TY - JOUR
T1 - Frequent isolation of extended-spectrum beta-lactamase-producing bacteria from fecal samples of individuals with severe motor and intellectual disabilities
AU - Takano, Chika
AU - Seki, Mitsuko
AU - Shiihara, Hiroaki
AU - Komine-Aizawa, Shihoko
AU - Kuroda, Kazumichi
AU - Takahashi, Shori
AU - Ushijima, Hiroshi
AU - Hayakawa, Satoshi
N1 - Publisher Copyright:
© 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
PY - 2018/3
Y1 - 2018/3
N2 - Extended-spectrum beta-lactamase (ESBL) producing bacteria spread worldwide and became major concern for antibiotic treatment. Although surveillance reports in general hospitals and long-term care facilities are increasing, their frequencies in individuals with severe motor and intellectual disabilities (SMID) are so far unknown. In this study, we examined the frequency of ESBL in stool samples collected from 146 asymptomatic SMID subjects hospitalized in a single institution. With their clinical information, we evaluated possible risk factors for ESBL colonization. From 146 fecal samples, ESBL-producing bacteria were isolated in 45 cases (31%). Drug sensitivity testing showed that 82% of the isolates were resistant to levofloxacin but were sensitive to tazobactam/piperacillin and cefmetazole. The most frequent genotype was CTX-M-9 detected in 36/45 (80%). A high degree of disability, antibiotic use within three months before sampling and post-tracheostomy were statistically significant risk factors. Tube feeding was also strongly correlated with ESBL colonization (p < 0.001) and associated with lower micro-organismic diversities. Our findings are the first to reveal a high prevalence of ESBL in the fecal samples of SMID individuals and suggest possible relationships between high degree disability, tube feeding and latest histories of antibiotic use.
AB - Extended-spectrum beta-lactamase (ESBL) producing bacteria spread worldwide and became major concern for antibiotic treatment. Although surveillance reports in general hospitals and long-term care facilities are increasing, their frequencies in individuals with severe motor and intellectual disabilities (SMID) are so far unknown. In this study, we examined the frequency of ESBL in stool samples collected from 146 asymptomatic SMID subjects hospitalized in a single institution. With their clinical information, we evaluated possible risk factors for ESBL colonization. From 146 fecal samples, ESBL-producing bacteria were isolated in 45 cases (31%). Drug sensitivity testing showed that 82% of the isolates were resistant to levofloxacin but were sensitive to tazobactam/piperacillin and cefmetazole. The most frequent genotype was CTX-M-9 detected in 36/45 (80%). A high degree of disability, antibiotic use within three months before sampling and post-tracheostomy were statistically significant risk factors. Tube feeding was also strongly correlated with ESBL colonization (p < 0.001) and associated with lower micro-organismic diversities. Our findings are the first to reveal a high prevalence of ESBL in the fecal samples of SMID individuals and suggest possible relationships between high degree disability, tube feeding and latest histories of antibiotic use.
KW - Extended-spectrum beta-lactamase
KW - Fecal sample
KW - Microbiome
KW - Severe motor and intellectual disabilities
KW - Tube feeding
UR - http://www.scopus.com/inward/record.url?scp=85041548037&partnerID=8YFLogxK
U2 - 10.1016/j.jiac.2017.10.003
DO - 10.1016/j.jiac.2017.10.003
M3 - Article
C2 - 29398476
AN - SCOPUS:85041548037
SN - 1341-321X
VL - 24
SP - 182
EP - 187
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
IS - 3
ER -