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. 2019 Sep;66(6):603-617.
doi: 10.1111/zph.12612. Epub 2019 Jul 2.

Carriage of carbapenemase- and extended-spectrum cephalosporinase-producing Escherichia coli and Klebsiella pneumoniae in humans and livestock in rural Cambodia; gender and age differences and detection of blaOXA-48 in humans

Clara Atterby  1 , Kristina Osbjer  2   3 , Viktoria Tepper  4 , Elisabeth Rajala  2 , Jorge Hernandez  5   6   7 , Sokerya Seng  3 , Davun Holl  8 , Jonas Bonnedahl  5   6 , Stefan Börjesson  9   10 , Ulf Magnusson  2 , Josef D Järhult  1
Affiliations

Carriage of carbapenemase- and extended-spectrum cephalosporinase-producing Escherichia coli and Klebsiella pneumoniae in humans and livestock in rural Cambodia; gender and age differences and detection of blaOXA-48 in humans

Clara Atterby et al. Zoonoses Public Health. 2019 Sep.

Abstract

Objectives: This study investigates the frequency and characteristics of carbapenemase-producing Escherichia coli/Klebsiella pneumoniae (CPE/K) and extended-spectrum cephalosporinase-producing E. coli/K. pneumoniae (ESCE/K) in healthy humans and livestock in rural Cambodia. Additionally, household practices as risk factors for faecal carriage of ESCE/K are identified.

Methods: Faecal samples were obtained from 307 humans and 285 livestock including large ruminants, pigs and poultry living in 100 households in rural Cambodia in 2011. Each household was interviewed, and multilevel logistic model determined associations between household practices/meat consumption and faecal carriage of ESCE/K. CPE and ESCE/K were detected and further screened for colistin resistance genes.

Results: CPE/K isolates harbouring blaOXA-48 were identified in two humans. The community carriage of ESCE/K was 20% in humans and 23% in livestock. The same ESBL genes: blaCTX-M-15 , blaCTX-M-14 , blaCTX-M-27 , blaCTX-M-55 , blaSHV-2 , blaSHV-12 , blaSHV-28 ; AmpC genes: blaCMY-2 , blaCMY-42, blaDHA-1 ; and colistin resistance genes: mcr-1-like and mcr-3-like were detected in humans and livestock. ESCE/K was frequently detected in women, young children, pigs and poultry, which are groups in close contact. The practice of burning or burying meat waste and not collecting animal manure indoors and outdoors daily were identified as risk factors for faecal carriage of ESCE/K.

Conclusions: Faecal carriage of E. coli and K. pneumoniae harbouring extended-spectrum cephalosporinase genes are common in the Cambodian community, especially in women and young children. Exposure to animal manure and slaughter products are risk factors for intestinal colonization of ESCE/K in humans.

Keywords: AmpC; Cambodia; ESBL; carbapenemase; colistin; risk factors; rural population; zoonoses.

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Conflict of interest statement

None to declare.

Figures

Figure 1
Figure 1
Distribution of carbapenemase‐ and extended‐spectrum cephalosporinase genes in Escherichia coli isolates (n) from humans and livestock living in 10 rural villages in Kampong Cham province, Cambodia in May 2011 [Colour figure can be viewed at http://www.wileyonlinelibrary.com]
Figure 2
Figure 2
Detection frequency of carbapenemase‐ and extended‐spectrum cephalosporinase‐producing Escherichia coli and Klebsiella pneumoniae isolates in 10 rural villages in Kampong Cham province, Cambodia in 2011. Number of isolates indicated above each column [Colour figure can be viewed at http://www.wileyonlinelibrary.com]
Figure 3
Figure 3
Detection frequencies of carbapenemase‐ and extended‐spectrum cephalosporinase‐producing Escherichia coli and Klebsiella pneumoniae in humans living in 10 rural villages in Kampong Cham province, Cambodia in May 2011, n = sampe size, * indicates statistical significant differences, p < 0.05 [Colour figure can be viewed at http://www.wileyonlinelibrary.com]
Figure 4
Figure 4
Detection frequencies of carbapenemase‐ and extended‐spectrum cephalosporinase‐producing Escherichia coli and Klebsiella pneumoniae in livestock living in 10 rural villages in Kampong Cham province, Cambodia in May 2011, n = sampe size, * indicates statistical significant difference, p < 0.02 [Colour figure can be viewed at http://www.wileyonlinelibrary.com]
Figure 5
Figure 5
Antibiotic resistance in CPE/K and ESCE/K isolates (n) from humans and animals in rural Kampong Cham, Cambodia in 2011 determined by disc diffusion test and characterized as wild‐type or non‐wild‐type phenotype (R) [Colour figure can be viewed at http://www.wileyonlinelibrary.com]
See this image and copyright information in PMC

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