Faecal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae among humans in Java, Indonesia, in 2001-2002

Juliette Severin, ES Lestari, Wendy Kloezen, Nicole Toom, NM Mertaniasih, K Kuntaman, M Purwanta, DO Duerink, U Hadi, Alex Belkum, Henri Verbrugh, Wil Goessens

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Objective To characterise commensal Escherichia coli and other Enterobacteriaceae with reduced susceptibility to cefotaxime that were collected in a large survey carried out among 3995 patients and healthy persons in two urban regions on Java, Indonesia, in 20012002. Methods The putative extended-spectrum b-lactamase (ESBL)-producing Enterobacteriaceae were analysed using double-disk synergy tests, isoelectric focusing, PCR assays, DNA sequencing, and pulsed-field gel electrophoresis (PFGE). Results On the day of discharge after five or more days of hospitalisation, at least 95 of 999 (9.5%) patients carried ESBL-positive Enterobacteriaceae as dominant faecal flora. Six patients were simultaneously colonised with E. coli and Klebsiella pneumoniae isolates with ESBL activity. On admission, only 6 of 998 (0.6%) patients were colonised. Faecal carriage of ESBL-producing Enterobacteriaceae among healthy persons or persons visiting a public health centre was not detected. The 107 ESBLpos Conclusions In 2001-2002, faecal carriage of ESBL-producing Enterobacteriaceae as dominant flora in Indonesia was almost exclusively hospital-associated. The presence of various blaESBL genes and the extensive genetic diversity among isolates argue against a single / dominant strain outbreak.
Original languageUndefined/Unknown
Pages (from-to)455-461
Number of pages7
JournalTropical Medicine and International Health
Issue number4
Publication statusPublished - 2012

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  • EMC MM-04-28-01

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