The increasing incidence of community acquired infection due to extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E) is dreadful because there are few therapeutic alternatives. Intestinal carriage is a key factor in ESBL infection epidemiology. This study aimed to detect the prevalence and risk factors of community fecal carriage of ESBL-E in children before male circumcision (MC) surgery.
The study was conducted with children who were subjected to MC surgery in Antalya Education and Research Hospital between July 2014 and December 2015. Patient demographics and possible risk factors for colonization are recorded. Preputium and rectal swap samples were collected from each child preoperatively. The samples were cultured onto chromID ESBL medium (bioMérieux, Lyon, France). Conventional identification and E-test methods were used for confirmation. Statistical analysis was performed using SPSS software version 22.0 (IBM, USA). Chi-square test was used for categorical variables.
A total of 128 children were included to the study. The mean age was 6.9±2.8 years. The rectal and preputial colonization rates of ESBL-E were 21.5% (32/128) and 4% (6/128) respectively. Prior hospitalization in last 6 months, frequent urinary tract infection and frequent antibiotic use were higher in children with rectal and preputial ESBL-E colonization. Antibiotic use for long duration was found significantly associated with preputial colonization of ESBL-E (p= 0.01).
Conclusion: The high carriage rate of ESBL-E in young children in the Turkish community setting is notable, point out the importance of this population as a reservoir. It seems that in early childhood use of antibiotics frequently and long duration causes ESBL-E colonization. We believe that antibiotic stewardship has a critical role for preventing colonization especially in children
H. Berk, None
H. Tokgoz, None