Colonization With Multidrug-Resistant Organisms Among Healthy Adults in the Community Setting: Prevalence, Risk Factors, and Composition of Gut Microbiome
Journal
Frontiers in Microbiology
Journal Volume
11
Pages
1402
Date Issued
2020
Author(s)
Chen Y.-A.
Chou Y.-H.
Chen H.-C.
Wang S.-S.
Abstract
Background: The prevalence of colonization with multidrug-resistant organisms (MDROs) among healthy adults in the community is largely unknown. This study investigated the colonization rate of multidrug-resistant Enterobacteriaceae, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE) in the community in Taiwan, and compared the gut microbiota between MDRO carriers and non-carriers. Methods: This prospective cohort study was conducted from March 2017 to February 2018 at the Hsin-Chu and Jin-Shan branches of National Taiwan University Hospital. Nasal swabs and stool samples were obtained from healthy adults attending a health examination to screen for MDROs. Bacteria isolates of MDROs were tested for antibiotic susceptibility and resistant genes. Relevant data were collected using a standardized questionnaire to evaluate the risk factors for MDROs carriage, and 16S rRNA metagenomics sequencing was performed to analyze gut microbiota. Results: Among 187 participants, 4.6% (8/174) carried MRSA and 41.4% (77/186) carried third-generation cephalosporin-resistant (3GC-R) Escherichia coli or Klebsiella pneumoniae. The carriage rate of AmpC beta-lactamases and ESBL-producing strains were 16.1 and 27.4%, respectively. No carbapenem-resistant Enterobacteriaceae (CRE) or VRE were detected. The dominant resistant gene of E. coli isolates was CTX-M-type (73%), while that of K. pneumoniae was AmpC beta-lactamases (80%). In the multivariate analysis, the significant risk factors for carrying 3GC-R E. coli or K. pneumoniae were being an employee of technology company A [adjusted odds ratio (aOR) 4.127; 95% confidence interval (CI) 1.824–9.336; p = 0.001], and traveling to Southeast Asia in the past year (aOR 6.545; 95% CI 1.071–40.001; p = 0.042). The gut microbiota analysis showed that the phylum Proteobacteria and the family Enterobacteriaceae were significantly more abundant in 3GC-R E. coli and K. pneumoniae carriers. Conclusion: A high rate of Taiwanese adults in the community carried 3GC-R Enterobacteriaceae, while no CRE or VRE colonization was noted. Compared with non-carriers, an expansion of Enterobacteriaceae in gut microbiota was found among 3GC-R Enterobacteriaceae carriers. ? Copyright ? 2020 Huang, Lai, Chen, Lin, Chou, Chen, Wang, Wang and Chang.
SDGs
Other Subjects
antibiotic agent; beta lactamase AmpC; carbapenem; carbapenemase; cefazolin; cefotaxime; ceftazidime; ciprofloxacin; clindamycin; cotrimoxazole; ertapenem; erythromycin; genomic DNA; gentamicin; imipenem; meropenem; minocycline; oxacillin; rifampicin; RNA 16S; tetracycline; tigecycline; vancomycin; adult; alcohol consumption; antibiotic resistance; antibiotic sensitivity; Article; bacterial gene; bacterium detection; bacterium isolation; carbapenem-resistant Enterobacteriaceae; cephalosporin resistance; cohort analysis; comorbidity assessment; comparative study; disease association; DNA extraction; education; Escherichia coli; feces analysis; female; gene sequence; genotyping technique; high income country; human; intestine flora; Klebsiella pneumoniae; male; metagenomics; methicillin resistant Staphylococcus aureus; microbial colonization; microbial community; molecular typing; multidrug resistant Enterobacteriaceae; nonhuman; normal human; prevalence; prospective study; questionnaire; risk factor; screening test; vancomycin resistant Enterococcus; zone of inhibition
Publisher
Frontiers Media S.A.
Type
journal article