Open AccessDecline in AmpC β-lactamase-producing Escherichia coli in a Dutch teaching hospital (2013-2016)
Author(s) -
Evert den Drijver,
Jaco J. Verweij,
Carlo Verhulst,
Stijn Oome,
Joke Soer,
Ina Willemsen,
Eefje J. A. Schrauwen,
Marjolein F Q Kluytmans-van den Bergh,
Jan Kluytmans
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0204864
Subject(s) - carriage , klebsiella , microbiology and biotechnology , escherichia coli , attenuator (electronics) , biology , plasmid , enterobacteriaceae , feces , medicine , gene , genetics , pathology , physics , attenuation , optics
Objective The objective of this study is to determine the prevalence of rectal carriage of plasmid- and chromosome-encoded AmpC β-lactamase-producing Escherichia coli and Klebsiella spp. in patients in a Dutch teaching hospital between 2013 and 2016. Methods Between 2013 and 2016, hospital-wide yearly prevalence surveys were performed to determine the prevalence of AmpC β-lactamase-producing E . coli and Klebsiella spp. rectal carriage. Rectal swabs were taken and cultured using an enrichment broth and selective agar plates. All E . coli and Klebsiella spp. isolates were screened for production of AmpC β-lactamase using phenotypic confirmation tests and for the presence of plasmid-encoded AmpC (pAmpC) genes. E . coli isolates were screened for chromosome-encoded AmpC (cAmpC) promoter/attenuator alterations. Results Fifty (2.4%) of 2,126 evaluable patients were identified as rectal carrier of AmpC β-lactamase-producing E . coli . No carriage of AmpC β-lactamase producing Klebsiella spp. was found. Nineteen (0.9%) patients harboured isolates with pAmpC genes and 30 (1,4%) patients harboured isolates with cAmpC promoter/attenuator alterations associated with AmpC β-lactamase overproduction. For one isolate, no pAmpC genes or cAmpC promotor/attenuator alterations could be identified. During the study period, a statistically significant decline in the prevalence of rectal carriage with E . coli with cAmpC promotor/attenuator alterations was found (p = 0.012). The prevalence of pAmpC remained stable over the years. Conclusions The prevalence of rectal carriage of AmpC-producing E . coli and Klebsiella spp. in patients in Dutch hospitals is low and a declining trend was observed for E . coli with cAmpC promotor/attenuator alterations.