Community faecal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae in french children

BMC Infectious Diseases

Edouard Bingen⁴  Franck Thollot²  Mohamed Benani³  Céline Courroux¹  Philippe Bidet¹  Corinne Levy³  Robert Cohen³  André Birgy¹ 

[1] Laboratoire associé au Centre National de Référence Escherichia coli et Shigelles, Service de Microbiologie, Hôpital Robert-Debré (AP-HP), Université Denis Diderot, Sorbonne, Paris Cité, Paris, F-75505, France;(Association Française de Pédiatrie Ambulatoire), Essey Les Nancy, France;ACTIV (Association Clinique et Thérapeutique Infantile du Val de Marne), St Maur Des Fossés, France and Centre Hospitalier Intercommunal de Créteil, 40 Avenue de Verdun, Créteil, 94000, France;Service de Microbiologie, Hôpital Robert-Debré (AP-HP), 48 boulevard Serrurier CEDEX 19, Paris, 75935, France

关键词: Children;    Enterobacteriaceae;    Extended-Spectrum Beta-Lactamase;    Community carriage;   

Others  :  1175137
DOI  :  10.1186/1471-2334-12-315

 received in 2012-04-17, accepted in 2012-11-12,  发布年份 2012

【 摘 要 】

Background

The increasing incidence of community acquired infection due to Extended-Spectrum Beta-Lactamase (ESBL) -Producing Enterobacteriaceae represent a great concern because there are few therapeutic alternatives. The fecal flora of children in the community can represent a reservoir for ESBLs genes which are located on highly transmissible plasmids and the spread of these genes among bacterial pathogens is concerning. Because intestinal carriage is a key factor in the epidemiology of ESBL-producing Enterobacteriaceae, the study of the prevalence of these resistant bacteria and risk factors in young children is of particular interest.

Methods

We assessed the prevalence and risk factors of community-acquired faecal carriage of extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae in children aged from 6 to 24 months, by means of rectal swabbing in community pediatric practices. Child’s lifestyle and risk factors for carriage of resistant bacteria were noted.

Results

Among the 411 children enrolled, 4.6% carried ESBL-producing Enterobacteriaceae. CTX-M-1, CTX-M-15 and CTX-M-14 were the predominant ESBLs. The 18 E. coli isolates were genetically heterogeneous. Recent third-generation oral-cephalosporin exposure was associated with a higher risk of ESBL carriage (AOR=3.52, 95% CI[1.06-11.66], p=0.04).

Conclusions

The carriage rate of ESBL-producing Enterobacteriacae in young children in the French community setting is noteworthy, underlining the importance of this population as a reservoir. Exposure to third-generation oral cephalosporins was associated with a significant risk of ESBL carriage in our study. Because of the significant public health implications including the treatment of community-acquired urinary tract infections, the spread of organisms producing ESBLs in the community merits close monitoring with enhanced efforts for surveillance.

【 授权许可】

   
2012 Birgy et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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