0.2; 95% CI: 0.06-0.6; P = 0.007). The faecal isolates of patients with UTI were CTX-M-producers in 66.6% and SHV-producers in 33.3% of the cases, while the percentages for other population groups were 40% to 55.5% and 50% to 75%, respectively. Of the 19 families with >1 carrier member, 8 families had 2 members who shared clonally related isolates, 8 families had 2 members carrying different clones producing the same enzymes and there were 3 families where all members had different enzyme-producing clones.

CONCLUSIONS:

Our results suggest that both acquisition from a common source and person-to-person transmission might contribute to ESBL dissemination.

PMID:
18641033
DOI:
10.1093/jac/dkn293
[Indexed for MEDLINE]

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