Fecal carriage of extended-spectrum β-lactamase- and AmpC- producing Escherichia coli among healthcare workers
Introduction: Commensal E. coli can be considered a reservoir of genes coding for antibiotic resistance that may be transmitted in hospitals by healthcare workers (HCWs). This study aimed to determine the fecal carriage rate of extended-spectrum β-lactamase (ESBL)-producing E. coli among HCWs.
Methodology: Stool samples were collected from 200 HCWs. Phenotypic screening for ESBL and AmpC β-lactamases was performed using disk diffusion and minimum inhibitory concentration methods followed by the combined disks test and double synergy differential test for confirmation. Multiplex polymerase chain reaction (PCR) was used to detect blaSHV, blaTEM, blaCTX-M, and CIT groups for AmpC genes.
Results: Of 200 E. coli isolates, 100% were susceptible to imipenem, and 59 (29.5%) were resistant to one or more third-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. The blaSHVgene was the predominant ESBL gene, detected in 81.8% of the resistant E. coli isolates.
Conclusions: These findings highlight the increase in fecal carriage of E. coli carrying ESBL and AmpC genes among HCWs, which may be one of the causes of the spread of ESBL-producing bacteria in hospitals and requires sound infection control measures. This is the first study of the fecal carriage rate of E. coli carrying AmpC genes in HCWs.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).