Programme Hospitalier Recherche Clinique, Institut Pasteur, Inserm, French Public Health Agency.

The study of several Escherichia coli intestinal commensal isolates per individual in 265 healthy human subjects belonging to seven populations distributed worldwide showed that the E. coli population is highly structured, with major differences between the tropical and temperate populations.Escherichia coli is a commensal inhabitant of the intestinal tracts of healthy humans and many animal species, but it can also cause a wide range of diseases, ranging from diarrhea to extraintestinal infections (8). As it has been proposed that pathogenic E. coli strains are derived from commensal strains by the acquisition of chromosomal or extrachromosomal virulence operons (19), identifying the factors that shape the genetic structure of commensal strains might help us understand the emergence of virulence. E. coli can be considered to have a clonal genetic structure with a low level of recombination (7, 10). Four main phylogenetic groups, A, B1, B2, and D, constitute the bulk of the species (15). A few authors have examined commensal strains from humans (3-5, 13) using population genetics molecular tools (for a pioneer review, see reference 14). A significant locale-specific distribution among groups A, B1, B2, and D has been observed in human commensal strains in three geographically distinct human populations (French, Croatian, and Malian) (9).To gain insight into the composition of the E. coli human commensal microbiota, we characterized the relative abundance of E. coli phylogenetic groups in a large collection of 1,740 isolates from 265 subjects belonging to seven populations spread over three continents and compared the results to those of previous studies using the same approach.Bacterial isolates. Isolates were collected between 1999 and 2001 from seven human populations composed of healthy adult subjects of both sexes from 15 to 65 years of age, except when otherwise stated. The populations were the following: (i) 27 subjects living in the Paris area (mainland France, Europe), (ii) 21 university students living in Brest (Brittany, mainland France), (iii) 25 bank and insurance workers (BIW) living in seven distinct areas of Brittany (mainland France), (iv) 25 pig farmers (PF) living in the same seven areas as the BIW, (v) 93 ethnically homogeneous Wayampi Amerindians living in three villages of southern French Guyana (South America) with no modern sanitary or hygienic facilities, (vi) 46 women living in Cotonou (Benin, Africa), and (vii) 28 subjects living in Bogotá (Colombia, South America). The individuals in the BIW and PF populations in Brittany were matched for county of residence, age (20 to 60 years), and sex (13 men and 12 women). A subset of 25 Amerindians was also matched for age and sex with the BIW and PF populations. These matched populations had neither been hospitalized nor had taken antibiotics for at least 1 month before stool sampling. In all, 1,740 E. coli isolates were obtained after plating fresh fecal samples on Drigalski agar, with 5 or 10 randomly chosen E. coli isolates per individual.The...

We assessed the quantitative contribution of pig farming to antimicrobial resistance in the commensal flora of pig farmers by comparing 113 healthy pig farmers from the major French porcine production areas to 113 nonfarmers, each matched for sex, age, and county of residence. All reported that they had not taken antiimicrobial agents within the previous month. Throat, nasal, and fecal swabs were screened for resistant microorganisms on agar containing selected antimicrobial agents. Nasopharyngeal carriage of Staphylococcus aureus was significantly more frequent in pig farmers, as was macrolide resistance of S. aureus from carriers. Nongroupable streptococci from the throat were more resistant to the penicillins in pig farmers. The intestinal isolation of enterococci resistant to erythromycin or vancomycin was not significantly higher in pig farmers in contrast to that of enterobacteria resistant to nalidixic acid, chloramphenicol, tetracycline, and streptomycin. Prevalence of resistance in predominant fecal enterobacteria was also significantly higher in pig farmers for cotrimoxazole, tetracycline, streptomycin, and nalidixic acid. We determined a significant association between pig farming and isolation of resistant commensal bacteria.

MRSA carriage at hospital admission is far more prevalent than MRSA-positive clinical specimens. This may contribute to failure of contact isolation programs. Screening cultures at admission help to identify the reservoir of unknown MRSA patients.