This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Valverde, A.
Right arrow Articles by Cantón, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Valverde, A.
Right arrow Articles by Cantón, R.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, October 2004, p. 4769-4775, Vol. 42, No. 10
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.10.4769-4775.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Dramatic Increase in Prevalence of Fecal Carriage of Extended-Spectrum ß-Lactamase-Producing Enterobacteriaceae during Nonoutbreak Situations in Spain

Aránzazu Valverde,1 Teresa M. Coque,1 M. Paz Sánchez-Moreno,2 Azucena Rollán,1 Fernando Baquero,1 and Rafael Cantón1*

Servicio de Microbiología, Hospital Universitario Ramón y Cajal,1 Sección de Microbiología, Laboratorio Municipal de Madrid, Madrid, Spain2

Received 28 April 2004/ Returned for modification 3 June 2004/ Accepted 11 July 2004

The occurrence of extended-spectrum ß-lactamase (ESBL)-producing isolates has increased worldwide. Fecal carriage of ESBL-producing isolates has mainly been detected in nosocomial outbreaks, and few studies have evaluated fecal carriage during nonoutbreak situations and among patients in the community. We have studied the prevalence of ESBLs in 1,239 fecal samples from 849 patients (64.1% of whom were ambulatory) in 1991 and have compared the prevalence data with those obtained in 2003 for 400 fecal samples from 386 patients (75.9% of whom were ambulatory) and 108 samples from independent healthy volunteers. Samples were diluted in saline and cultured in two MacConkey agar plates supplemented with ceftazidime (1 µg/ml) and cefotaxime (1 µg/ml), respectively. Colonies were screened (by the double-disk synergy test) for ESBL production. The clonal relatedness of all ESBL-producing isolates was determined by pulsed-field gel electrophoresis with XbaI digestion; and the ESBLs of all ESBL-producing isolates were characterized by isoelectric focusing, PCR, and sequencing. The rates of fecal carriage of ESBL-producing isolates increased significantly (P < 0.001) in both hospitalized patients and outpatients, from 0.3 and 0.7%, respectively, in 1991, to 11.8 and 5.5%, respectively, in 2003. The rate of occurrence of ESBL-producing isolates among healthy volunteers was 3.7%. All ESBL-producing isolates recovered in 2003 were nonepidemic clones of Escherichia coli. ESBL characterization revealed an increasing diversity of ESBL types: TEM-4 and CTX-M-10 were the only enzymes detected in 1991, whereas TEM-4, TEM-52, SHV-12, CTX-M-9, CTX-M-10, CTX-M-14, and a CTX-M-2-like enzyme were recovered in 2003. The ESBL-producing isolates recovered from outpatients in 2003 corresponded to a CTX-M-9-type cluster (62.5%) and SHV-12 (31.2%), whereas TEM-4 was detected only in hospitalized patients. The frequencies of coresistance in isolates recovered in 2003 were as follows: sulfonamide, 75%; tetracycline, 64.3%; streptomycin, 57.1%; quinolones, 53.5%; and trimethoprim, 50%. The increased prevalence of fecal carriage of ESBL-producing isolates during nonoutbreak situations in hospitalized patients and the establishment of these isolates in the community with coresistance to non-ß-lactam antibiotics, including quinolones, represent an opportunity for these isolates to become endemic.

* Corresponding author. Mailing address: Servicio de Microbiología, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain. Phone: 34-913368330. Fax: 34-913368809. E-mail: rcanton.hrc{at}salud.madrid.org.

Journal of Clinical Microbiology, October 2004, p. 4769-4775, Vol. 42, No. 10
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.10.4769-4775.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Valverde, A., Canton, R., Garcillan-Barcia, M. P., Novais, A., Galan, J. C., Alvarado, A., de la Cruz, F., Baquero, F., Coque, T. M. (2009). Spread of blaCTX-M-14 Is Driven Mainly by IncK Plasmids Disseminated among Escherichia coli Phylogroups A, B1, and D in Spain. Antimicrob. Agents Chemother. 53: 5204-5212 [Abstract] [Full Text]  
  • Kowal-Vern, A., Poulakidas, S., Barnett, B., Conway, D., Culver, D., Ferrari, M., Potenza, B., Koenig, M., Mah, J., Majewski, M., Morris, L., Powers, J., Stokes, E., Tan, M., Salstrom, S.-J., Zaletel, C., Ambutas, S., Casey, K., Stein, J., DeSane, M., Berry, K., Konz, E. C., Riemer, M. R., Cullum, M. E. (2009). Fecal Containment in Bedridden Patients: Economic Impact of 2 Commercial Bowel Catheter Systems. Am J Crit Care 18: S2-S14 [Abstract] [Full Text]  
  • Leflon-Guibout, V., Blanco, J., Amaqdouf, K., Mora, A., Guize, L., Nicolas-Chanoine, M.-H. (2008). Absence of CTX-M Enzymes but High Prevalence of Clones, Including Clone ST131, among Fecal Escherichia coli Isolates from Healthy Subjects Living in the Area of Paris, France. J. Clin. Microbiol. 46: 3900-3905 [Abstract] [Full Text]  
  • Rodriguez-Bano, J., Lopez-Cerero, L., Navarro, M. D., de Alba, P. D., Pascual, A. (2008). Faecal carriage of extended-spectrum {beta}-lactamase-producing Escherichia coli: prevalence, risk factors and molecular epidemiology. J Antimicrob Chemother 62: 1142-1149 [Abstract] [Full Text]  
  • Calatayud, L., Arnan, M., Linares, J., Dominguez, M. A., Gudiol, C., Carratala, J., Batlle, M., Ribera, J. M., Gudiol, F. (2008). Prospective Study of Fecal Colonization by Extended-Spectrum-{beta}-Lactamase-Producing Escherichia coli in Neutropenic Patients with Cancer. Antimicrob. Agents Chemother. 52: 4187-4190 [Abstract] [Full Text]  
  • Tumbarello, M., Sali, M., Trecarichi, E. M., Leone, F., Rossi, M., Fiori, B., De Pascale, G., D'Inzeo, T., Sanguinetti, M., Fadda, G., Cauda, R., Spanu, T. (2008). Bloodstream Infections Caused by Extended-Spectrum-{beta}-Lactamase- Producing Escherichia coli: Risk Factors for Inadequate Initial Antimicrobial Therapy. Antimicrob. Agents Chemother. 52: 3244-3252 [Abstract] [Full Text]  
  • Valverde, A., Grill, F., Coque, T. M., Pintado, V., Baquero, F., Canton, R., Cobo, J. (2008). High Rate of Intestinal Colonization with Extended-Spectrum-{beta}-Lactamase-Producing Organisms in Household Contacts of Infected Community Patients. J. Clin. Microbiol. 46: 2796-2799 [Abstract] [Full Text]  
  • Vinue, L., Lantero, M., Saenz, Y., Somalo, S., de Diego, I., Perez, F., Ruiz-Larrea, F., Zarazaga, M., Torres, C. (2008). Characterization of extended-spectrum {beta}-lactamases and integrons in Escherichia coli isolates in a Spanish hospital. J Med Microbiol 57: 916-920 [Full Text]  
  • Madec, J.-Y., Lazizzera, C., Chatre, P., Meunier, D., Martin, S., Lepage, G., Menard, M.-F., Lebreton, P., Rambaud, T. (2008). Prevalence of Fecal Carriage of Acquired Expanded-Spectrum Cephalosporin Resistance in Enterobacteriaceae Strains from Cattle in France. J. Clin. Microbiol. 46: 1566-1567 [Full Text]  
  • Warren, R. E., Ensor, V. M., O'Neill, P., Butler, V., Taylor, J., Nye, K., Harvey, M., Livermore, D. M., Woodford, N., Hawkey, P. M. (2008). Imported chicken meat as a potential source of quinolone-resistant Escherichia coli producing extended-spectrum {beta}-lactamases in the UK. J Antimicrob Chemother 61: 504-508 [Abstract] [Full Text]  
  • Reglier-Poupet, H., Naas, T., Carrer, A., Cady, A., Adam, J.-M., Fortineau, N., Poyart, C., Nordmann, P. (2008). Performance of chromID ESBL, a chromogenic medium for detection of Enterobacteriaceae producing extended-spectrum {beta}-lactamases. J Med Microbiol 57: 310-315 [Abstract] [Full Text]  
  • Valverde, A., Coque, T. M., Garcia-San Miguel, L., Baquero, F., Canton, R. (2008). Complex molecular epidemiology of extended-spectrum -lactamases in Klebsiella pneumoniae: a long-term perspective from a single institution in Madrid. J Antimicrob Chemother 61: 64-72 [Abstract] [Full Text]  
  • Brasme, L., Nordmann, P., Fidel, F., Lartigue, M. F., Bajolet, O., Poirel, L., Forte, D., Vernet-Garnier, V., Madoux, J., Reveil, J. C., Alba-Sauviat, C., Baudinat, I., Bineau, P., Bouquigny-Saison, C., Eloy, C., Lafaurie, C., Simeon, D., Verquin, J. P., Noel, F., Strady, C., De Champs, C. (2007). Incidence of class A extended-spectrum {beta}-lactamases in Champagne-Ardenne (France): a 1 year prospective study. J Antimicrob Chemother 60: 956-964 [Abstract] [Full Text]  
  • Upton, A., Mohiuddin, J., Bathgate, T., Taylor, S., Simmons, G., Woodhouse, R., Heffernan, H. (2007). High prevalence of CTX-M-15 extended-spectrum {beta}-lactamase among contacts of patients with shigellosis due to Shigella flexneri carrying CTX-M-15. J Antimicrob Chemother 60: 906-908 [Full Text]  
  • Lee, J., Pai, H., Kim, Y. K., Kim, N. H., Eun, B. W., Kang, H. J., Park, K. H., Choi, E. H., Shin, H. Y., Kim, E. C., Lee, H. J., Ahn, H. S. (2007). Control of extended-spectrum {beta}-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a children's hospital by changing antimicrobial agent usage policy. J Antimicrob Chemother 60: 629-637 [Abstract] [Full Text]  
  • Livermore, D. M., Canton, R., Gniadkowski, M., Nordmann, P., Rossolini, G. M., Arlet, G., Ayala, J., Coque, T. M., Kern-Zdanowicz, I., Luzzaro, F., Poirel, L., Woodford, N. (2007). CTX-M: changing the face of ESBLs in Europe. J Antimicrob Chemother 59: 165-174 [Abstract] [Full Text]  
  • Glupczynski, Y., Berhin, C., Bauraing, C., Bogaerts, P. (2007). Evaluation of a New Selective Chromogenic Agar Medium for Detection of Extended-Spectrum {beta}-Lactamase-Producing Enterobacteriaceae. J. Clin. Microbiol. 45: 501-505 [Abstract] [Full Text]  
  • Morosini, M.-I., Garcia-Castillo, M., Coque, T. M., Valverde, A., Novais, A., Loza, E., Baquero, F., Canton, R. (2006). Antibiotic Coresistance in Extended-Spectrum-{beta}-Lactamase-Producing Enterobacteriaceae and In Vitro Activity of Tigecycline.. Antimicrob. Agents Chemother. 50: 2695-2699 [Abstract] [Full Text]  
  • Mugnaioli, C., Luzzaro, F., De Luca, F., Brigante, G., Perilli, M., Amicosante, G., Stefani, S., Toniolo, A., Rossolini, G. M. (2006). CTX-M-Type Extended-Spectrum {beta}-Lactamases in Italy: Molecular Epidemiology of an Emerging Countrywide Problem.. Antimicrob. Agents Chemother. 50: 2700-2706 [Abstract] [Full Text]  
  • Potz, N. A. C., Hope, R., Warner, M., Johnson, A. P., Livermore, D. M., on behalf of the London & South East ESBL Project, (2006). Prevalence and mechanisms of cephalosporin resistance in Enterobacteriaceae in London and South-East England. J Antimicrob Chemother 58: 320-326 [Abstract] [Full Text]  
  • Oteo, J., Navarro, C., Cercenado, E., Delgado-Iribarren, A., Wilhelmi, I., Orden, B., Garcia, C., Miguelanez, S., Perez-Vazquez, M., Garcia-Cobos, S., Aracil, B., Bautista, V., Campos, J. (2006). Spread of Escherichia coli Strains with High-Level Cefotaxime and Ceftazidime Resistance between the Community, Long-Term Care Facilities, and Hospital Institutions.. J. Clin. Microbiol. 44: 2359-2366 [Abstract] [Full Text]  
  • Mesa, R. J., Blanc, V., Blanch, A. R., Cortes, P., Gonzalez, J. J., Lavilla, S., Miro, E., Muniesa, M., Saco, M., Tortola, M. T., Mirelis, B., Coll, P., Llagostera, M., Prats, G., Navarro, F. (2006). Extended-spectrum {beta}-lactamase-producing Enterobacteriaceae in different environments (humans, food, animal farms and sewage). J Antimicrob Chemother 58: 211-215 [Abstract] [Full Text]  
  • Calbo, E., Romani, V., Xercavins, M., Gomez, L., Vidal, C. G., Quintana, S., Vila, J., Garau, J. (2006). Risk factors for community-onset urinary tract infections due to Escherichia coli harbouring extended-spectrum {beta}-lactamases. J Antimicrob Chemother 57: 780-783 [Abstract] [Full Text]  
  • Valverde, A., Canton, R., Galan, J. C., Nordmann, P., Baquero, F., Coque, T. M. (2006). In117, an Unusual In0-Like Class 1 Integron Containing CR1 and blaCTX-M-2 and Associated with a Tn21-Like Element. Antimicrob. Agents Chemother. 50: 799-802 [Abstract] [Full Text]  
  • Brinas, L., Lantero, M., de Diego, I., Alvarez, M., Zarazaga, M., Torres, C. (2005). Mechanisms of resistance to expanded-spectrum cephalosporins in Escherichia coli isolates recovered in a Spanish hospital. J Antimicrob Chemother 56: 1107-1110 [Abstract] [Full Text]  
  • Miro, E., Mirelis, B., Navarro, F., Rivera, A., Mesa, R. J., Roig, M. C., Gomez, L., Coll, P. (2005). Surveillance of extended-spectrum {beta}-lactamases from clinical samples and faecal carriers in Barcelona, Spain. J Antimicrob Chemother 56: 1152-1155 [Abstract] [Full Text]  
  • Arpin, C., Dubois, V., Maugein, J., Jullin, J., Dutilh, B., Brochet, J.-P., Larribet, G., Fischer, I., Quentin, C. (2005). Clinical and Molecular Analysis of Extended-Spectrum {beta}-Lactamase-Producing Enterobacteria in the Community Setting. J. Clin. Microbiol. 43: 5048-5054 [Abstract] [Full Text]  
  • Livermore, D. M., Hawkey, P. M. (2005). CTX-M: changing the face of ESBLs in the UK. J Antimicrob Chemother 56: 451-454 [Abstract] [Full Text]  
  • Lasalde, C., Rodriguez, R., Toranzos, G. A. (2005). Statistical Analyses: Possible Reasons for Unreliability of Source Tracking Efforts. Appl. Environ. Microbiol. 71: 4690-4695 [Abstract] [Full Text]  
  • Mugnaioli, C., Luzzaro, F., De Luca, F., Brigante, G., Amicosante, G., Rossolini, G. M. (2005). Dissemination of CTX-M-Type Extended-Spectrum {beta}-Lactamase Genes to Unusual Hosts. J. Clin. Microbiol. 43: 4183-4185 [Abstract] [Full Text]  
  • Moubareck, C., Daoud, Z., Hakime, N. I., Hamze, M., Mangeney, N., Matta, H., Mokhbat, J. E., Rohban, R., Sarkis, D. K., Doucet-Populaire, F. (2005). Countrywide Spread of Community- and Hospital-Acquired Extended-Spectrum {beta}-Lactamase (CTX-M-15)-Producing Enterobacteriaceae in Lebanon. J. Clin. Microbiol. 43: 3309-3313 [Abstract] [Full Text]  
  • Pitout, J. D. D., Nordmann, P., Laupland, K. B., Poirel, L. (2005). Emergence of Enterobacteriaceae producing extended-spectrum {beta}-lactamases (ESBLs) in the community. J Antimicrob Chemother 56: 52-59 [Abstract] [Full Text]  
  • Paterson, D. L., Rossi, F., Baquero, F., Hsueh, P.-R., Woods, G. L., Satishchandran, V., Snyder, T. A., Harvey, C. M., Teppler, H., DiNubile, M. J., Chow, J. W. (2005). In vitro susceptibilities of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: the 2003 Study for Monitoring Antimicrobial Resistance Trends (SMART). J Antimicrob Chemother 55: 965-973 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»