Publication

Abstract : Asymptomatic colonization of the intestinal compartment with ESBL-producing Enterobacteriaceae isolates (ESBLE) has been described previously [1-4]. Higher prevalence of ESBL-producing E. coli fecal carriage has been reported in the nosocomial setting than in the community. Patients of medical units with high levels of antibiotic consumption have also shown higher rates of ESBL colonization. Similarly nursing homes and residents of health care or skilled care facilities, also have high rates of colonization with multi resistant pathogens, including ESBL producers, than that among true community patients or healthy volunteers [5,6]. Studies have shown that ESBL producing uropathogens have their reservoir in the digestive tract [6]. ESBL producing E. coli cause clinically significant hospital associated infections and are also known to cause community acquired infections due to selective pressure owing to widespread use of third generation cephalosporin. Community acquired infections due to ESBLE has been reported from studies from Europe and India [1,7]. Previous studies have documented 2-5 years of ESBL digestive carriage [1,7]. Finally hospitalization of carriers increases the risk of infection for other hospitalized patients via cross infection [8]. Patients with fecal carriage of ESBLE isolates have been investigated previously duringnosocomial outbreaks, but the number of prospective longitudinal studies conducted in the community remains scarce. Previous studies have suggested that ESBL phenotypes in clinical isolates co vary with the percentage of healthy fecal carriers of ESBLE.