JAC Advance Access originally published online on May 23, 2006
Journal of Antimicrobial Chemotherapy 2006 58(1):211-215; doi:10.1093/jac/dkl211
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Extended-spectrum ß-lactamase-producing Enterobacteriaceae in different environments (humans, food, animal farms and sewage)
1 Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Spain 2 Departament de Genètica i Microbiologia de la Universitat Autònoma de Barcelona, Cerdanyola del Vallès Spain 3 Departament de Microbiologia, Facultat de Biologia Universitat de Barcelona, Spain 4 Servei de Microbiologia, Hospital Vall d'Hebron Barcelona, Spain 5 Laboratori de Sanitat Ramadera (DARP-Generalitat de Catalunya) Spain 6 Centre de Recerca en Sanitat Animal Cerdanyola del Vallès, Bellaterra, Spain
Received 20 December 2005; returned 3 February 2006; revised 2 May 2006; accepted 2 May 2006
*Correspondence address. Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau, Sant Antoni Ma Claret 167, 08025 Barcelona, Spain. Tel: +34-932919071; Fax: +34-932919070; E-mail: fnavarror{at}santpau.es
Objectives: This study aimed to determine the presence of extended-spectrum ß-lactamase (ESBL)-producing Enterobacteriaceae in different environments.
Methods: Clinical samples and stool samples from animal farms, sewage, human faecal carriers attending the emergency room and faecal carriers in the context of food-borne disease outbreaks were subcultured onto MacConkey agar supplemented with cefotaxime for the detection of ESBL-producing Enterobacteriaceae. Identification, susceptibility pattern and ERIC–PCR were used for clone delineation in each sample. Community consumption of antibiotics was also recorded.
Results: An ESBL-producing Enterobacteriaceae prevalence of 1.9% was observed in human infections. A cross-sectional survey of human faecal carriers in the community showed a general prevalence of 6.6% with a temporal distribution. High use of antibiotics in winter coincided with a lower prevalence in carriers. ESBL-producing Enterobacteriaceae were detected in the five samples of human sewage, in samples from 8 of 10 pig farms, 2 of 10 rabbit farms, from all 10 poultry farms and in 3 of 738 food samples studied. Faecal carriage of ESBL-producing Enterobacteriaceae was detected in samples from 19 of 61 food-borne outbreaks evaluated. All food-borne outbreaks were due to enteropathogens. The prevalence of carriers in these outbreaks ranged from 4.4% to 66.6%.
Conclusions: This widespread occurrence of ESBL-producing Enterobacteriaceae suggests that the community could act as a reservoir and that food could contribute to the spread of these strains.
Keywords: ß-lactamases , drug resistance , ESBLs , food outbreaks , farms , sewage
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