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High prevalence of MDR gram-negative bacteria in feces of healthy blood donors in Mexico

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Abstract

During the initial stage of a study to recruit universal intestinal microbiota donors in Mexico City, we found multiple “healthy” subjects that colonized with MDRO (Multidrug-resistant organisms). We aimed to describe clinical and demographic characteristics of these individuals. This was a prospective observational study. Participants were consecutively recruited among blood donors. A fecal sample was collected from each subject and analyzed at the same day in search of MDRO through chromographic culture media and, if growth observed, later confirmed by MALDI-TOF and susceptibility testing in Vitek 2 system. From July 2018 to March 2019, 85 individuals were screened for fecal colonization. Median age was 35 years (IQR 27–46 years), and 48/85 (56.4%) were males. Seventy-two (84.7%) subjects harbored at least one MDRO. ESBL-producing microorganisms were found in 72/85 (84.3%) subjects, and E. coli was the most frequent (63/85, 74.1%). Four samples (2 E. coli, 2 P. aeruginosa, 2.4% each) harbored carbapenem-resistant Enterobacteriaceae (CRE), together with an ESBL-producing microorganism. Antibiotic use (p = 0.06) and PPIs or H2-blockers intake (p = 0.03) were more common in the colonized subjects during the previous 6-month period. We report a high incidence of enteric colonization of healthy subjects with MDRO, a condition that may be related to antibiotics or PPIs/H2-blockers consumption. This surprisingly high MDRO colonization rate in potential FMT donors emphasizes the need for careful screening of donors to avoid possible transmission to FMT recipients.

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Acknowledgments

A sincere and grateful recognition to Dr. Dale N. Gerding for a fine review of the manuscript. The authors would also like to thank Brenda P. Castillo-Marmolejo, Carlos A. Castelán-García, and Ana K. Ríos-Barba for their valuable assistance with the enrollment of subjects, and Estrella Tovar-Calderón for her support with identification of samples.

Funding

This work was supported by the National Council of Science and Technology (Consejo Nacional de Ciencia y Tecnología, CONACYT) through the Sectoral Fund for Health and Social Security Research (Fondo Sectorial de Investigación en Salud y Seguridad Social, FOSISS) 2017 [Grant Number 289673].

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Authors and Affiliations

  1. Laboratory of Clinical Microbiology, Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

    Karla M. Tamez-Torres, Alfredo Ponce-de-Leon, Pedro Torres-Gonzalez, Esteban Perez-Garcia, Estefania Torres-Veintimilla & Miriam Bobadilla-del Valle

  2. Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Av. Vasco de Quiroga 15, Belisario Domínguez Sección XVI, Tlalpan, Zip Code 14080, Mexico City, Mexico

    Jose Sifuentes-Osornio

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  1. Karla M. Tamez-Torres
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  2. Alfredo Ponce-de-Leon
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  3. Pedro Torres-Gonzalez
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  4. Esteban Perez-Garcia
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  5. Estefania Torres-Veintimilla
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  6. Miriam Bobadilla-del Valle
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  7. Jose Sifuentes-Osornio
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Contributions

Conceptualization Jose Sifuentes-Osornio, Alfredo Ponce-de Leon, Pedro Torres-Gonzalez, Miriam Bobadilla-del Valle, and Karla M. Tamez-Torres; Data curation Karla M. Tamez-Torres, Esteban Perez-Garcia, and Estefania Torres-Veintimilla; Formal analysis and Methodology Karla M. Tamez-Torres, Pedro Torres-Gonzalez, Jose Sifuentes-Osornio, and Alfredo Ponce-de Leon; Resources Miriam Bobadilla-del Valle and Estefania Torres-Veintimilla; Funding acquisition Pedro Torres-Gonzalez, Miriam Bobadilla-del Valle, Jose Sifuentes-Osornio, and Alfredo Ponce-de Leon; Supervision Jose Sifuentes-Osornio and Alfredo Ponce-de Leon; Writing – original draft:Karla M. Tamez-Torres, Miriam Bobadilla-del Valle, and Esteban Perez-Garcia; Writing – reviwe and editing Jose Sifuentes-Osornio and Alfredo Ponce-de Leon.

Corresponding author

Correspondence to Jose Sifuentes-Osornio.

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Conflict of interest

This work received a grant from the National Council of Science and Technology (Consejo Nacional de Ciencia y Tecnología, CONACYT) through the Sectoral Fund for Health and Social Security Research (Fondo Sectorial de Investigación en Salud y Seguridad Social, FOSISS) 2017 [Grant Number 289673].

None of the authors received payment specifically for the realization of this work.

Ethical approval

Each subject signed a written Informed Consent letter for the participation in the study as well as for the management of their personal data. Results from cultures was anonymized and only a consecutive laboratory number was used for sample identification. All procedures performed in studies involving human participants were with the ethical standards of the institutional research committee (Comisión Institucional de Ética en Investigación en Humanos, reference number 2868) and in accordance with the 1964 Declaration of Helsinki and its later amendments.

Additional information

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Supplementary Fig. 1

STROBE flow diagram of the study participants. (PNG 314 kb)

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Tamez-Torres, K.M., Ponce-de-Leon, A., Torres-Gonzalez, P. et al. High prevalence of MDR gram-negative bacteria in feces of healthy blood donors in Mexico. Eur J Clin Microbiol Infect Dis 39, 1439–1444 (2020). https://doi.org/10.1007/s10096-020-03858-z

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