Asymptomatic faecal carriage of ESBL producing enterobacteriaceae in Hungarian healthy individuals and in long-term care applicants: A shift towards CTX-M producers in the community

Abstract

Background Faecal carriage of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae in healthy individuals was examined and compared to previous results obtained in such individuals a few years earlier. Methods Faecal samples from 779 individuals screened for employment purposes and from 225 applicants to long-term care (LTC) were screened between November 2013 and May 2014. Results The overall rate of faecal carriage was 3.0% (30/1004). The carriage rate was significantly higher in applicants for LTC (5.3% vs 2.3%; p = 0.019). All isolates carried CTX-M ESBLs, with an overwhelming dominance of blaCTX-M-15 (84.4%) in both groups and in both E. coli and Klebsiella pneumoniae. Conclusions The prevalences were comparable to those in the earlier study, but a marked decrease of the diversity of ESBL genes in E. coli from the employment screening group was found, suggesting that the ESBL-producing isolates originating from diverse sources are being replaced by highly successful blaCTX-M-15 producing strains.

Keywords: Escherichia coli; Extended-spectrum beta-lactamases; Klebsiella pneumoniae.