Epidemiology of extended-spectrum ß-lactamase-producing Enterobacteriaceae among healthcare students, Portuguese Red Cross Health School of Lisbon, Portugal

Claudine Fournier, Marta Aires de Sousa, Begoña Fuster Escriva, Leila Sale, Patrice Nordmann, Laurent Poirel
2020 Journal of Global Antimicrobial Resistance  
The aim of the present study was to prospectively evaluate the prevalence of intestinal carriage by ESBL-producing Enterobacteriaceae among Portuguese students attending healthcare bachelors, and to determine the molecular features of ESBL-producing isolates. One-hundred and eleven fecal samples recovered from Portuguese healthcare students were screened for either ESBL-producing, carbapenem-resistant, colistin-resistant, or pan-aminoglycoside-resistant Enterobacteriaceae, using respective
more » ... ning media. All recovered isolates were tested for antimicrobial susceptibility and characterized by pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST). A total of 17 ESBL-producing Enterobacteriaceae (16 Escherichia coli and a single Klebsiella pneumoniae) were recovered from 16 students, corresponding to a prevalence of 14.5%. The E. coli isolates were distributed into three sequence types (ST) and seven PFGE types. The most common ESBL identified was CTX-M-1 (n = 13; 76%), followed by CTX-M-15 (n = 3; 18%), and CTX-M-8 (n = 1; 6%). The majority of the strains were resistant to sulfonamides (88%) and fosfomycin (71%). Resistance to aminoglycosides was observed at low rate, i.e. 12% for both tobramycin and kanamycin. No colistin-, carbapenem, or pan-aminoglycoside-resistant isolates were recovered. A major clone, ST10-blaCTX-M-1, included 12 E. coli isolates. The blaCTX-M-1 gene was always located onto an IncFIA/FIB plasmid type, co-harboring genes encoding resistance to tetracycline, sulfonamides, trimethoprim-sulfamethoxazole, and fosfomycin. The most commonly identified ESBL gene in E. coli was blaCTX-M-1, usually identified among ESBL-producing isolates recovered from animals. A high prevalence of fecal carriage of ESBL-producing E. coli was found among healthy healthcare students, underlying this population as an important reservoir.
doi:10.1016/j.jgar.2020.07.004 pmid:32659506 fatcat:volilpeti5chtg4s42vde42gcy