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Faecal carriage of extended‐spectrum β‐lactamase‐producing Enterobacteriaceae among humans in Java, Indonesia, in 2001–2002
Objective To characterise commensal Escherichia coli and other Enterobacteriaceae with reduced susceptibility to cefotaxime that were collected in a large survey carried out among 3995 patients and healthy persons in two urban regions on Java, Indonesia, in 2001–2002. Methods The putative extended...
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| Published in: | Tropical medicine & international health 2012-04, Vol.17 (4), p.455-461 |
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| creator | Severin, Juliëtte A. Lestari, Endang Sri Kloezen, Wendy Lemmens‐den Toom, Nicole Mertaniasih, Ni Made Kuntaman, Kuntaman Purwanta, Marijam Offra Duerink, D. Hadi, Usman van Belkum, Alex Verbrugh, Henri A. Goessens, Wil H. |
| description | Objective To characterise commensal Escherichia coli and other Enterobacteriaceae with reduced susceptibility to cefotaxime that were collected in a large survey carried out among 3995 patients and healthy persons in two urban regions on Java, Indonesia, in 2001–2002.
Methods The putative extended‐spectrum β‐lactamase (ESBL)‐producing Enterobacteriaceae were analysed using double‐disk synergy tests, isoelectric focusing, PCR assays, DNA sequencing, and pulsed‐field gel electrophoresis (PFGE).
Results On the day of discharge after five or more days of hospitalisation, at least 95 of 999 (9.5%) patients carried ESBL‐positive Enterobacteriaceae as dominant faecal flora. Six patients were simultaneously colonised with E. coli and Klebsiella pneumoniae isolates with ESBL activity. On admission, only 6 of 998 (0.6%) patients were colonised. Faecal carriage of ESBL‐producing Enterobacteriaceae among healthy persons or persons visiting a public health centre was not detected. The 107 ESBL‐positive strains included 68 E. coli, 35 K. pneumoniae, and four other Enterobacteriaceae. blaCTX‐M‐15 was the most prevalent ESBL in both E. coli (47.1%) and K. pneumoniae (45.7%), but the E. coli O25b‐ST131 clone was virtually absent. Other ESBL types found were: SHV‐2, ‐2a, ‐5, ‐12, CTX‐M‐3, ‐9, ‐14, and TEM‐19. PFGE revealed extensive genetic diversity among the isolates.
Conclusions In 2001–2002, faecal carriage of ESBL‐producing Enterobacteriaceae as dominant flora in Indonesia was almost exclusively hospital‐associated. The presence of various blaESBL genes and the extensive genetic diversity among isolates argue against a single/dominant strain outbreak.
Objectif: Caractériser Escherichia coli et autres entérobactéries commensales présentant une sensibilité réduite au céfotaxime, recueillies dans le cadre d’une enquête étendue réalisée auprès de 3995 patients et personnes saines dans deux régions urbaines de Java, en Indonésie, en 2001–2002.
Méthodes: Les entérobactéries supposées productrices de β‐lactamase à spectre étendu (BLSE) ont été analysées en utilisant des tests synergiques à double‐disque, la focalisation isoélectrique, la PCR, le séquençage de l’ADN et l’électrophorèse en champ pulsé (PFGE).
Résultats: Le jour de leur sortie après cinq jours ou plus d’hospitalisation, au moins 95 des 999 (9,5%) patients testés portaient des entérobactéries BLSE comme flore fécale dominante. Six patients étaient simultanément colonisés par des isolats E. coli et Klebsiel |
| doi_str_mv | 10.1111/j.1365-3156.2011.02949.x |
| format | article |
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Methods The putative extended‐spectrum β‐lactamase (ESBL)‐producing Enterobacteriaceae were analysed using double‐disk synergy tests, isoelectric focusing, PCR assays, DNA sequencing, and pulsed‐field gel electrophoresis (PFGE).
Results On the day of discharge after five or more days of hospitalisation, at least 95 of 999 (9.5%) patients carried ESBL‐positive Enterobacteriaceae as dominant faecal flora. Six patients were simultaneously colonised with E. coli and Klebsiella pneumoniae isolates with ESBL activity. On admission, only 6 of 998 (0.6%) patients were colonised. Faecal carriage of ESBL‐producing Enterobacteriaceae among healthy persons or persons visiting a public health centre was not detected. The 107 ESBL‐positive strains included 68 E. coli, 35 K. pneumoniae, and four other Enterobacteriaceae. blaCTX‐M‐15 was the most prevalent ESBL in both E. coli (47.1%) and K. pneumoniae (45.7%), but the E. coli O25b‐ST131 clone was virtually absent. Other ESBL types found were: SHV‐2, ‐2a, ‐5, ‐12, CTX‐M‐3, ‐9, ‐14, and TEM‐19. PFGE revealed extensive genetic diversity among the isolates.
Conclusions In 2001–2002, faecal carriage of ESBL‐producing Enterobacteriaceae as dominant flora in Indonesia was almost exclusively hospital‐associated. The presence of various blaESBL genes and the extensive genetic diversity among isolates argue against a single/dominant strain outbreak.
Objectif: Caractériser Escherichia coli et autres entérobactéries commensales présentant une sensibilité réduite au céfotaxime, recueillies dans le cadre d’une enquête étendue réalisée auprès de 3995 patients et personnes saines dans deux régions urbaines de Java, en Indonésie, en 2001–2002.
Méthodes: Les entérobactéries supposées productrices de β‐lactamase à spectre étendu (BLSE) ont été analysées en utilisant des tests synergiques à double‐disque, la focalisation isoélectrique, la PCR, le séquençage de l’ADN et l’électrophorèse en champ pulsé (PFGE).
Résultats: Le jour de leur sortie après cinq jours ou plus d’hospitalisation, au moins 95 des 999 (9,5%) patients testés portaient des entérobactéries BLSE comme flore fécale dominante. Six patients étaient simultanément colonisés par des isolats E. coli et Klebsiella pneumoniae avec une activité BLSE. À l’admission, seuls six des 998 (0,6%) patients étaient colonisés. Le portage fécal d’entérobactéries productrices de BLSE chez les personnes saines ou les personnes visitant un centre de santé publique n’a pas été détecté. Les 107 souches BLSE positives comprenaient 68 E. coli, 35 K. pneumoniae et 4 autres entérobactéries. blaCTX‐M‐15était la BLSE la plus répandue à la fois chez E. coli (47,1%) et chez K. pneumoniae (45,7%), mais le clone E. coli O25b‐ST131 était pratiquement absent. D’autres types de BLSE ont été trouvés: SHV‐2,‐2a, ‐5, ‐12, CTX‐M‐3, ‐9, ‐14 et TEM‐19. La PFGE a révélé une importante diversité génétique parmi les isolats.
Conclusions: En 2001–2002, le portage fécal d’entérobactéries productrices de BLSE comme flore dominante en Indonésie était presque exclusivement associéà l’hôpital. La présence de divers gènes blaESBL et la vaste diversité génétique parmi les isolats réfute l’idée une épidémie par une souche unique/ dominante.
Objetivo: Caracterizar las Escherichia coli comensales y otras Enterobacterias con susceptibilidad reducida frente a cefotaxima recolectadas durante un gran estudio realizado en 3995 pacientes y personas sanas en dos regiones urbanas de Java, Indonesia, entre el 2001–2002.
Métodos: Se analizaron Enterobacterias productoras de β‐lactamasas de espectro extendido (BLEE)‐ mediante las pruebas de sinergia de doble disco, electroenfoque, PCR, secuenciación del ADN y electroforesis en campo pulsado (PFGE).
Resultados: En el día en el que se les dio de alta tras cinco o más días de hospitalización, al menos 95 de 999 (9.5%) pacientes eran portadores de una Enterobacteria BLEE‐positiva como flora fecal dominante. Seis pacientes fueron colonizados de forma simultánea con cepas de E. coli y Klebsiella pneumoniae con actividad BLEE. Al momento del ingreso, solo seis de 998 (0.6%) pacientes estaban colonizados. No se detectó la presencia en heces de Enterobacterias productoras de BLEE entre personas sanas o público visitante del centro sanitario. Las 107 cepas BLEE positivas incluían 68 E. coli, 35 K. pneumoniae y cuatro otras Enterobacterias. La BLEE más prevalente era blaCTX‐M‐15 tanto en E. coli (47.1%) como en K. pneumoniae (45.7%), pero el clon O25b‐ST131 de E. coli estaba virtualmente ausente. Otros tipos de BLEE encontrados incluían: SHV‐2, ‐2a, ‐5, ‐12, CTX‐M‐3, ‐9, ‐14 y TEM‐19. El análisis mediante PFGE reveló una extensa diversidad genética entre las cepas aisladas.
Conclusiones: En 2001–2002, la carga en heces de Enterobacterias productoras de BLEE como flora dominante en Indonesia estaba casi exclusivamente asociada al ambiente hospitalario. La presencia de varios genes blaBLEE y de una amplia diversidad genética entre los aislados son argumentos en contra de la presencia de un brote con una sola cepa dominante.</description><identifier>ISSN: 1360-2276</identifier><identifier>EISSN: 1365-3156</identifier><identifier>DOI: 10.1111/j.1365-3156.2011.02949.x</identifier><identifier>PMID: 22248076</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Antibacterial agents ; antibiotic resistance ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Asia ; Asie ; beta-Lactamases - genetics ; beta-Lactamases - isolation & purification ; Biological and medical sciences ; BLEE ; BLSE ; Cluster Analysis ; colonisation ; colonización ; CTX‐M‐15 ; Electrophoresis, Gel, Pulsed-Field ; Enterobacteriaceae ; ESBL ; Escherichia coli ; Escherichia coli - genetics ; Escherichia coli - isolation & purification ; Escherichia coli Infections - epidemiology ; Escherichia coli Infections - microbiology ; Feces - microbiology ; Female ; General aspects ; Humans ; Indonesia - epidemiology ; Inpatients - statistics & numerical data ; Klebsiella Infections - epidemiology ; Klebsiella Infections - microbiology ; Klebsiella pneumoniae ; Klebsiella pneumoniae - genetics ; Klebsiella pneumoniae - isolation & purification ; Male ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; resistencia a antibióticos ; Retrospective Studies ; Risk Factors ; résistance aux antibiotiques ; Sequence Analysis, DNA ; Young Adult</subject><ispartof>Tropical medicine & international health, 2012-04, Vol.17 (4), p.455-461</ispartof><rights>2012 Blackwell Publishing Ltd</rights><rights>2015 INIST-CNRS</rights><rights>2012 Blackwell Publishing Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4829-30fc09d03cbb257ae803ae3ec5a54ad65f13fc177b9e8b54da217e4138c2acb23</citedby><cites>FETCH-LOGICAL-c4829-30fc09d03cbb257ae803ae3ec5a54ad65f13fc177b9e8b54da217e4138c2acb23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25631003$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22248076$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Severin, Juliëtte A.</creatorcontrib><creatorcontrib>Lestari, Endang Sri</creatorcontrib><creatorcontrib>Kloezen, Wendy</creatorcontrib><creatorcontrib>Lemmens‐den Toom, Nicole</creatorcontrib><creatorcontrib>Mertaniasih, Ni Made</creatorcontrib><creatorcontrib>Kuntaman, Kuntaman</creatorcontrib><creatorcontrib>Purwanta, Marijam</creatorcontrib><creatorcontrib>Offra Duerink, D.</creatorcontrib><creatorcontrib>Hadi, Usman</creatorcontrib><creatorcontrib>van Belkum, Alex</creatorcontrib><creatorcontrib>Verbrugh, Henri A.</creatorcontrib><creatorcontrib>Goessens, Wil H.</creatorcontrib><creatorcontrib>“Antimicrobial Resistance in Indonesia, Prevalence and Prevention” (AMRIN) study group</creatorcontrib><creatorcontrib>on behalf of the “Antimicrobial Resistance in Indonesia, Prevalence and Prevention” (AMRIN) study group</creatorcontrib><title>Faecal carriage of extended‐spectrum β‐lactamase‐producing Enterobacteriaceae among humans in Java, Indonesia, in 2001–2002</title><title>Tropical medicine & international health</title><addtitle>Trop Med Int Health</addtitle><description>Objective To characterise commensal Escherichia coli and other Enterobacteriaceae with reduced susceptibility to cefotaxime that were collected in a large survey carried out among 3995 patients and healthy persons in two urban regions on Java, Indonesia, in 2001–2002.
Methods The putative extended‐spectrum β‐lactamase (ESBL)‐producing Enterobacteriaceae were analysed using double‐disk synergy tests, isoelectric focusing, PCR assays, DNA sequencing, and pulsed‐field gel electrophoresis (PFGE).
Results On the day of discharge after five or more days of hospitalisation, at least 95 of 999 (9.5%) patients carried ESBL‐positive Enterobacteriaceae as dominant faecal flora. Six patients were simultaneously colonised with E. coli and Klebsiella pneumoniae isolates with ESBL activity. On admission, only 6 of 998 (0.6%) patients were colonised. Faecal carriage of ESBL‐producing Enterobacteriaceae among healthy persons or persons visiting a public health centre was not detected. The 107 ESBL‐positive strains included 68 E. coli, 35 K. pneumoniae, and four other Enterobacteriaceae. blaCTX‐M‐15 was the most prevalent ESBL in both E. coli (47.1%) and K. pneumoniae (45.7%), but the E. coli O25b‐ST131 clone was virtually absent. Other ESBL types found were: SHV‐2, ‐2a, ‐5, ‐12, CTX‐M‐3, ‐9, ‐14, and TEM‐19. PFGE revealed extensive genetic diversity among the isolates.
Conclusions In 2001–2002, faecal carriage of ESBL‐producing Enterobacteriaceae as dominant flora in Indonesia was almost exclusively hospital‐associated. The presence of various blaESBL genes and the extensive genetic diversity among isolates argue against a single/dominant strain outbreak.
Objectif: Caractériser Escherichia coli et autres entérobactéries commensales présentant une sensibilité réduite au céfotaxime, recueillies dans le cadre d’une enquête étendue réalisée auprès de 3995 patients et personnes saines dans deux régions urbaines de Java, en Indonésie, en 2001–2002.
Méthodes: Les entérobactéries supposées productrices de β‐lactamase à spectre étendu (BLSE) ont été analysées en utilisant des tests synergiques à double‐disque, la focalisation isoélectrique, la PCR, le séquençage de l’ADN et l’électrophorèse en champ pulsé (PFGE).
Résultats: Le jour de leur sortie après cinq jours ou plus d’hospitalisation, au moins 95 des 999 (9,5%) patients testés portaient des entérobactéries BLSE comme flore fécale dominante. Six patients étaient simultanément colonisés par des isolats E. coli et Klebsiella pneumoniae avec une activité BLSE. À l’admission, seuls six des 998 (0,6%) patients étaient colonisés. Le portage fécal d’entérobactéries productrices de BLSE chez les personnes saines ou les personnes visitant un centre de santé publique n’a pas été détecté. Les 107 souches BLSE positives comprenaient 68 E. coli, 35 K. pneumoniae et 4 autres entérobactéries. blaCTX‐M‐15était la BLSE la plus répandue à la fois chez E. coli (47,1%) et chez K. pneumoniae (45,7%), mais le clone E. coli O25b‐ST131 était pratiquement absent. D’autres types de BLSE ont été trouvés: SHV‐2,‐2a, ‐5, ‐12, CTX‐M‐3, ‐9, ‐14 et TEM‐19. La PFGE a révélé une importante diversité génétique parmi les isolats.
Conclusions: En 2001–2002, le portage fécal d’entérobactéries productrices de BLSE comme flore dominante en Indonésie était presque exclusivement associéà l’hôpital. La présence de divers gènes blaESBL et la vaste diversité génétique parmi les isolats réfute l’idée une épidémie par une souche unique/ dominante.
Objetivo: Caracterizar las Escherichia coli comensales y otras Enterobacterias con susceptibilidad reducida frente a cefotaxima recolectadas durante un gran estudio realizado en 3995 pacientes y personas sanas en dos regiones urbanas de Java, Indonesia, entre el 2001–2002.
Métodos: Se analizaron Enterobacterias productoras de β‐lactamasas de espectro extendido (BLEE)‐ mediante las pruebas de sinergia de doble disco, electroenfoque, PCR, secuenciación del ADN y electroforesis en campo pulsado (PFGE).
Resultados: En el día en el que se les dio de alta tras cinco o más días de hospitalización, al menos 95 de 999 (9.5%) pacientes eran portadores de una Enterobacteria BLEE‐positiva como flora fecal dominante. Seis pacientes fueron colonizados de forma simultánea con cepas de E. coli y Klebsiella pneumoniae con actividad BLEE. Al momento del ingreso, solo seis de 998 (0.6%) pacientes estaban colonizados. No se detectó la presencia en heces de Enterobacterias productoras de BLEE entre personas sanas o público visitante del centro sanitario. Las 107 cepas BLEE positivas incluían 68 E. coli, 35 K. pneumoniae y cuatro otras Enterobacterias. La BLEE más prevalente era blaCTX‐M‐15 tanto en E. coli (47.1%) como en K. pneumoniae (45.7%), pero el clon O25b‐ST131 de E. coli estaba virtualmente ausente. Otros tipos de BLEE encontrados incluían: SHV‐2, ‐2a, ‐5, ‐12, CTX‐M‐3, ‐9, ‐14 y TEM‐19. El análisis mediante PFGE reveló una extensa diversidad genética entre las cepas aisladas.
Conclusiones: En 2001–2002, la carga en heces de Enterobacterias productoras de BLEE como flora dominante en Indonesia estaba casi exclusivamente asociada al ambiente hospitalario. La presencia de varios genes blaBLEE y de una amplia diversidad genética entre los aislados son argumentos en contra de la presencia de un brote con una sola cepa dominante.</description><subject>Adult</subject><subject>Antibacterial agents</subject><subject>antibiotic resistance</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Asia</subject><subject>Asie</subject><subject>beta-Lactamases - genetics</subject><subject>beta-Lactamases - isolation & purification</subject><subject>Biological and medical sciences</subject><subject>BLEE</subject><subject>BLSE</subject><subject>Cluster Analysis</subject><subject>colonisation</subject><subject>colonización</subject><subject>CTX‐M‐15</subject><subject>Electrophoresis, Gel, Pulsed-Field</subject><subject>Enterobacteriaceae</subject><subject>ESBL</subject><subject>Escherichia coli</subject><subject>Escherichia coli - genetics</subject><subject>Escherichia coli - isolation & purification</subject><subject>Escherichia coli Infections - epidemiology</subject><subject>Escherichia coli Infections - microbiology</subject><subject>Feces - microbiology</subject><subject>Female</subject><subject>General aspects</subject><subject>Humans</subject><subject>Indonesia - epidemiology</subject><subject>Inpatients - statistics & numerical data</subject><subject>Klebsiella Infections - epidemiology</subject><subject>Klebsiella Infections - microbiology</subject><subject>Klebsiella pneumoniae</subject><subject>Klebsiella pneumoniae - genetics</subject><subject>Klebsiella pneumoniae - isolation & purification</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>resistencia a antibióticos</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>résistance aux antibiotiques</subject><subject>Sequence Analysis, DNA</subject><subject>Young Adult</subject><issn>1360-2276</issn><issn>1365-3156</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqNkUFu1TAQhiMEoqVwBeQNEgsSxnacOAsWqGrhoaJuytqaOJOSp8R52Am87rrgAEjchINwiJ4Ep--1LMGb-e35ZvxLf5IwDhmP5_U647JQqeSqyARwnoGo8irbPkgO7xsPbzWkQpTFQfIkhDUA5LkqHicHQohcQ1kcJt9PkSz2zKL3HV4SG1tG24lcQ83N9Y-wITv5eWC_f8Vbj3bCAQNFvfFjM9vOXbITN5Ef69ijuMISEsNhjI3P84AusM6xD_gVX7GVa0ZHoYsyvgkAfnP9MxbxNHnUYh_o2b4eJZ9OTy6O36dn5-9Wx2_PUptrUaUSWgtVA9LWtVAlkgaJJMkqVDk2hWq5bC0vy7oiXau8QcFLyrnUVqCthTxKXu72RvNfZgqTGbpgqe_R0TgHw7lQQmkt8n-jIECrErSMqN6h1o8heGrNxncD-qsImSUuszZLKmZJxSxxmdu4zDaOPt__MtcDNfeDd_lE4MUewBBjaj0624W_nCokB1g8vNlx37qerv7bgLn4uFqU_AMPpLS6</recordid><startdate>201204</startdate><enddate>201204</enddate><creator>Severin, Juliëtte A.</creator><creator>Lestari, Endang Sri</creator><creator>Kloezen, Wendy</creator><creator>Lemmens‐den Toom, Nicole</creator><creator>Mertaniasih, Ni Made</creator><creator>Kuntaman, Kuntaman</creator><creator>Purwanta, Marijam</creator><creator>Offra Duerink, D.</creator><creator>Hadi, Usman</creator><creator>van Belkum, Alex</creator><creator>Verbrugh, Henri A.</creator><creator>Goessens, Wil H.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7U2</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>201204</creationdate><title>Faecal carriage of extended‐spectrum β‐lactamase‐producing Enterobacteriaceae among humans in Java, Indonesia, in 2001–2002</title><author>Severin, Juliëtte A. ; Lestari, Endang Sri ; Kloezen, Wendy ; Lemmens‐den Toom, Nicole ; Mertaniasih, Ni Made ; Kuntaman, Kuntaman ; Purwanta, Marijam ; Offra Duerink, D. ; Hadi, Usman ; van Belkum, Alex ; Verbrugh, Henri A. ; Goessens, Wil H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4829-30fc09d03cbb257ae803ae3ec5a54ad65f13fc177b9e8b54da217e4138c2acb23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Antibacterial agents</topic><topic>antibiotic resistance</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Asia</topic><topic>Asie</topic><topic>beta-Lactamases - genetics</topic><topic>beta-Lactamases - isolation & purification</topic><topic>Biological and medical sciences</topic><topic>BLEE</topic><topic>BLSE</topic><topic>Cluster Analysis</topic><topic>colonisation</topic><topic>colonización</topic><topic>CTX‐M‐15</topic><topic>Electrophoresis, Gel, Pulsed-Field</topic><topic>Enterobacteriaceae</topic><topic>ESBL</topic><topic>Escherichia coli</topic><topic>Escherichia coli - genetics</topic><topic>Escherichia coli - isolation & purification</topic><topic>Escherichia coli Infections - epidemiology</topic><topic>Escherichia coli Infections - microbiology</topic><topic>Feces - microbiology</topic><topic>Female</topic><topic>General aspects</topic><topic>Humans</topic><topic>Indonesia - epidemiology</topic><topic>Inpatients - statistics & numerical data</topic><topic>Klebsiella Infections - epidemiology</topic><topic>Klebsiella Infections - microbiology</topic><topic>Klebsiella pneumoniae</topic><topic>Klebsiella pneumoniae - genetics</topic><topic>Klebsiella pneumoniae - isolation & purification</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>resistencia a antibióticos</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>résistance aux antibiotiques</topic><topic>Sequence Analysis, DNA</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Severin, Juliëtte A.</creatorcontrib><creatorcontrib>Lestari, Endang Sri</creatorcontrib><creatorcontrib>Kloezen, Wendy</creatorcontrib><creatorcontrib>Lemmens‐den Toom, Nicole</creatorcontrib><creatorcontrib>Mertaniasih, Ni Made</creatorcontrib><creatorcontrib>Kuntaman, Kuntaman</creatorcontrib><creatorcontrib>Purwanta, Marijam</creatorcontrib><creatorcontrib>Offra Duerink, D.</creatorcontrib><creatorcontrib>Hadi, Usman</creatorcontrib><creatorcontrib>van Belkum, Alex</creatorcontrib><creatorcontrib>Verbrugh, Henri A.</creatorcontrib><creatorcontrib>Goessens, Wil H.</creatorcontrib><creatorcontrib>“Antimicrobial Resistance in Indonesia, Prevalence and Prevention” (AMRIN) study group</creatorcontrib><creatorcontrib>on behalf of the “Antimicrobial Resistance in Indonesia, Prevalence and Prevention” (AMRIN) study group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Tropical medicine & international health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Severin, Juliëtte A.</au><au>Lestari, Endang Sri</au><au>Kloezen, Wendy</au><au>Lemmens‐den Toom, Nicole</au><au>Mertaniasih, Ni Made</au><au>Kuntaman, Kuntaman</au><au>Purwanta, Marijam</au><au>Offra Duerink, D.</au><au>Hadi, Usman</au><au>van Belkum, Alex</au><au>Verbrugh, Henri A.</au><au>Goessens, Wil H.</au><aucorp>“Antimicrobial Resistance in Indonesia, Prevalence and Prevention” (AMRIN) study group</aucorp><aucorp>on behalf of the “Antimicrobial Resistance in Indonesia, Prevalence and Prevention” (AMRIN) study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Faecal carriage of extended‐spectrum β‐lactamase‐producing Enterobacteriaceae among humans in Java, Indonesia, in 2001–2002</atitle><jtitle>Tropical medicine & international health</jtitle><addtitle>Trop Med Int Health</addtitle><date>2012-04</date><risdate>2012</risdate><volume>17</volume><issue>4</issue><spage>455</spage><epage>461</epage><pages>455-461</pages><issn>1360-2276</issn><eissn>1365-3156</eissn><abstract>Objective To characterise commensal Escherichia coli and other Enterobacteriaceae with reduced susceptibility to cefotaxime that were collected in a large survey carried out among 3995 patients and healthy persons in two urban regions on Java, Indonesia, in 2001–2002.
Methods The putative extended‐spectrum β‐lactamase (ESBL)‐producing Enterobacteriaceae were analysed using double‐disk synergy tests, isoelectric focusing, PCR assays, DNA sequencing, and pulsed‐field gel electrophoresis (PFGE).
Results On the day of discharge after five or more days of hospitalisation, at least 95 of 999 (9.5%) patients carried ESBL‐positive Enterobacteriaceae as dominant faecal flora. Six patients were simultaneously colonised with E. coli and Klebsiella pneumoniae isolates with ESBL activity. On admission, only 6 of 998 (0.6%) patients were colonised. Faecal carriage of ESBL‐producing Enterobacteriaceae among healthy persons or persons visiting a public health centre was not detected. The 107 ESBL‐positive strains included 68 E. coli, 35 K. pneumoniae, and four other Enterobacteriaceae. blaCTX‐M‐15 was the most prevalent ESBL in both E. coli (47.1%) and K. pneumoniae (45.7%), but the E. coli O25b‐ST131 clone was virtually absent. Other ESBL types found were: SHV‐2, ‐2a, ‐5, ‐12, CTX‐M‐3, ‐9, ‐14, and TEM‐19. PFGE revealed extensive genetic diversity among the isolates.
Conclusions In 2001–2002, faecal carriage of ESBL‐producing Enterobacteriaceae as dominant flora in Indonesia was almost exclusively hospital‐associated. The presence of various blaESBL genes and the extensive genetic diversity among isolates argue against a single/dominant strain outbreak.
Objectif: Caractériser Escherichia coli et autres entérobactéries commensales présentant une sensibilité réduite au céfotaxime, recueillies dans le cadre d’une enquête étendue réalisée auprès de 3995 patients et personnes saines dans deux régions urbaines de Java, en Indonésie, en 2001–2002.
Méthodes: Les entérobactéries supposées productrices de β‐lactamase à spectre étendu (BLSE) ont été analysées en utilisant des tests synergiques à double‐disque, la focalisation isoélectrique, la PCR, le séquençage de l’ADN et l’électrophorèse en champ pulsé (PFGE).
Résultats: Le jour de leur sortie après cinq jours ou plus d’hospitalisation, au moins 95 des 999 (9,5%) patients testés portaient des entérobactéries BLSE comme flore fécale dominante. Six patients étaient simultanément colonisés par des isolats E. coli et Klebsiella pneumoniae avec une activité BLSE. À l’admission, seuls six des 998 (0,6%) patients étaient colonisés. Le portage fécal d’entérobactéries productrices de BLSE chez les personnes saines ou les personnes visitant un centre de santé publique n’a pas été détecté. Les 107 souches BLSE positives comprenaient 68 E. coli, 35 K. pneumoniae et 4 autres entérobactéries. blaCTX‐M‐15était la BLSE la plus répandue à la fois chez E. coli (47,1%) et chez K. pneumoniae (45,7%), mais le clone E. coli O25b‐ST131 était pratiquement absent. D’autres types de BLSE ont été trouvés: SHV‐2,‐2a, ‐5, ‐12, CTX‐M‐3, ‐9, ‐14 et TEM‐19. La PFGE a révélé une importante diversité génétique parmi les isolats.
Conclusions: En 2001–2002, le portage fécal d’entérobactéries productrices de BLSE comme flore dominante en Indonésie était presque exclusivement associéà l’hôpital. La présence de divers gènes blaESBL et la vaste diversité génétique parmi les isolats réfute l’idée une épidémie par une souche unique/ dominante.
Objetivo: Caracterizar las Escherichia coli comensales y otras Enterobacterias con susceptibilidad reducida frente a cefotaxima recolectadas durante un gran estudio realizado en 3995 pacientes y personas sanas en dos regiones urbanas de Java, Indonesia, entre el 2001–2002.
Métodos: Se analizaron Enterobacterias productoras de β‐lactamasas de espectro extendido (BLEE)‐ mediante las pruebas de sinergia de doble disco, electroenfoque, PCR, secuenciación del ADN y electroforesis en campo pulsado (PFGE).
Resultados: En el día en el que se les dio de alta tras cinco o más días de hospitalización, al menos 95 de 999 (9.5%) pacientes eran portadores de una Enterobacteria BLEE‐positiva como flora fecal dominante. Seis pacientes fueron colonizados de forma simultánea con cepas de E. coli y Klebsiella pneumoniae con actividad BLEE. Al momento del ingreso, solo seis de 998 (0.6%) pacientes estaban colonizados. No se detectó la presencia en heces de Enterobacterias productoras de BLEE entre personas sanas o público visitante del centro sanitario. Las 107 cepas BLEE positivas incluían 68 E. coli, 35 K. pneumoniae y cuatro otras Enterobacterias. La BLEE más prevalente era blaCTX‐M‐15 tanto en E. coli (47.1%) como en K. pneumoniae (45.7%), pero el clon O25b‐ST131 de E. coli estaba virtualmente ausente. Otros tipos de BLEE encontrados incluían: SHV‐2, ‐2a, ‐5, ‐12, CTX‐M‐3, ‐9, ‐14 y TEM‐19. El análisis mediante PFGE reveló una extensa diversidad genética entre las cepas aisladas.
Conclusiones: En 2001–2002, la carga en heces de Enterobacterias productoras de BLEE como flora dominante en Indonesia estaba casi exclusivamente asociada al ambiente hospitalario. La presencia de varios genes blaBLEE y de una amplia diversidad genética entre los aislados son argumentos en contra de la presencia de un brote con una sola cepa dominante.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>22248076</pmid><doi>10.1111/j.1365-3156.2011.02949.x</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1360-2276 |
| ispartof | Tropical medicine & international health, 2012-04, Vol.17 (4), p.455-461 |
| issn | 1360-2276 1365-3156 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1125258824 |
| source | Wiley |
| subjects | Adult Antibacterial agents antibiotic resistance Antibiotics. Antiinfectious agents. Antiparasitic agents Asia Asie beta-Lactamases - genetics beta-Lactamases - isolation & purification Biological and medical sciences BLEE BLSE Cluster Analysis colonisation colonización CTX‐M‐15 Electrophoresis, Gel, Pulsed-Field Enterobacteriaceae ESBL Escherichia coli Escherichia coli - genetics Escherichia coli - isolation & purification Escherichia coli Infections - epidemiology Escherichia coli Infections - microbiology Feces - microbiology Female General aspects Humans Indonesia - epidemiology Inpatients - statistics & numerical data Klebsiella Infections - epidemiology Klebsiella Infections - microbiology Klebsiella pneumoniae Klebsiella pneumoniae - genetics Klebsiella pneumoniae - isolation & purification Male Medical sciences Middle Aged Pharmacology. Drug treatments resistencia a antibióticos Retrospective Studies Risk Factors résistance aux antibiotiques Sequence Analysis, DNA Young Adult |
| title | Faecal carriage of extended‐spectrum β‐lactamase‐producing Enterobacteriaceae among humans in Java, Indonesia, in 2001–2002 |
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