Prevalence and characterization of β-lactamase-producing Enterobacteriaceae in healthy human carriers

Int Microbiol. 2020 May;23(2):171-177. doi: 10.1007/s10123-019-00087-z. Epub 2019 Jun 19.

Abstract

Presence of extended-spectrum β-lactamase (ESBL-E), AmpC-producing and carbapenemase-producing (CPE) Enterobacteriaceae has been observed not only in the clinical environment, but also in the out-of-hospital environment. The objective of this study was to isolate and characterize strains of ESBL, AmpC, and CPE present in feces of healthy carriers in Navarra (n = 125). Despite the fact that no CPE strains were isolated, 16% and 11.2% of the studied population were ESBL-E and AmpC carriers, respectively. No significant differences were found by gender or age; young people (5-18 years old) showed the highest ESBL-E prevalence (31.8%). The isolates corresponded to E. coli (57.1%), Enterobacter spp. (28.6%), and Citrobacter freundii (14.3%), and all strains showed multidrug-resistant profiles. High resistance against cephalosporins, penicillins, and monobactams, and sensitivity to carbapenems, quinolones, and aminoglycosides were observed. With respect to ESBL producers, 52.4% were CTX-M-type (19.0% CTX-M-14, 9.5% CTX-M-1, and 28.6% CTX-M-15) and 47.6% were TEM-type (38.1% TEM-171). These results confirm the extensive dissemination of these resistances among a healthy population and pose the need to implement control measures and strategies according to the One Health approach in order to prevent the increase of severe and untreatable infections in a not far future.

Keywords: AmpC; CTX-M; Carbapenemases; ESBL; Resistances.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / genetics
  • Cephalosporins / pharmacology
  • Child
  • Child, Preschool
  • Citrobacter freundii / drug effects
  • Citrobacter freundii / isolation & purification
  • Citrobacter freundii / metabolism
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Enterobacter / drug effects
  • Enterobacter / isolation & purification
  • Enterobacter / metabolism
  • Enterobacteriaceae* / drug effects
  • Enterobacteriaceae* / isolation & purification
  • Enterobacteriaceae* / metabolism
  • Escherichia coli / drug effects
  • Escherichia coli / isolation & purification
  • Escherichia coli / metabolism
  • Feces / microbiology*
  • Female
  • Healthy Volunteers
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Monobactams / pharmacology
  • Multilocus Sequence Typing
  • Penicillins / pharmacology
  • Prevalence
  • Young Adult
  • beta-Lactamases / genetics*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Cephalosporins
  • Monobactams
  • Penicillins
  • beta-lactamase TEM-3
  • beta-Lactamases
  • carbapenemase