Community acquisition of β-lactamase producing Enterobacteriaceae in neonatal gut

BMC Microbiology

Research Article

Charu Kothari¹  Monorama Deb¹  Rajni Gaind¹  Harish Chellani²  Sugandha Arya²  Vidya Kumari²  Anju Sinha³  Sunita Saxena⁴  Laishram Chandreshwor Singh⁴ 

[1] Department of Microbiology, VMMC and Safdarjung Hospital, 110029, New Delhi, India;Department of Paediatrics, VMMC and Safdarjung Hospital, 110029, New Delhi, India;Indian Council of Medical Research, 110029, New Delhi, India;National Institute of Pathology, Indian Council of Medical Research, 110029, New Delhi, India;

关键词: ESBL;    AmpC;    Carbapenemases;    Neonates;    Antibiotic resistance;    Enterobacteriaceae;    Fecal carriage;    Gut colonization;   

DOI  :  10.1186/1471-2180-13-136

 received in 2013-01-14, accepted in 2013-06-06,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundCommensal flora constitutes a reservoir of antibiotic resistance. The increasing variety of β-lactamases and the emergence of Carbapenem resistant Enterobacteriaceae (CRE) in community, raise concerns regarding efficacy of β-lactams. It is important to know the exact load of antibiotic resistance in the absence of any antibiotic selection pressure including via food and water.In the present study gut colonization in neonates with no direct antibiotic pressure was used as a model to evaluate β-lactam resistance in the community.ResultsIn this prospective study, 75 healthy, vaginally delivered, antibiotic naive, breast fed neonates were studied for gut colonization by Extended spectrum β-lactamases (ESBL), AmpC β-lactamases hyperproducing Enterobacteriaceae and CRE on day 0, 21 and 60. Total 267 Enterobacteriaceae were isolated and E.coli was the predominant flora. ESBL, AmpC and coproduction was seen in 20.6%, 19.9% and 11.2% isolates respectively. ESBL carriage increased threefold from day 1 to 60 showing predominance of CTX-M group 15 (82.5%), ampC genes were heterogeneous. Colonization with CRE was rare, only one baby harboured Enterobacter sp positive for kpc-2. The reservoirs for these genes are likely to be mother and the environment.ConclusionsData strongly suggests that in absence of any antibiotic pressure there is tremendous load of antibiotic resistance to β-lactam drugs. Wide spread presence of ESBL and AmpC can drive rapid emergence and dissemination of CRE. This is the first report from India which depicts the smaller picture of true antibiotic pressure present in the Indian community.

【 授权许可】

Unknown   
© Kothari et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.