High prevalence of faecal carriage of ESBL-producing Enterobacteriaceae in Norwegian patients with gastroenteritis

Abstract

We conducted a cross-sectional study to examine the prevalence of faecal carriage of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in patients with gastroenteritis. During April 2011, all faecal samples submitted to our hospital laboratory were examined for ESBL-producing Enterobacteriaceae. Isolates expressing an ESBL phenotype were investigated for the presence of genes encoding broad-spectrum beta-lactamases, ESBLs, carbapenemases, and plasmid-mediated AmpC. Information on age, gender, and travel history was extracted from the laboratory records. In total 273 faecal samples were included. The overall carrier rate in the study population was 15.8%. The ESBL carrier rate among patients with no history of recent travel, or where this information was missing, was 10.3%. In contrast, the carrier rate was 56.3% (odds ratio 16.3, p < 0.001) among patients with a record of travel to Asia. Two ESBL-producing isolates were identified as enteropathogenic Escherichia coli. Co-resistance between third-generation cephalosporins, trimethoprim–sulfamethoxazole, and fluoroquinolones was seen in 49% of isolates. No carbapenemase-producers were found.

Keywords::

• ESBL
• Escherichia coli
• CTX-M
• multidrug resistance
• EPEC
• gastroenteritis

Acknowledgements

Preliminary data from the study were presented at the 22^nd ECCMID 2012 (Clin Microbiol Infect 2012;18(Suppl 3):15–6). Bjørg Haldorsen and Bettina Aasnæs are acknowledged for excellent technical assistance. The study was financed by Akershus University Hospital and the Reference Centre for Detection of Antimicrobial Resistance, Department of Microbiology and Infection Control, University Hospital of North Norway.

Declaration of interest: There are no conflicts of interest.