Author(s): RodrguezBao J, LpezCerero L, Navarro MD, Daz de Alba P, Pascual A
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Abstract OBJECTIVES: The aim of this study was to investigate the epidemiology of faecal carriage of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in the community. PATIENTS AND METHODS: Faecal carriage with ESBL-producing E. coli was studied in 53 outpatients with urinary tract infection (UTI) due to these organisms, 73 household members, 32 non-household relatives and 54 unrelated patients. Clonal relatedness of the isolates was investigated using repetitive extragenic palindromic-PCR and PFGE, and ESBLs were characterized by PCR and sequencing. Multivariate analysis was performed to investigate risk factors for faecal carriage. RESULTS: The prevalence of faecal carriage was 67.9\% in patients with UTI, 27.4\% in household members, 15.6\% in non-household relatives and 7.4\% in unrelated patients. Being a relative of a patient with UTI was independently associated with an increased risk of being a carrier. Among the relatives, multivariate analysis showed that those eating their main meal outside their own home >15 days during the previous month were less likely to be faecal carriers (OR = 0.2; 95\% CI: 0.06-0.6; P = 0.007). The faecal isolates of patients with UTI were CTX-M-producers in 66.6\% and SHV-producers in 33.3\% of the cases, while the percentages for other population groups were 40\% to 55.5\% and 50\% to 75\%, respectively. Of the 19 families with >1 carrier member, 8 families had 2 members who shared clonally related isolates, 8 families had 2 members carrying different clones producing the same enzymes and there were 3 families where all members had different enzyme-producing clones. CONCLUSIONS: Our results suggest that both acquisition from a common source and person-to-person transmission might contribute to ESBL dissemination.
This article was published in J Antimicrob Chemother
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