4.6 Article

Distribution of Extended-Spectrum β-Lactamase Genes and Antimicrobial Susceptibility among Residents in Geriatric Long-Term Care Facilities in Japan

Journal

ANTIBIOTICS-BASEL
Volume 11, Issue 1, Pages -

Publisher

MDPI
DOI: 10.3390/antibiotics11010036

Keywords

extended-spectrum beta-lactamase; geriatric long-term care facilities; antimicrobial susceptibility

Funding

  1. Japan Agency for Medical Research and Development (AMED)
  2. Research Program on Emerging and Re-emerging Infectious Disease [JP20fk0108134]

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A high prevalence of extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) in geriatric long-term care facilities may require monitoring. This study analyzed ESBL-causative gene types and antimicrobial susceptibility in ESBL-PE strains from residents in Japanese g-LTCFs. The majority of strains contained bla(CTX-M) group genes and exhibited differences in antimicrobial susceptibility across facilities. Treatment strategies should take into account the specific antimicrobial susceptibility profiles of each g-LTCF.
A high prevalence of extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) may call for monitoring in geriatric long-term care facilities (g-LTCFs). We surveyed the distribution of ESBL-causative gene types and antimicrobial susceptibility in ESBL-PE strains from residents in g-LTCFs, and investigated the association between ESBL-causative gene types and antimicrobial susceptibility. First, we analyzed the types of ESBL-causative genes obtained from 141 ESBL-PE strains collected from the feces of residents in four Japanese g-LTCFs. Next, we determined the minimum inhibitory concentration values for alternative antimicrobial agents against ESBL-PE, including beta-lactams and non-beta-lactams. Escherichia coli accounted for 96% of the total ESBL-PE strains. Most strains (94%) contained bla(CTX-M) group genes. The genes most commonly underlying resistance were of the bla(CTX-M-9) and bla(CTX-M-1) groups. Little difference was found in the distribution of ESBL-causative genes among the facilities; however, antimicrobial susceptibility differed widely among the facilities. No specific difference was found between antimicrobial susceptibility and the number of ESBL-causative genes. Our data showed that ESBL-PEs were susceptible to some antimicrobial agents, but the susceptibility largely differed among facilities. These findings suggest that each g-LTCF may require specific treatment strategies based on their own antibiogram. Investigations into drug resistance should be performed in g-LTCFs as well as acute medical facilities.

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