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Tytuł:
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Prevalence of and risk factors associated with faecal carriage of CTX-M β-lactamase-producing Enterobacteriaceae in rural Thai communities.
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Autorzy:
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Luvsansharav UO; Department of Bioinformatics, Osaka University Graduate School of Medicine, Osaka, Japan.
Hirai I
Nakata A
Imura K
Yamauchi K
Niki M
Komalamisra C
Kusolsuk T
Yamamoto Y
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Źródło:
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The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2012 Jul; Vol. 67 (7), pp. 1769-74. Date of Electronic Publication: 2012 Apr 18.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: 1997- : London : Oxford University Press
Original Publication: London, New York, Academic Press.
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MeSH Terms:
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Carrier State/*epidemiology
Enterobacteriaceae/*enzymology
Enterobacteriaceae Infections/*epidemiology
beta-Lactamases/*metabolism
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/pharmacology ; Carrier State/microbiology ; Cefotaxime/pharmacology ; Ceftazidime/pharmacology ; Culture Media/chemistry ; DNA, Bacterial/genetics ; Enterobacteriaceae/genetics ; Enterobacteriaceae/isolation & purification ; Enterobacteriaceae Infections/microbiology ; Feces/microbiology ; Female ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Prevalence ; Risk Factors ; Rural Population ; Thailand/epidemiology ; Young Adult ; beta-Lactamases/genetics
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Substance Nomenclature:
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0 (Anti-Bacterial Agents)
0 (Culture Media)
0 (DNA, Bacterial)
9M416Z9QNR (Ceftazidime)
EC 3.5.2.6 (beta-Lactamases)
N2GI8B1GK7 (Cefotaxime)
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Entry Date(s):
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Date Created: 20120420 Date Completed: 20121002 Latest Revision: 20181201
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Update Code:
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20240104
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DOI:
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10.1093/jac/dks118
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PMID:
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22514260
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Objectives: To determine the prevalence of CTX-M β-lactamase-producing Enterobacteriaceae and to study the risk factors associated with faecal carriage in asymptomatic rural Thai people.
Methods: In all, 417 stool samples were obtained from rural Thai people and screened for extended-spectrum β-lactamases (ESBLs) using MacConkey agar supplemented with 2 mg/L cefotaxime. Results were confirmed using cefotaxime and ceftazidime with and without clavulanic acid. The bla(CTX-M) genes were identified and genotyped using PCR with bacterial DNA samples. Multivariate analysis was performed to investigate risk factors associated with the faecal carriage of CTX-M producers.
Results: The prevalence of CTX-M-type ESBL-producing Enterobacteriaceae was 65.7%. The CTX-M-9 group (60.6%) was dominant, followed by the CTX-M-1 group (38.7%). Most of the bacteria were Escherichia coli (85.4%) and Klebsiella pneumoniae (4.7%). Of a total of 234 E. coli strains, 48.7% belonged to phylogenetic group A, 28.6% to group B1, 15.8% to group D and 6.8% to group B2. Most CTX-M producers were susceptible to carbapenems and amikacin, but resistant to tetracycline and gentamicin. In a multivariate logistic regression model, better education status (OR 2.245; 95% CI 1.297-3.884), history of hospitalization (OR 1.643; 95% CI 1.036-2.603) and the use of antibiotics within the last 3 months (OR 1.883; 95% CI 1.221-2.903) were independently associated with faecal carriage.
Conclusions: Faecal carriage of CTX-M-type ESBL-producing Enterobacteriaceae among asymptomatic individuals in rural Thailand remains alarmingly high, and previous antibiotic use and a history of hospitalization may contribute to its dissemination.
