Monitoring Antibiotic Resistance Profiles of Fecal Isolates of Enterobacteriaceae and the Prevalence of Carbapenem-Resistant Enterobacteriaceae Among Food handlers in Kuwait

• Published in: Journal of global antimicrobial resistance. 2021-05
• Main Authors: Moghnia, Ola H, Rotimi, Vincent O, Al-Sweih, Noura A
• Format: Article
• Language: English
• ISSN: 2213-7173

Carbapenem-resistant Enterobacteriaceae (CRE) have become one of the most challenging problems in infectious diseases worldwide. Unrecognized personnel colonized as food handlers (FHs) with CRE serve as a reservoir for transmission. This study assessed the prevalence and susceptibility pattern of CRE isolates from FHs working in commercial eateries in the community (CFHs) and healthcare settings (HCFHs) in Kuwait over a period between 2016-2018. Representative colonies from fecal samples were identified by API 20E and VITEK 2 ID System. Susceptibility testing against 21 antibiotics was determined using E-test and agar dilution methods. A total of 681species of the family Enterobacteriaceae were isolated from 405 FHs, of which (425; 62.4%) and (126; 18.5%) were E. coli and K. pneumoniae isolates, respectively. The prevalence rates of CRE among FHs were (31; 7.6%), including CFHs (10; 32%) versus HCFHs (21; 68%). Ampicillin, tetracycline and cephalothin showed very poor activities against most isolates and resistance rates were 63.3%, 41.7% and 40.8%, respectively. Isolates with multi-drug resistant (MDR) were 30.5%, including E. coli (130; 30.6%) and K. pneumoniae (22; 17.6%). An alarming level of colistin 11.3% was noted. A significant proportion 13.2% of FHs isolates exhibited extended-spectrum β-lactamases (ESBLs) phenotypes, including E. coli (80; 18.8%) and K. pneumoniae (5; 4%). The study revealed that asymptomatic intestinal carriage of CRE, MDR and ESBLs were relatively common in our community. It is conceivable that FHs may, in part, pose a significant risk on the consumers in the acquisition and spread of resistant strains.