Fecal Carriage of Extended Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli and Klebsiella spp. in Children in Zonguldak

Introduction: The aim of this study was to determine the prevalence of fecal carriage of extended-spectrum beta-lactamase (ESBL)-producing bacteria, ESBL enzyme types, and risk factors affecting colonization in children. Materials and Methods: Stool specimens of 0-15 years old children admitted to the pediatric outpatient clinic for any reason between October 2012-December 2013 were evaluated. Demographic data of the patients were collected through a questionnaire. Patients samples were cultured on selective EMB agar plates. The presence of ESBL was investigated by double disc synergy test and agar gradient test was used when necessary. Enzyme types of the isolates were determined by polymerase chain reaction (PCR). Results: The prevalence of fecal carriage was determined as 33% (150 of 454). Of the 154 ESBL-producing bacteria, 142 (92.2%), 11 (57.1%), and 1 (0.6%) were E. coil, K. pneumoniae and K. oxytoca, respectively. Of the ESBL-producing bacteria, 92.8% were positive for bla(CTX-M)genes. Of the bla(CTX-M) gene-positive isolates, 81.1% were positive for bla(CTX-M-)(15)( )and 94.4% were positive for bla(CTX-M-3) genes while 62.5% isolates were positive for both bla(CTX-M-3) and bla(CTX-M-15) genes. No significant association was demonstrated between carriage rates and the questioned risk factors. Conclusion: A high rate (33%) of fecal carriage of ESBL bacteria was found in the child population of Zonguldak. No significant association was demonstrated between carriage rates and the questioned risk factors. Predominant beta-lactamase enzyme types were CTX-M group while CTX-M-3 and CTX-M-15 were the most common enzyme types.