Gastrointestinal tract- reservoir of extenden spectrum β lactamases producing strains colonizing respiratory tract in infants

Abstract

Introduction The useage of broad spectrum antibiotics leads to emergence of ESBL (extended spectrum β lactamases) gram - negative strains. Members of the normal gastrointestinal (GI) tract flora may cause endogenous disease if they reach tissues where they can not be tolerated. Objectives The aims of this study are: to elaborate the prevalence of ESBL – producing strains obtained from patients with respiratory tract infections (RTIs), to investigate gastrointestinal colonization and possible endogenous reservoirs of infection, and to elaborate some epidemiological features of patients harboring ESBLs. Methods Standard microbiological procedures were used for detecting bacteria, modificate triple disk diffusion test for detecting ESBLs, and disc diffusion test for measurement of antibiotic susceptibility From 20 randomly selected patients with ESBLs cultivated from respiratory tract, stool samples and gastric contents were taken for detecting GIT colonization at the same time. Results Of all enterobacteriaceae, ESBLs producers were 62.21% (214/344). Of all stool samples, 100% (20/20) were with predominant ESBLs gram - negative flora, and of all gastric samples in 90% (18/20) ESBLs gram- negatives were isolated, of which 94.4% (17/18) identified to the species level were identical to those isolated from respiratory tract. Conclusion The prevalence of ESBLs isolated from respiratory tract in young patients is increasing. It seems that gram-negative ESBL-producers isolated from respiratory tract were indigenous gastrointestinal tract flora. Some epidemiological findings suggest possible risk factor for translocation of microbiological flora.