• Neha Sharma Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Lovely Professional University, Jalandhar, Phagwara, Punjab, India.
  • Anania Arjuna Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Lovely Professional University, Jalandhar, Phagwara, Punjab, India.




Morbidity, Mortality, Extended-spectrum beta-lactamases, Escherichia coli



 Antibiotic resistance is an emerging threat worldwide, endangering the treatment of serious diseases. Widespread resistance to beta-lactam antibiotics among Gram-negative bacteria (GNB) is a serious threat to the currently used antibacterial therapy. Extended-spectrum beta-lactamases (ESBLs) are a group of enzymes capable of hydrolyzing extended-spectrum cephalosporins and are inhibited by clavulanic acid. These enzymes are a major cause of hospital-acquired infection and community-acquired infections caused by E. coli (Escherichia coli). E. coli forms a part of normal intestinal flora and is an important reservoir of the antibiotic-resistant genes for ESBLs. These resistant antibiotic genes can be easily spread among GNB as these are carried on plasmids. Fecal carriers of ESBL producing E. coli in hospitalized patients and in community can be a reservoir for person-to-person transmission strengthening their dissemination. Over the last few decades, there had been a considerable increase in the emergence and spread of antimicrobial-resistant enzymes favoring the predominance of antibiotic-resistant bacteria which results in morbidity, mortality, and increased hospital expenditure. The gastrointestinal tract plays an important role in development of antibiotic-resistant microorganism and harboring the microorganisms as commensal. Antibiotic consumption may lead to alteration in the genome of the microorganisms leading to emergence of resistant microorganisms. The resistant microorganisms may then spread into the environment through faces aiding dissemination of the resistant genes.


Download data is not yet available.


Ventola CL. The antibiotic resistance crisis: Part 1: Causes and threats. Pharm Ther 2015;40(4):277-83.

Rolain JM, Canton R, Cornaglia G. Emergence of antibiotic resistance: Need for a new paradigm. Clin Microbiol Infect 2012;18:615-6.

Shaikh S, Fatima J, Shakil S, Rizvi SM, Kamal MA. Antibiotic resistance and extended spectrum beta-lactamases: Types, epidemiology and treatment. Saudi J Biol Sci 2015;22(1):90-101.

Kong KF, Schneper L, Mathee K. Beta-lactam antibiotics: From antibiosis to resistance and bacteriology. APMIS Actapathol Microbiol Etimmunol Scand 2010;118(1):1-36.

Paterson DL, Bonomo RA. Extended-spectrum β-lactamases: A clinical update. Clin Microbiol Rev 2005;18(4):657-86.

Vaidya VK. Horizontal transfer of antimicrobial resistance by extended-spectrum β lactamase-producing Enterobacteriaceae. J Lab Phys 2011;3(1):37-42.

Lagacé-Wiens PR, Nichol KA, Nicolle LE, Decorby MR, McCracken M, Alfa MJ, et al. ESBL genotypes in fluoroquinolone-resistant and fluoroquinolone-susceptible ESBL-producing Escherichia coli urinary isolates in Manitoba. Can J Infect Dis Med Microbiol 2007;18(2):133-7.

Philippon A, Labia R, Jacoby G. Extended-spectrum beta-lactamases. Antimicrob Agents Chemother 1989;33:1131-6.

Huddleston JR. Horizontal gene transfer in the human gastrointestinal tract: Potential spread of antibiotic resistance genes. Infect Drug Resist 2014;7:167-76.

Levy SB, Marshall B. Antibacterial resistance worldwide: Causes, challenges and responses. Nat Med 2004;10:S122-9.

Murray B. New aspects of antimicrobial resistance and the resulting therapeutic dilemmas. J Infect Dis 1991;163:1185.

Drawz SM, Bonomo RA. Three decades of β-lactamase inhibitors. Clin Microbiol Rev 2010;23(1):160-201.

Spratt BG. Properties of the penicillin-binding proteins of Escherichia coli K12. Eur J Biochem 1977;72(2):341-52.

Chambers HF. Penicillin-binding protein-mediated resistance in pneumococci and staphylococci. J Infect Dis 1999;179 Suppl 2:S353-9.

Aminov RI. A brief history of the antibiotic era: Lessons learned and challenges for the future. Front Microbiol 2010;1:134.

Bradford PA. Extended-spectrum β-lactamases in the 21st century: Characterization, epidemiology, and detection of this important resistance. Threat Clin Microbiol Rev 2001;14(4):933-51.

Rawat D, Nair D. Extended-spectrum β-lactamases in gram negative bacteria. J Glob Infect Dis 2010;2(3):263-74.

Katouli M. Population structure of gut Escherichia coli and its role in development of extra-intestinal infections. Iran J Microbiol 2010;2(2):59-72.

Carlet J. The gut is the epicentre of antibiotic resistance. Antimicrob Resist Infect Control 2012;1(1):39.

Brolund A. Overview of ESBL-producing Enterobacteriaceae from a nordic perspective. Infect Ecol Epidemiol 2014;4. DOI: 10.3402/iee. v4.24555.

Bush K, Jacoby GA. Updated functional classification of β-lactamases. Antimicrob Agents Chemother 2010;54(3):969-76.

Rice LB. The clinical consequences of antimicrobial resistance. Curr Opin Microbiol 2009;12(5):476-81.

Davies J, Davies D. Origins and evolution of antibiotic resistance. Microbiol Mol Biol Rev 2010;74(3):417-33.

Stobberingh EE, Arends J, Hoogkamp-Korstanje JA, Goessens WH, Visser MR. Occurrence of extended-spectrum beta lactamases in Dutch hospitals. Infection 1999;27:348-54.

Branger C, Lesimple AL, Bruneu B, Berry P, Lambert-Zechovsky N. A long-term investigation of the clonal dissemination of Klebsiella pneumoniae isolates producing extended-spectrum beta lactamases in a university hospital. J Med Microbiol 1998;47:201-9.

Jacoby GA. Extended-spectrum β-lactamases and other enzymes providing resistance to oxyimino β-lactams. Infect Dis Clin N Am 1997;11:875-87.

Jones SL, Nguyen VK, Nguyen TM, Athan E. Prevalence of multiresistant gram-negative organisms in a surgical hospital in Ho Chi Minh city, Vietnam. Trop Med Int Health 2006;11:1725-30.

Ko KS, Lee MY, Song JH, Lee H, Jung DS, Jung SI, et al. Prevalence and characterization of extended-spectrum beta-lactamase producing Enterobacteriaceae isolated in Korean hospitals. Diagn Microbiol Infect Dis 2008;61:453-9.

Varaiya AY, Dogra JD, Kalkarni MH, Bhalekar PN. Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumonia in diabetic foot infections. Indian J Pathol Microbiol 2008;51:370-2.

Mendes C, Hsiung A, Kiffer C, Oplustil V, Sinto S, Sampaio J, et al. Evaluation of the in vitro activity of 9 antimicrobials against bacterial strains isolated from patients in intensive care units in Brazil: MYSTIC antimicrobial surveillance program. Braz J Infect Dis 2000;4:236-44.

Otman J, Cavassin ED, Perugini ME, Vidotto MC. An outbreak of extended-spectrum beta-lactamase-producing Klebsiella species in a neonatal intensive care unit in Brazil. Infect Control Hosp Epidemiol 2002;23:8-9.

Pfaller MA, Jones RN, Doern GV. Multicenter evaluation of the antimicrobial activity for six broad-spectrum beta-lactams in Venezuela: Comparison of data from 1997 and 1998 using the etest method. Venezuelan antimicrobial resistance study group. Diagn Microbiol Infect Dis 1999;35:153-8.

Pfaller MA, Jones RN, Doern GV, Salazar JC. Multicenter evaluation of antimicrobial resistance to six broad-spectrum betalactams in Colombia: Comparison of data from 1997 and 1998 using the Etest method. The Colombian antimicrobial resistance study group. Diagn Microbiol Infect Dis 1999;35:235-41.

Mahomed S, Mahomed Y. Faecal carriage of extended spectrum beta-lactamase producing Escherichia coli and Klebsiella pneumoniae in children from the community of Kwadedangendlale, KwaZulu-Natal, South Africa. Int J Infect Control 2014;11:3.

Reuland EA, Overdevest IT, Al-Naiemi N, Kalpoe JS, Rijnsburger MC, Raadsen SA, et al. High prevalence of ESBL-producing Enterobacteriaceae carriage in Dutch community patients with gastrointestinal complaints. Clin Microbiol Infect 2013;19(6):542-9.

Ruppe E, Woerther PL, Diop A, Sene AM, da Costa A, Arlet G, et al. Carriage of CTX-M-15-producing Escherichia coli isolates among children living in a remote village in Senegal. Antimicrob Agents Chemother 2009;53:3135-7.

Woerther PL, Angebault C, Jacquier H, Hugede HC, Janssens AC, Sayadi S, et al. Massive increase, spread, and exchange of extended spectrum β-lactamase-encoding genes among intestinal Enterobacteriaceae in hospitalized children with severe acute malnutrition in Niger. Clin Infect Dis 2011;53:677-85.

CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-First Informational Supplement. CLSI Document M100-S21. Wayne, PA: Clinical and Laboratory Standards Institute; 2011.

Sanidhya R, Priya RL, Selvam E. Antibiotic susceptibility pattern and ESBL prevalence in Escherichia coli isolates from pus samples in a tertiary care hospital. Int J Pharm Pharm Sci 2015;7(3):263-4.

Muraleetharan M, Vishwanathan T. Epidemiological studies on varying extended spectrum beta lactamase-producing uropathogenic bacteria. Int J Pharm Pharm Sci 2014;6(11):57-60.

Blom A, Ahl J, MÃ¥nsson F, Resman F, Tham J. The prevalence of ESBL-producing Enterobacteriaceae in a nursing home setting compared with elderly living at home: A cross-sectional comparison. BMC Infect Dis 2016;16:111.

Asir J, Nair S, Devi S, Prashanth K, Saranathan R, Kanungo R. Simultaneous gut colonisation and infection by ESBL-producing Escherichia coli in hospitalised patients. Acad Manage J 2015;8(6):200-7.

Shakya P, Barrett P, Diwan V, Marothi Y, Shah H, Chhari N, et al. Antibiotic resistance among Escherichia coli isolates from stool samples of children aged 3 to 14 years from Ujjain, India. BMC Infect Dis 2013;13:477.

Wickramasinghe NH, Xu L, Eustace A, Shabir S, Saluja T, Hawkey PM, et al. High community faecal carriage rates of CTX-M ESBL-producing Escherichia coli in a specific population group in Birmingham, UK. J Antimicrob Chemother 2012;67(5):1108-13.

Peirano G, Laupland KB, Gregson DB, Pitout JD. Colonization of returning travelers with CTX-M-producing Escherichia coli. J Travel Med 2011;18:299-303.

Herindrainy P, Randrianirina F, Ratovoson R, Hariniana ER, Buisson Y, Genel N, et al. Rectal carriage of extended-spectrum beta-lactamase-producing gram-negative bacilli in community settings in Madagascar. PLoS One 2011;6(7):e22738.



How to Cite

Sharma, N., and A. Arjuna. “FECAL CARRIAGE OF EXTENDED-SPECTRUM BETA-LACTAMASESPRODUCING ESCHERICHIA COLI IN HOSPITALS AND COMMUNITY SETTINGS: A REVIEW”. Asian Journal of Pharmaceutical and Clinical Research, vol. 10, no. 9, Sept. 2017, pp. 10-14, doi:10.22159/ajpcr.2017.v10i9.19126.



Review Article(s)

Most read articles by the same author(s)

1 2 > >>