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Title: Prevalence of and risk factors associated with faecal carriage of CTX-M β-lactamase-producing enterobacteriaceae in rural Thai communities
Authors: Ulzii Orshikh Luvsansharav
Itaru Hirai
Arisa Nakata
Kaori Imura
Kou Yamauchi
Marie Niki
Chalit Komalamisra
Teera Kusolsuk
Yoshimasa Yamamoto
Osaka University Faculty of Medicine
Mahidol University
Osaka Prefectural Institute of Public Health
Keywords: Medicine;Pharmacology, Toxicology and Pharmaceutics
Issue Date: 1-Jul-2012
Citation: Journal of Antimicrobial Chemotherapy. Vol.67, No.7 (2012), 1769-1774
Abstract: Objectives: To determine the prevalence of CTX-M β-lactamase-producing Enterobacteriaceae and to study the risk factors associated with faecal carriage in asymptomatic rural Thai people. Methods: In all, 417 stool samples were obtained from rural Thai people and screened for extended-spectrum β-lactamases (ESBLs) using MacConkey agar supplemented with 2 mg/L cefotaxime. Results were confirmed using cefotaxime and ceftazidime with and without clavulanic acid. The bla CTX-M genes were identified and genotyped using PCR with bacterial DNA samples. Multivariate analysis was performed to investigate risk factors associated with the faecal carriage of CTX-M producers. Results: The prevalence of CTX-M-type ESBL-producing Enterobacteriaceae was 65.7%. The CTX-M-9 group (60.6%) was dominant, followed by the CTX-M-1 group (38.7%). Most of the bacteria were Escherichia coli (85.4%) and Klebsiella pneumoniae (4.7%). Of a total of 234 E. coli strains, 48.7% belonged to phylogenetic group A, 28.6% to group B1, 15.8% to group D and 6.8% to group B2. Most CTX-M producers were susceptible to carbapenems and amikacin, but resistant to tetracycline and gentamicin. In a multivariate logistic regression model, better education status (OR 2.245; 95% CI 1.297-3.884), history of hospitalization (OR 1.643; 95% CI 1.036-2.603) and the use of antibiotics within the last 3 months (OR 1.883; 95% CI 1.221-2.903) were independently associated with faecal carriage. Conclusions: Faecal carriage of CTX-M-type ESBL-producing Enterobacteriaceae among asymptomatic individuals in rural Thailand remains alarmingly high, and previous antibiotic use and a history of hospitalization may contribute to its dissemination. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
ISSN: 14602091
Appears in Collections:Scopus 2011-2015

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