Extended-spectrum beta-lactamase-producing Escherichia coli in patients with travellers' diarrhoea.

Authors:
Johan Tham
Johan Tham
Lund University
Sweden
Alma Brolund
Alma Brolund
Karolinska Institutet
Sweden
Jonas Ahl
Jonas Ahl
Lund University
Eva Melander
Eva Melander
Lund University
Sweden

Scand J Infect Dis 2010 Apr;42(4):275-80

Department of Clinical Sciences, Lund University, Malmö, Swden.

The identification of patients carrying extended-spectrum beta-lactamase (ESBL)-producing bacteria is important, since these patients are at risk of receiving inappropriate empirical therapy if they become infected. The purpose of this study was to investigate the occurrence of ESBL-producing bacteria in patients with travellers' diarrhoea. Patients with travellers' diarrhoea (N = 242) having delivered stool samples for the diagnosis of Salmonella, Shigella, Yersinia or Campylobacter, were also examined for ESBL-producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis. The overall prevalence of faecal carriage of ESBL-producing bacteria was 24% (58/242). Of the patients who had travelled in Europe, 3% (2/63) were found to be ESBL carriers in comparison to 36% (50/138) of those who had travelled outside Europe. ESBL-producing E. coli was especially common among patients returning from India (11/14), Egypt (19/38; 50%) and Thailand (8/38; 22%). In total, 90% of the genes of the ESBL-positive samples were of CTX-M type. The CTX-M-1 group dominated, followed by the CTX-M-9 group. The repetitive sequence-based PCR fingerprint pattern showed that there was no similarity between the ESBL strains found. Patients who have travelled outside Europe are at high risk of being colonized with ESBL-producing Enterobacteriaceae, and, if infected, are also at risk of receiving inappropriate empirical antibiotic therapy.

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http://dx.doi.org/10.3109/00365540903493715DOI Listing
April 2010
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