High prevalence and risk factors of fecal carriage of CTX-M type extended-spectrum beta-lactamase-producing Enterobacteriaceae from healthy rural residents of Taian, China

Abstract

The study was carried out to understand the prevalence of CTX-M type extended-spectrum beta-lactamase (ESBL)-harboring Enterobacteriaceae and to analyze risk factors related with fecal carriage in healthy rural residents in Taian, China. A total of 620 stool samples were collected from rural residents. The ESBL-positive Enterobacteriaceae was screened using ChromID ESBL agar, and then further confirmed by double-disk diffusion. The CTX-M genes were determined using polymerase chain reaction. The risk factors associated with fecal carriage of CTX-M-positive isolates were analyzed using the standard statistic methods. 458 isolates carrying CTX-M gene (458/620, 73.9%) were obtained from different individuals, and the most dominant genotype was CTX-M-9 group (303/458, 66.2%). The dominant species were Escherichia coli (E. coli; 403/458, 88.0%) and Klebsiella pneumoniae (K. pneumoniae; 26/458, 5.7%) among the isolates carrying CTX-M genes. All the CTX-M producers were resistant to ampicillin, cefazolin, cefuroxime, and ceftriaxone, but were all susceptible to biapenem, imipenem, and meropenem. The results of multivariate logistic regression model identified the enrollment in formal education (OR 2.321; 95% CI 1.302–3.768; P= 0.039), the hospitalization history within the last 6 months (OR 1.753; 95% CI 1.127–2.584; P= 0.031) and the antibiotics use within the last 6 months (OR 1.892; 95% CI 1.242–2.903; P= 0.034). The three variables were significantly associated with carriage of CTX-M ESBL producers (x2 = 21.21; df = 3; P< 0.001). The prevalence of fecal carriage of CTX-M ESBL-producing Enterobacteriaceae among healthy rural humans in Taian was high, and the recent antibiotic use and hospitalization history may be the important contributors.

Antimicrobial Susceptibility and Molecular Epidemiology of Multidrug-Resistant <i>Klebsiella pneumoniae</i> in Central China

“…CTX-M-3 was found to be the major CTX-M-1 group ESBL, followed by CTX-M-15 and CTX-M-55. However, previous studies have shown a completely different distribution for CTX-M-1 group beta-lactamases, and CTX-M-55 has already replaced CTX-M-3 as the main concern with regard to antibiotic treatment options for infections in mainland China (7,11,19). The rising proportion of bla CTX-M-55 in our study suggests 2 possibilities.…”

Fecal Carriage of Extended-Spectrum β-Lactamases in Healthy Humans, Poultry, and Wild Birds in León, Nicaragua—A Shared Pool of blaCTX-M Genes and Possible Interspecies Clonal Spread of Extended-Spectrum β-Lactamases-Producing Escherichia coli

“…14 In our study, the prevalence of ESBL-producing isolates was high in healthy humans (27%), but in line with previous studies performed in rural low-income countries. 19,20 Also, industrialized countries such as South Korea have demonstrated a relatively high prevalence carriage of ESBLproducing Enterobacteriaceae in healthy humans. 21 In summary, the spread of ESBL-producing Enterobacteriaceae seems to be multifactorial, but low-income countries such as Nicaragua may be more affected.…”

Prevalence and antimicrobial resistance profiles of Escherichia coli isolated from free-range pigs

“…It can be isolated from various natural environments such as: air, soil, water, and human and animal feces, and it is an important indicator bacterium for epidemiological survey of drug-resistant bacteria [2][3][4][5]. At present, studies on drug-resistant bacteria of animal-origins have attracted great concern [6].…”