Fecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae in community setting in Casablanca

Infect Dis (Lond). 2015 Jan;47(1):27-32. doi: 10.3109/00365548.2014.961542. Epub 2014 Oct 20.

Abstract

Background: The importance of community-acquired infections due to extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) has been increasingly recognized in recent years. This study aimed to determine the prevalence of intestinal carriage of ESBL-PE in the community in Casablanca, Morocco.

Methods: During 6 months (2013), 93 fecal samples were examined for ESBL-PE. Isolates expressing an ESBL phenotype were investigated for the presence of genes encoding β-lactamases and plasmid-mediated quinolone resistance. Conjugation experiments were done to determine the mobility of ESBL genes.

Results: The prevalence of fecal carriage of ESBL-PE was 4.3% (4/93; 95% CI, 0.2-8.4). Klebsiella pneumoniae (n = 2), Enterobacter cloacae (n = 2), Escherichia coli (n = 1), and Serratia odorifera (n = 1) were the ESBL-producing species. Four (66.7%) of these isolates were multidrug-resistant. The blaSHV-12 (n = 5) was the most frequent ESBL gene detected, followed by blaCTX-M-15 (n = 3).The non-ESBL gene detected was blaTEM-1 (n = 5). One isolate harbored the qnrB1 variant. RESULTS of conjugation experiments indicated that blaSHV-12 + blaTEM-1 + qnrB1 and blaCTX-M-15 + blaTEM-1 genes were co-transferred and that these genes were carried by a conjugative plasmid of high molecular weight (125 kb).

Conclusion: Our results show the importance of the intestinal tract as a reservoir for ESBL-PE in the community in Morocco.

Keywords: Casablanca city; ESBL; Enterobacteriaceae; community; fecal carriage.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / pharmacology
  • Carrier State / epidemiology*
  • Ciprofloxacin / pharmacology
  • Enterobacter cloacae / drug effects
  • Enterobacter cloacae / enzymology
  • Enterobacter cloacae / genetics
  • Enterobacteriaceae Infections / epidemiology*
  • Feces / microbiology*
  • Female
  • Humans
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / enzymology
  • Klebsiella pneumoniae / genetics
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Morocco
  • Norfloxacin / pharmacology
  • Serratia / drug effects
  • Serratia / enzymology
  • Serratia / genetics
  • Young Adult
  • beta-Lactam Resistance
  • beta-Lactamases / genetics

Substances

  • Anti-Bacterial Agents
  • Ciprofloxacin
  • beta-Lactamases
  • Norfloxacin