Fecal Carriage of Extended‑spectrum Beta‑lactamase and AmpC Beta‑lactamase‑producing Enterobacteriaceae in a Turkish Community

Abstract

Background: Community‑acquired infection caused by extended‑spectrum beta‑lactamase (ESBL)‑producing microorganisms has an increasing frequency. Aim: The aim of this study was to determine the fecal carriage of ESBL and AmpC beta‑lactamase‑producing Enterobacteriaceae in community and to investigate cefotaxime‑M (CTX‑M) genes among ESBL isolates. Materials and Methods: A total of 1402 fecal specimens which were collected from outpatients included in the study. ESBL screening, ESBL production, and AmpC beta‑lactamase detection were performed. Matrix‑assisted laser desorption ionization‑time‑of‑flight (MALDI‑TOF) was used for identification of species. Antibiotic susceptibilities of the isolates were detected by disk diffusion method. CTX‑M beta‑lactamase genes were investigated by polymerase chain reaction. Results: During the study period, a total of 1402 fecal samples were analysed with ESBL screening test and 490 Enterobacteriaceae strains isolated from these samples (Escherichia coli [n = 461, 94.1%], Klebsiella pneumoniae [n = 25, 5.1%], and Enterobacter cloacae [n = 4, 0.8%]). Fecal carriage of ESBL‑producing Enterobacteriaceae in the community was 34.3%. AmpC beta‑lactamases were detected in 26 (5.3%), and the frequency of CTX‑M was found as 96.9%. The resistance rates of the E. coli strains to fluoroquinolones, trimethoprim–sulfamethoxazole, and carbapenems were 31.2%, 33.3%, and 0%, respectively. Conclusion: The relative high prevalence of fecal carriage of ESBL‑producing bacteria in community warrants further study in this field including developing policies about antimicrobial use and close monitoring of resistance
patterns.

Keywords: AmpC, cefotaxime‑M, Enterobacteriaceae, extended‑spectrum β‑lactamase, fecal carriage