10-Fold increase (2006-11) in the rate of healthy subjects with extended-spectrum β-lactamase-producing Escherichia coli faecal carriage in a Parisian check-up centre

• Published in: Journal of antimicrobial chemotherapy Vol. 68; no. 3; pp. 562 - 8
• Main Authors: Nicolas-Chanoine, Marie-Hélène, Gruson, Coraline, Bialek-Davenet, Suzanne, Bertrand, Xavier, Thomas-Jean, Frédérique, Bert, Frédéric, Moyat, Mati, Meiller, Elodie, Marcon, Estelle, Danchin, Nicolas, Noussair, Latifa, Moreau, Richard, Leflon-Guibout, Véronique
• Format: Journal Article
• Language: English
• Published: England Oxford University Press (OUP) 01.03.2013
• Subjects: Adult; Aged; beta-Lactamases - genetics; beta-Lactamases - secretion; Carrier State - epidemiology; Carrier State - microbiology; Electrophoresis, Gel, Pulsed-Field; Escherichia coli - enzymology; Escherichia coli - isolation & purification; Escherichia coli Infections - classification; Escherichia coli Infections - epidemiology; Escherichia coli Infections - genetics; Escherichia coli Infections - microbiology; Feces - microbiology; Female; Genotype; Humans; Life Sciences; Male; Microbiology and Parasitology; Middle Aged; Molecular Epidemiology; Molecular Typing; Paris - epidemiology; Phylogeny; Prevalence; Surveys and Questionnaires; Paris
• ISSN: 1460-2091; 0305-7453; 1460-2091
• DOI: 10.1093/jac/dks429

In 2006, 0.6% of healthy subjects living in the Paris area had extended-spectrum β-lactamase (ESBL)-producing Escherichia coli in their gut. To assess the evolution of this rate, a study identical to that of 2006 was conducted in 2011. Healthy adults who visited the IPC check-up centre in February-March 2011 and agreed to participate, provided stools and answered a questionnaire on the visit day. Stools were analysed to detect ESBL producers and to isolate the dominant E. coli population. ESBLs were molecularly characterized. For the subjects harbouring ESBL-producing E. coli, the phylogenetic group and sequence type (ST) were determined for both ESBL-producing and dominant E. coli isolates. PFGE profiles were also determined when two types of isolates had the same ST. Among the 345 subjects included, 21 (6%) had ESBL-producing E. coli faecal carriage. None of the previously published risk factors was identified. CTX-M accounted for 86% and SHV-12 for 14%. Dominant and ESBL-producing E. coli were similarly distributed into phylogenetic groups (A, 52%-48%; B1, 5%; B2, 24%-14%; and D, 19%-33%). Dominant and ESBL-producing E. coli displayed a polyclonal structure (18 STs each). However, ST10 and ST131 were identified in dominant and ESBL-producing E. coli isolates from different subjects. Most (20/21) ESBL producers were subdominant and belonged (16/21) to STs different from that of the corresponding dominant E. coli. The 10-fold increase in the rate of healthy subjects with ESBL-producing E. coli faecal carriage over a 5 year period suggests wide dissemination of these isolates in the Parisian community.