Carriage of ESBL/AmpC-producing or ciprofloxacin non-susceptible Escherichia coli and Klebsiella spp. in healthy people in Norway

Abstract

BackgroundAsymptomatic carriage has been recognised as an important risk factor for infection caused by antibiotic resistant bacteria. A 14% global prevalence of Extended-Spectrum Beta-lactamase (ESBL) carriage was recently reported, but large intra-and interregional variations were observed. We investigated the faecal carriage rates of ESBL-, AmpC-producing and ciprofloxacin non-susceptible Escherichia coli and Klebsiella spp. in healthy Norwegians.MethodsRectal samples were obtained from 284 volunteers, together with demographic data and information on recent travel history. The rectal samples were screened by selective plating and E. coli and Klebsiella spp. identified using MALDI-TOF. Phenotypic and molecular characterization of resistant isolates was also performed.ResultsESBL- or AmpC-producing E. coli and Klebsiella spp. were isolated from 4.9% and 3.2% of the study population, respectively. Carriage of ciprofloxacin non-susceptible isolates was detected in 9.9% of the volunteers. Molecular typing of ESBL/plasmid-mediated AmpC (pAmpC)-producing isolates suggested an allodemic situation rather than the dissemination of a specific clone in the Norwegian community. In concurrence with previous findings, travel to South-East Asia was associated with increased risk of carrying resistant E. coli or Klebsiella spp., highlighting the contribution of factors such as increased global mobility in erasing the boundaries between healthcare and community settings when it comes to spread of resistant bacteria.ConclusionsOverall, our study recognised Norway as a low-incidence country for faecal carriage of resistant bacteria among healthy individuals. Furthermore, our work denoted the importance of healthy humans as a reservoir for transmission of antibiotic resistant E. coli and Klebsiella spp.Electronic supplementary materialThe online version of this article (doi:10.1186/s13756-016-0156-x) contains supplementary material, which is available to authorized users.

Prevalence and risk factors for intestinal carriage of CTX-M-type ESBLs in Enterobacteriaceae from a Thai community

“…Risk factors associated with the carriage of AmpC-positive Enterobacteriaceae could not be identified, probably due to the small number of carriage rate. However, our results suggested that the AmpC-producers have spread beyond hospital settings in Thailand, as seen in other studies elsewhere [7,9] . In addition, the co-existence of two ß-lactamase genes in a single isolate were found in 6.5% of isolates (19/291) ( Table 2).…”

“…Several reports on the intestinal carriage of ESBL + E in community settings have been documented. Studies in the European countries such as the Netherlands and Norway revealed a small number (<10%) of ESBL + E in healthy subjects [7,9] . The relatively low carriage rates of ESBL + E among healthy populations were reported from Asia, including Japan [22] and Korea [23] .…”

“…Previous studies have shown that intestinal carriage by ESBL-positive Enterobacteriaceae (ESBL + E) has been associated with developing infection due to ESBL producers [4,5] . Many studies have reported the fecal carriage of ESBL + E among healthy populations [6,7,8,9] . Moreover, the high carriage rates of ESBL + E (53.9-75.5%) have been reported among healthy residents in central Thailand [10,11,12,13] .…”

<p>Characterization of Phenotypic and Genotypic Traits of <em>Klebsiella pneumoniae</em> from Lung Cancer Patients with Respiratory Infection</p>

“…27 The frequency of ESBL-K. pneumoniae in our study was higher in lung cancer patients than in the healthy population. 28 The most common determinants were the bla CTX-M , bla SHV and bla TEM genes in two dominant pulsotypes, which have been reported to be the most frequent ESBLs in K. pneumoniae isolates. 26 Epidemiological studies suggest that the increasingly widespread occurrence of CRKP has become a major public health crisis.…”

Low prevalence of zoonotic multidrug‐resistant bacteria in veterinarians in a country with prudent use of antimicrobials in animals

“…Thus, our results indicate that working as a veterinarian does not increase carriage rates of ESBL/pAmpC‐PE. Numbers from other Nordic countries with low occurrence vary from 3.2% to 4.9% (Egervärn et al, ; Ulstad et al, ). Our findings are in line with results of a study conducted in Dutch slaughterhouses which found an overall prevalence equalling that of the general population (Dohmen et al, ).…”