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.

Extended-Spectrum Beta-Lactamase and Carbapenemase Producing Enterobacteriaceae among Patients with Gastrointestinal Complaints in North West Ethiopia

“…In this study, the overall prevalence of MDR-Enterobacteriaceae (MDR-E) was 196(48.5%) which is similar with a study done in Norway 48% (11). However, our result is lower than a study done in Mozambic University 88% (18) and Switherland 51% (42).…”

“…Extended spectrum beta lactamase producing Enterobacteriaceae have worldwide distributions with varying degree of prevalence in the community as well as hospitals (9,10). Infections due to ESBL-PE and carbapenemase-producing Enterobacteriaceae (CPE) represent a major global health threat because they are usually resistant to multiple antimicrobial agents and lack of carbapenem drugs (11,12). Although antimicrobial resistance is a global problem, the impact is higher in Sub-Saharan Africa due to limited available resources for healthcare infrastructure and wide irrational use of antimicrobial agents.…”

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

“…Two Norwegian studies report on faecal carriage rates of AMR bacteria. Rettedal et al found that 2.9% and 0.3% of healthy pregnant women were colonised by ESBL-producing or AmpC-producing E. coli , respectively [22], whereas Jørgensen et al observed an overall ESBL carriage rate of 15.8% in patients with diarrhoea, ranging from 10.3% in patients with no recent travel history to 56.3% in patients with a history of recent travel to Asia [23]. …”

Bruk av antibiotika hos barn i perioden 2005 – 16

“…Tilsvarende tall for Europa er 5-10%. Hos personer som har vaert på turistreise til Midtøsten eller Syd-øst Asia finner man ofte at 30-50% er friske baerere ved hjemkomst (Jorgensen et al, 2014;Ostholm-Balkhed et al, 2013;Tham et al, 2013 -L, et al 2013) De fleste antimikrobielle midler er naturlige substanser eller syntetiske modifikasjoner av slike naturlige stoffer og bare noen få antimikrobielle midler som sulfonamider og kinoloner er helsyntetiske. Antibiotikaproduserende bakterier må kunne beskytte seg selv mot antibiotika de produserer og er derfor naturlig resistente.…”