Dr. Rasha H Bassyouni is currently working in Fayoum University in Egypt


Abstract Commensal E. coli is a reservoir of genes coding for antibiotic resistance which can be transmitted in hospitals through Health Care Workers (HCWs). Objective: The objective of this study was to determine the prevalence of faecal carriage of ESBLs producing E. coli among HCWs at Fayoum University Hospital by conventional microbiological methods and on molecular basis. Methods: Stool samples were collected from 200 HCWs. Phenotypic screening test for ESBLs and AmpC β-lactamases was done using disc diffusion method and minimum inhibitory concentrations of ceftazidime and cefotaxime. Phenotypic confirmation was performed by Combined Discs Test and Double Synergy Differential Test (DSDT). Multiplex PCR was used to detect blaSHV, blaTEM, blaCTX-M and CIT group for AmpC genes. Results: Of 200 isolated E. coli; 100% were susceptible to imipenem, 59 (29.5%) isolates were resistant for one or more of 3rd generation cephalosporins. By molecular analysis: 21% (42/200) were colonized by ESBL-producing E. coli and 3% (6/200) were colonized by AmpC-producing E. coli. bla.SHV genes was the predominant ESBL gene detected in 81.8% of the resistant E. coli isolates while blaTEM 15.9%, blaCTX-M 4.5% and AmpC genes (CIT group) 13.6% . Conclusion: These findings suggest that the fecal carriage of ESBL and AmpC producers among HCWs is increasing which is alarming. The most prevalent ESBLs were the SHV-related enzymes. This may be one of the causes of the increased spread of ESBL-producing bacteria in hospitals and requires sound infection control measures and regular detection of ESBL-AmpC producing isolates.