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Fecal Carriage of Antimicrobial-Resistant Enterobacteriaceae in Healthy Korean Adults

  • Joo, Eun-Jeong (Division of Infectious Diseases, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Sun Ju (Department of Molecular Cell Biology and Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Baek, Misuk (Department of Molecular Cell Biology and Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Yujin (Department of Molecular Cell Biology and Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Seo, Jungyu (Department of Molecular Cell Biology and Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yeom, Joon-Sup (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Ko, Kwan Soo (Department of Molecular Cell Biology and Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2018.01.03
  • Accepted : 2018.05.07
  • Published : 2018.07.28

Abstract

The spread of antibiotic-resistant Enterobacteriaceae in the community is one of the main challenges for antibiotic treatment of community-onset infections. We evaluated the microbiological and molecular characteristics of stool samples from adults with comprehensive health examinations. Of 109 fecal samples, bacterial growth was observed in 86 samples and 61 gram-negative bacterial isolates were identified, of which 45 were Escherichia coli isolates (73.8%). Two isolates of Raoultella showed imipenem resistance, and both E. coli and Citrobacter freundii showed intermediate resistance to imipenem. Colistin resistance was identified in isolates of Klebsiella variicola and Salmonella subterranean, but no isolates carried mcr-1. As for E. coli genotypes, 35 sequence types were identified. $bla_{TEM-1}$, $bla_{TEM-30}$, and $bla_{CTX-M}$ were identified in 15, 1, and 4 E. coli isolates, respectively. In addition, all four Klebsiella pneumoniae isolates carried $bla_{SHV}$. Many genotypes that have been identified in isolates causing human infections were found in isolates in this study. There is a need to control the rise and spread of antibiotic-resistant pathogens by fecal carriage.

Keywords

References

  1. Woe rther PL, Burdet C, Chachaty E, Andremont A. 2013. Trends in human fecal carriage of extended-spectrum betalactamases in the community: toward the globalization of CTX-M. Clin. Microbiol. Rev. 26: 744-758. https://doi.org/10.1128/CMR.00023-13
  2. Ko YJ, Moon HW, Hur M, Park CM, Cho SE, Yun YM. 2013. Fecal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae in Korean community and hospital settings. Infection 41: 9-13. https://doi.org/10.1007/s15010-012-0272-3
  3. Ni colas-Chanoine MH, Blanco J, Leflon-Guibout V, Demarty R, Alonso MP, Canica MM, et al. 2008. Intercontinental emergence of Escherichia coli clone O25:H4-ST131 producing CTX-M-15. J Antimicrob. Chemother. 61: 273-281.
  4. K o KS, Lee MY, Song JH, Lee H, Jung DS, Jung SI, et al. 2008. Prevalence and characterization of extended-spectrum beta-lactamase-producing Enterobacteriaceae isolated in Korean hospitals. Diagn. Microbiol. Infect. Dis. 61: 453-459. https://doi.org/10.1016/j.diagmicrobio.2008.03.005
  5. J eong SH, Kim HS, Kim JS, Shin DH, Park MJ, Shin S, et al. 2016. Prevalence and molecular characteristics of carbapenemase-producing Enterobacteriaceae from five hospitals in Korea. Ann. Lab. Med. 36: 529-535. https://doi.org/10.3343/alm.2016.36.6.529
  6. Ol aitan AO, Diene SM, Kempf M, Berrazeg M, Bakour S, Gupta SK, et al. 2014. Worldwide emergence of colistin resistance in Klebsiella pneumoniae from healthy humans and patients in Lao PDR, Thailand, Israel, Nigeria and France owing to inactivation of the PhoP/PhoQ regulator mgrB: an epidemiological and molecular study. Int. J. Antimicrob. Agents 44: 500-507. https://doi.org/10.1016/j.ijantimicag.2014.07.020
  7. L iu YY, Wang Y, Walsh TR, Yi LX, Zhang R, Spencer J, et al. 2016. Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study. Lancet Infect. Dis. 16: 161-168. https://doi.org/10.1016/S1473-3099(15)00424-7
  8. Al Masalma M, Armougom F, Scheld WM, Dufour H, Roche PH, Drancourt M, et al. 2009. The expansion of the microbiological spectrum of brain abscesses with use of multiple 16S ribosomal DNA sequencing. Clin. Infect. Dis. 48: 1169-1178. https://doi.org/10.1086/597578
  9. M ollet C, Drancourt M, Raoult D. 1997. rpoB sequence analysis as a novel basis for bacterial identification. Mol. Microbiol. 26: 1005-1011. https://doi.org/10.1046/j.1365-2958.1997.6382009.x
  10. Clinical and Laboratory Standards Institute. 2016. Performance Standards for Antimicobial Susceptibility Testing: 26th Informational Supplement M100-S26. CLSI, Wayne, PA, USA.
  11. P oirel L, Walsh TR, Cuvillier V, Nordmann P. 2011. Multiplex PCR for detection of acquired carbapenemase genes. Diagn. Microbiol. Infect. Dis. 70: 119-123. https://doi.org/10.1016/j.diagmicrobio.2010.12.002
  12. Ki m J, Lim YM, Rheem I, Lee Y, Lee JC, Seol SY, et al. 2005. CTX-M and SHV-12 beta-lactamases are the most common extended-spectrum enzymes in clinical isolates of Escherichia coli and Klebsiella pneumoniae collected from 3 university hospitals within Korea. FEMS Microbiol. Lett. 245: 93-98. https://doi.org/10.1016/j.femsle.2005.02.029
  13. L au SH, Reddy S, Cheesbrough J, Bolton FJ, Willshaw G, Cheasty T, et al. 2008. Major uropathogenic Escherichia coli strain isolated in the northwest of England identified by multilocus sequence typing. J. Clin. Microbiol. 46: 1076-1080. https://doi.org/10.1128/JCM.02065-07
  14. Diancourt L, Passet V, Verhoef J, Grimont PA, Brisse S. 2005. Multilocus sequence typing of Klebsiella pneumoniae nosocomial isolates. J. Clin. Microbiol. 43: 4178-4182. https://doi.org/10.1128/JCM.43.8.4178-4182.2005
  15. Kim SY, Shin SY, Rhee JY, Ko KS. 2017. Imipenem-resistant gram-negative bacterial isolates carried by persons upon medical examination in Korea. J. Microbiol. 55: 612-618. https://doi.org/10.1007/s12275-017-6555-8
  16. Ko KS, Choi Y, Lee JY. 2017. Old drug, new findings: colistin resistance and dependence of Acinetobacter baumannii. Precis. Future Med. 1: 159-167. https://doi.org/10.23838/pfm.2017.00184
  17. Na kamura A, Komatsu M, Noguchi N, Ohno Y, Hashimoto E, Matsutani H, et al. 2016. Analysis of molecular epidemiologic characteristics of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli colonizing feces in hospital patients and community dwellers in a Japanese city. J. Infect. Dis. 22: 102-107.
  18. Luvsansharav UO, Hirai I, Niki M, Sasaki T, Makimoto K, Komalamisra C, et al. 2011. Analysis of risk factors for a high prevalence of extended-spectrum ${\beta}$-lactamase-producing Enterobacteriaceae in asymptomatic individuals in rural Thailand. J. Med. Microbiol. 60: 619-624. https://doi.org/10.1099/jmm.0.026955-0
  19. L i B, Sun JY, Liu QZ, Han LZ, Huang XH, Ni YX. 2011. High prevalence of CTX-M beta-lactamases in faecal Escherichia coli strains from healthy humans in Fuzhou, China. Scand. J. Infect. Dis. 43: 170-174. https://doi.org/10.3109/00365548.2010.538856
  20. C hun S, Yun JW, Huh HJ, Lee NY. 2015. Clinical characteristics of Raoultella ornithinolytica bacteremia. Infection 43: 59-64. https://doi.org/10.1007/s15010-014-0696-z
  21. Nicolas-Chanoine MH, Bertrand X, Madec JY. 2014. Escherichia coli ST131, an intriguing clonal group. Clin. Microbiol. Rev. 27: 543-574. https://doi.org/10.1128/CMR.00125-13
  22. P ark SH, Byun JH, Choi SM, Lee DG, Kim SH, Kwon JC, et al. 2012. Molecular epidemiology of extended-spectrum beta-lactamase-producing Escherichia coli in the community and hospital in Korea: emergence of ST131 producing CTXM-15. BMC Infect. Dis. 12: 149. https://doi.org/10.1186/1471-2334-12-149
  23. Jeong SH, Lee KM, Lee J, Bae IK, Kim JS, Kim HS, et al. 2015. Clonal and horizontal spread of the blaOXA-232 gene among Enterobacteriaceae in a Korean hospital. Diagn. Microbiol. Infect. Dis. 82: 70-72. https://doi.org/10.1016/j.diagmicrobio.2015.02.001
  24. Bonomo RA, Rudin SA, Shlaes DM. 1997. Tazobactam is a potent inactivator of selected inhibitor-resistant class A beta-lactamases. FEMS Microbiol. Lett. 148: 59-62. https://doi.org/10.1016/S0378-1097(97)00013-X
  25. Yun KW, Kim DS, Kim W, Lim IS. 2015. Molecular typing of uropathogenic Escherichia coli isolated from Korean children with urinary tract infection. Korean J. Pediatr. 58: 20-27. https://doi.org/10.3345/kjp.2015.58.1.20

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