Faecal carriage of extended-spectrum β-lactamase (ESBL)-producing enterobacteria

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Faecal carriage of extended-spectrum β-lactamase (ESBL)-producing Enterobacteria in liver disease patients from two hospitals in Egypt and in France: a comparative epidemiologic study N.S. Fam1*, S. Defasque 2, F. Bert 2, V. Leflon-Guibout 2, A. El- Ray 3, M. El-Ghannam 3 , M.E. Attia 3, M. Omar 1, D.G. Desouki 1, D. Valla 4 and M.-H. Nicolas-Chanoine 2 1Microbiology Department, Theodor Bilharz Research Institute, Cairo, Egypt 2Microbiology Department, Hôpital AP-HP Beaujon, Clichy, France 3Hepatology Department Theodor Bilharz Research Institute Cairo, Egypt 4Hepatology Department, Hôpital AP-HP Beaujon, Clichy, France *Corresponding author : Professor Dr. Nevine Fam , Microbiology Department, Theodor Bilharz Research Institute, Cairo, Egypt, (Email: nevinefam@yahoo.com). Running Head: Liver disease and ESBL faecal carriage SUMMARY This study aimed to assess and compare the epidemiology of faecal carriage of extended spectrum beta-lactamase-producing Enterobacteria (ESBL-E) in hepatology departments of two hospitals specialized in liver diseases, Theodor Bilharz Research Institute (TBRI) in Cairo (Egypt) and Beaujon hospital (Bj) in Clichy (France). CTX-M groups were identified by PCR, and TEM and SHV derivatives with the check point system. Phylogenetic groups of E. coli were determined by multiplex PCR, and clone ST131 by PCR of gene pabB. Prevalence of ESBL-E was 77.6% (45/58) in TBRI and 6.5% (13/199) in Bj (p<10-7). Previous hospitalization was more common (p = 0.003) in Bj patients (93%) than in TBRI patients (45%) suggesting high prevalence of ESBL-E in the Egyptian community. The presence of E. coli B2 ST131 among ESBL-E faecal E. coli in Egypt confirms its pervasiveness in the community and raises concern to this highly virulent and resistant clone.

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