Intestinal carriage of extended-spectrum beta-lactamases producing klebsiella among children under ۱۰ years in Tehran

Background and Aim : Multidrug-resistant gram-negative bacteria are a serious threat to public health. In recent years, the production of extended-spectrum beta-lactamases (ESBLs) in the Enterobacteriaceae has increased significantly. Reports of carriers of ESBL-producing bacteria are significant in healthy individuals, especially children. This article aims to assess the prevalence of ESBL-producing Klebsiella carriers.Methods : Two cefotaxime and ceftazidime antibiotics were used to screen of ESBls producing bacteria. The production of ESBLs was confirmed by double-disc assay with amoxiclav, cefotaxime, and ceftazidime discs. TEM and CTX-M-۱ genes were identified by PCR. Antimicrobial susceptibility was performed by disk-diffusion method.Results : a total of ۲۴ ESBls-producing Klebsiella were isolated from ۳۳۲ volunteers. The highest prevalence was observed among children ۴ to ۶ years (۴۱.۷%). CTX-M-۱ was the most common ESBL gene (۶۶.۷%). ۱.۶% of isolates carried blaCTX-M-۱ and blaTEM simultaneously. ۸.۳% isolates carried only the blaTEM. The highest antibiotic resistance was observed in cefotaxime (۸۷.۵%) and ceftazidime (۸۷.۵%) and the lowest in gentamicin (۴.۲%). Resistance to trimethoprim/sulfamethoxazole, tetracycline, ciprofloxacin, aztreonam and amoxicillin/clavulanate antibiotics were ۷۹.۲%, ۶۲.۵%, ۱۳%, ۵۴.۲% and ۵۴.۲%, respectively. ۹۱.۷% and ۷۰.۸% of isolates were susceptible to imipenem and meropenem, respectively. ۹۵% of isolates exhibited multidrug resistance.Conclusion : This prevalence of ESBls-producing Klebsiella in healthy children under ۱۰ years is significant and poses a serious threat to community health. Carrying ESBL-producing organisms is a potential risk factor for transmission and spread of infection and requiring substantial monitoring and control over antibiotic use in agriculture and animal husbandry as well as against nosocomial infections.