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Faecal carriage of extended-spectrum β-lactamase-producing enterobacteria among soldiers at admission in a French military hospital after aeromedical evacuation from overseas

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Abstract

The aim of this study was to assess the faecal carriage of carbapenemase-producing enterobacteria (CPE) and extended-spectrum β-lactamase (ESBL)-producing enterobacteria among soldiers at admission in a French military hospital after aeromedical evacuation from overseas. During a period of 1 year, 83 rectal swabs collected in French soldiers at admission were screened for multidrug-resistant enterobacteria with a chromogenic medium. ESBL detection was performed with the double-disc synergy test in the absence or presence of cloxacillin. The genotypic characterisation of resistance mechanisms, sequence typing and phylotyping was performed by polymerase chain reaction (PCR) and sequencing with bacterial DNA extracted from isolates. No CPE was detected. Eleven ESBL Escherichia coli isolates belonging to four phylogenetic groups were detected, including ten CTX-M-15 and one CTX-M-14. The overall gut colonisation with ESBL-producing bacteria (13.25 %) was 6-fold higher than that reported in soldiers in the suburbs of Paris in 2009. ESBL faecal carriage was particularly high (34.48 %) in soldiers repatriated from Afghanistan (risk ratio = 18.62; p = 0.0001). This study highlights the importance of systematic additional contact precautions and CPE/ESBL screening in soldiers repatriated from overseas in French hospitals.

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Acknowledgements

The authors would like to thank Dr. Olivier Clermont and Pr. Erick Denamur from INSERM U722 for the reference strains.

Funding sources

This work was supported by the French Defence Health Service.

Conflict of interest

The authors report no conflicting interests.

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Authors and Affiliations

  1. Service de Microbiologie et Hygiène hospitalière, Hôpital d’Instruction des Armées Bégin, Saint Mandé, France

    F. Janvier, H. Delacour, S. Tessé, S. Larréché, N. Sanmartin, D. Ollat, C. Rapp & A. Mérens

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  1. F. Janvier
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  2. H. Delacour
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  3. S. Tessé
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  4. S. Larréché
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  5. N. Sanmartin
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  6. D. Ollat
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  7. C. Rapp
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  8. A. Mérens
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Correspondence to F. Janvier.

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Janvier, F., Delacour, H., Tessé, S. et al. Faecal carriage of extended-spectrum β-lactamase-producing enterobacteria among soldiers at admission in a French military hospital after aeromedical evacuation from overseas. Eur J Clin Microbiol Infect Dis 33, 1719–1723 (2014). https://doi.org/10.1007/s10096-014-2141-8

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  • DOI: https://doi.org/10.1007/s10096-014-2141-8

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