TY - JOUR
T1 - Faecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae among humans in Java, Indonesia, in 2001-2002
AU - Severin, Juliëtte A.
AU - Lestari, Endang Sri
AU - Kloezen, Wendy
AU - Lemmens-den Toom, Nicole
AU - Mertaniasih, Ni Made
AU - Kuntaman, Kuntaman
AU - Purwanta, Marijam
AU - Offra Duerink, D.
AU - Hadi, Usman
AU - van Belkum, Alex
AU - Verbrugh, Henri A.
AU - Goessens, Wil H.
AU - Gardjito, Widjoseno
AU - Kolopaking, Erni P.
AU - Wirjoatmodjo, K. Karjadi
AU - Roeshadi, Djoko
AU - Suwandojo, Eddy
AU - Rahardjo, Eddy
AU - Ismoedijanto,
AU - Tahalele, Paul
AU - Hendromartono,
AU - Parathon, Hari
AU - Zairina, Nun
AU - Qibtiyah, Mariyatul
AU - Isbandiati, Endang
AU - Deborah, Kartuti
AU - Alimsardjono, Lindawati
AU - Lusida, Maria Inge
AU - Soejoenoes, Ariawan
AU - Riyanto, Budi
AU - Wahjono, Hendro
AU - Musrichan,
AU - Adhisaputro,
AU - Winarto,
AU - Subakir,
AU - Isbandrio, Bambang
AU - Triwara, Bambang
AU - Syoeib, Johnny
AU - Wibowo, Bambang
AU - Sofro, Muchlis A.U.
AU - Farida, Helmia
AU - Hapsari, M. M.D.E.A.H.
AU - Nugraha, Tri Laksana
AU - van den Broek, Peterhans
AU - Duerink, D. Offra
AU - Gyssens, Inge C.
AU - Keuter, Monique
PY - 2012/4/1
Y1 - 2012/4/1
N2 - 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, 35K. 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.
AB - 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, 35K. 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.
KW - Antibiotic resistance
KW - Asia
KW - CTX-M-15
KW - Colonisation
KW - ESBL
UR - http://www.scopus.com/inward/record.url?scp=84858996755&partnerID=8YFLogxK
U2 - 10.1111/j.1365-3156.2011.02949.x
DO - 10.1111/j.1365-3156.2011.02949.x
M3 - Article
C2 - 22248076
AN - SCOPUS:84858996755
SN - 1360-2276
VL - 17
SP - 455
EP - 461
JO - Tropical Medicine and International Health
JF - Tropical Medicine and International Health
IS - 4
ER -
