Asymptomatic faecal carriage of ESBL producing enterobacteriaceae in Hungarian healthy individuals and in long-term care applicants: A shift towards CTX-M producers in the community

Abstract

Background Faecal carriage of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae in healthy individuals was examined and compared to previous results obtained in such individuals a few years earlier. Methods Faecal samples from 779 individuals screened for employment purposes and from 225 applicants to long-term care (LTC) were screened between November 2013 and May 2014. Results The overall rate of faecal carriage was 3.0% (30/1004). The carriage rate was significantly higher in applicants for LTC (5.3% vs 2.3%; p = 0.019). All isolates carried CTX-M ESBLs, with an overwhelming dominance of bla_CTX-M-15 (84.4%) in both groups and in both E. coli and Klebsiella pneumoniae. Conclusions The prevalences were comparable to those in the earlier study, but a marked decrease of the diversity of ESBL genes in E. coli from the employment screening group was found, suggesting that the ESBL-producing isolates originating from diverse sources are being replaced by highly successful bla_CTX-M-15 producing strains.

Keywords:

• Extended-spectrum beta-lactamases
• Klebsiella pneumoniae
• Escherichia coli

Acknowledgements

The help of the technicians of the Synlab Ltd. during screening work is gratefully acknowledged.

Disclosure statement

The study itself received no financial support. G. Kardos and J. Mózes were supported by scholarships TÁMOP 4.2.4. A/2-11-1-2012-0001 ‘National Excellence Program–Elaborating and operating an inland student and researcher personal support system’. The authors report no conflicts of interest.