High community faecal carriage rates of CTX-M ESBL-producing Escherichia coli in a specific population group in Birmingham, UK

To determine the proportion of E. coli carrying specific CTX-M extended-spectrum β-lactamase (ESBL) genotypes in a community population of East and North Birmingham. General practice and outpatient stool samples from 732 individuals submitted for examination for faecal pathogens in 2010 were screene...

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Veröffentlicht in:Journal of antimicrobial chemotherapy 2012-05, Vol.67 (5), p.1108-1113
Hauptverfasser: WICKRAMASINGHE, Nimal H, LI XU, EUSTACE, Andrew, SHABIR, Sahida, SALUJA, Tranprit, HAWKEY, Peter M
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container_end_page 1113
container_issue 5
container_start_page 1108
container_title Journal of antimicrobial chemotherapy
container_volume 67
creator WICKRAMASINGHE, Nimal H
LI XU
EUSTACE, Andrew
SHABIR, Sahida
SALUJA, Tranprit
HAWKEY, Peter M
description To determine the proportion of E. coli carrying specific CTX-M extended-spectrum β-lactamase (ESBL) genotypes in a community population of East and North Birmingham. General practice and outpatient stool samples from 732 individuals submitted for examination for faecal pathogens in 2010 were screened for ESBL-producing E. coli using chromogenic agar. Multiplex PCR, denaturing HPLC, DNA sequencing and PFGE were used to determine the CTX-M genotype and clonal subtype. Isolates from people were assigned to 'Europe', 'Middle East/South Asia' (MESA) or 'uncategorized' groups using software to determine probable global origin based on the subject's full name. Prevalence of CTX-M carriage in the sample population was 11.3%. There was a statistically significant difference (P < 0.001) between carriage in the Europe group (8.1%) and the MESA group (22.8%). There was also a higher rate of carriage of CTX-M-15-producing E. coli (P < 0.001) in MESA subjects. The high community carriage rate and the significant difference in carriage between the Europe and MESA subjects may have important consequences for therapy. If the rising trend in carriage of bacteria producing ESBLs continues, guidelines for empirical therapy for patients presenting from the community may need to be modified. The findings also raise the concern that the pattern and routes of spread of CTX-M-15 may be replicated in the future by broader-spectrum β-lactamases, such as New Delhi metallo-β-lactamase ('NDM-1').
doi_str_mv 10.1093/jac/dks018
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General practice and outpatient stool samples from 732 individuals submitted for examination for faecal pathogens in 2010 were screened for ESBL-producing E. coli using chromogenic agar. Multiplex PCR, denaturing HPLC, DNA sequencing and PFGE were used to determine the CTX-M genotype and clonal subtype. Isolates from people were assigned to 'Europe', 'Middle East/South Asia' (MESA) or 'uncategorized' groups using software to determine probable global origin based on the subject's full name. Prevalence of CTX-M carriage in the sample population was 11.3%. There was a statistically significant difference (P &lt; 0.001) between carriage in the Europe group (8.1%) and the MESA group (22.8%). There was also a higher rate of carriage of CTX-M-15-producing E. coli (P &lt; 0.001) in MESA subjects. The high community carriage rate and the significant difference in carriage between the Europe and MESA subjects may have important consequences for therapy. If the rising trend in carriage of bacteria producing ESBLs continues, guidelines for empirical therapy for patients presenting from the community may need to be modified. The findings also raise the concern that the pattern and routes of spread of CTX-M-15 may be replicated in the future by broader-spectrum β-lactamases, such as New Delhi metallo-β-lactamase ('NDM-1').</description><identifier>ISSN: 0305-7453</identifier><identifier>EISSN: 1460-2091</identifier><identifier>DOI: 10.1093/jac/dks018</identifier><identifier>PMID: 22403261</identifier><identifier>CODEN: JACHDX</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Agar ; Ambulatory Care ; Animal populations ; Antibiotics. Antiinfectious agents. 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General practice and outpatient stool samples from 732 individuals submitted for examination for faecal pathogens in 2010 were screened for ESBL-producing E. coli using chromogenic agar. Multiplex PCR, denaturing HPLC, DNA sequencing and PFGE were used to determine the CTX-M genotype and clonal subtype. Isolates from people were assigned to 'Europe', 'Middle East/South Asia' (MESA) or 'uncategorized' groups using software to determine probable global origin based on the subject's full name. Prevalence of CTX-M carriage in the sample population was 11.3%. There was a statistically significant difference (P &lt; 0.001) between carriage in the Europe group (8.1%) and the MESA group (22.8%). There was also a higher rate of carriage of CTX-M-15-producing E. coli (P &lt; 0.001) in MESA subjects. The high community carriage rate and the significant difference in carriage between the Europe and MESA subjects may have important consequences for therapy. If the rising trend in carriage of bacteria producing ESBLs continues, guidelines for empirical therapy for patients presenting from the community may need to be modified. The findings also raise the concern that the pattern and routes of spread of CTX-M-15 may be replicated in the future by broader-spectrum β-lactamases, such as New Delhi metallo-β-lactamase ('NDM-1').</description><subject>Agar</subject><subject>Ambulatory Care</subject><subject>Animal populations</subject><subject>Antibiotics. Antiinfectious agents. 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If the rising trend in carriage of bacteria producing ESBLs continues, guidelines for empirical therapy for patients presenting from the community may need to be modified. The findings also raise the concern that the pattern and routes of spread of CTX-M-15 may be replicated in the future by broader-spectrum β-lactamases, such as New Delhi metallo-β-lactamase ('NDM-1').</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>22403261</pmid><doi>10.1093/jac/dks018</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection; Free Full-Text Journals in Chemistry
subjects Agar
Ambulatory Care
Animal populations
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antimicrobial agents
Bacteriological Techniques
beta -Lactamase
beta-Lactamases - secretion
Biological and medical sciences
Carrier State - epidemiology
Carrier State - microbiology
Chromatography, High Pressure Liquid
Cluster Analysis
Computer programs
DNA sequencing
E coli
Electrophoresis, Gel, Pulsed-Field
Escherichia coli
Escherichia coli - enzymology
Escherichia coli - isolation & purification
Escherichia coli Infections - classification
Escherichia coli Infections - epidemiology
Escherichia coli Infections - genetics
Escherichia coli Infections - microbiology
Feces
Feces - microbiology
General Practice
Genotype
Genotypes
High-performance liquid chromatography
Humans
Medical sciences
Metallo- beta -lactamase
Pathogens
Pharmacology. Drug treatments
Polymerase chain reaction
Population Groups
Prevalence
Sequence Analysis, DNA
software
Statistical analysis
United Kingdom - epidemiology
title High community faecal carriage rates of CTX-M ESBL-producing Escherichia coli in a specific population group in Birmingham, UK
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