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Publication Type : Journal Article
Thematic Areas : Medical Sciences, Nanosciences and Molecular Medicine
Publisher : Journal of Global Antimicrobial Resistance.
Source : Journal of Global Antimicrobial Resistance, Volume 6, September 2016
Keywords : beta-Lactamases, Carrier State, Enterobacteriaceae, Enterobacteriaceae Infections, Feces, female, Humans, India, male, middle aged
Campus : Kochi
School : School of Medicine
Center : Amrita Center for Nanosciences and Molecular Medicine Move
Department : Nanosciences and Molecular Medicine, Microbiology
Year : 2016
Abstract : The prevalence of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) in hospitalised and community patients is of significant public health concern. The aim of this study was to estimate the faecal carriage rate of ESBL-PE in hospitalised patients and healthy asymptomatic individuals coming for health check-up. Non-repetitive, consecutive stool samples from 480 adults (260 healthy individuals and 220 hospitalised patients) aged ≥18 years from November 2011 to July 2013 were screened using MacConkey agar supplemented with ceftazidime. All screen-positive isolates were identified to species level and were tested for ESBL production. Representative ESBL-PE isolates were subjected to susceptibility testing and multiplex ESBL PCR. The faecal carriage rate of ESBL-PE was found to be 62.7% among hospitalised patients and 33.8% among healthy asymptomatic individuals. The most common ESBL-PE was Escherichia coli (70.3% and 78.4% in hospitalised patients and healthy individuals, respectively), followed by Klebsiella pneumoniae (26.8% and 17.0%). ESBL-PE showed the highest sensitivity to carbapenems (85% and 100%, respectively), followed by amikacin (67.2% and 98%), cefoperazone/sulbactam (27.8% and 88.2%) and piperacillin/tazobactam (18% and 74.5%). Ciprofloxacin exhibited a high level of resistance among both groups. Molecular analysis for ESBL genes showed a predominance of the CTX-M gene. In conclusion, the faecal carriage rate of ESBL-PE among hospitalised patients was almost double that of healthy individuals. Carriage of carbapenem-resistant isolates is emerging among hospitalised patients. The spread of these organisms in the community merits radical measures to improve sanitation and implement antibiotic stewardship.
Cite this Research Publication : Rachana Babu, Anil Kumar, Shamsul Karim, Sruthi Warrier, Suresh G. Nair, Sanjeev K. Singh, Raja Biswas "Faecal carriage rate of extended-spectrum β-lactamase-producing Enterobacteriaceae in hospitalised patients and healthy asymptomatic individuals coming for health check-up", Journal of Global Antimicrobial Resistance, 2016