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  • 1 German Armed Forces Hospital of Hamburg Department of Tropical Medicine at the Bernhard Nocht Institute Bernhard Nocht street 74 D-20359 Hamburg Germany
  • 2 Bernhard Nocht Institute for Tropical Medicine Hamburg Infectious Disease Epidemiology Department Hamburg Germany
  • 3 University Hospital Joseph Raseta de Befelatanana Infectious Disease Department Antananarivo Madagascar
  • 4 University of Antananarivo Department of Microbiology and Parasitology Antananarivo Madagascar
  • 5 University Hospital Joseph Raseta de Befelatanana Laboratory Department Antananarivo Madagascar
  • 6 University Hospital Rostock Institute for Microbiology, Virology and Hygiene Rostock Germany
  • 7 Justus-Liebig-University Giessen Institute for Medical Microbiology Giessen Germany
Open access

This study assesses the nasal occurrence of β-lactamase-producing Enterobacteriaceae both in patients in a hospital department of infectious diseases at admission and in healthy Madagascan students and health care workers.Nasal swabs from 681 students, 824 health care workers, and 169 patients were obtained in Antananarivo, Madagascar, and transferred to Germany. Screening for β-lactamase (ESBL, ampC) producing Enterobacteriaceae was performed by cultural and molecular approaches, comprising Brilliance ESBL agar, E-testing, ABCD-testing, and commercial hyplex ESBL and SuperBug ID PCR.Regarding ESBL-positive strains and strains with resistance against at least three out of the four tested bactericidal antibiotic drugs, 0.3% (five out of 1541) of the students and health care workers group showed nasal colonization, whereas colonization was observed in 7.1% (12 out of 169) of the hospitalized patients at admission. No appreciably reduced detection rates after sample storage and intercontinental transport were observed.A considerable proportion of nasal colonization with cephalosporin-resistant Enterobacteriaceae was demonstrated in Madagascan hospital patients at admission, posing a risk of developing future endogenous infections. The nasal colonization of healthy individuals was negligible. Good storage and transport stability of Enterobacteriaceae will allow for future studies even in areas difficult to access.

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Jeffrey S. Buguliskis (Thomas Jefferson University, USA)

  • Jörn Albring (University of Münster, Germany)
  • Stefan Bereswill (Charité - University Medicine Berlin, Germany)
  • Dunja Bruder (University of Megdeburg, Germany)
  • Jan Buer (University of Duisburg, Germany)
  • Jeff Buguliskis (Thomas Jefferson University, USA)
  • Edit Buzas (Semmelweis University, Hungary)
  • Charles Collyer (University of Sydney, Australia)
  • Renato Damatta (UENF, Brazil)
  • Ivelina Damjanova (Semmelweis University, Hungary)
  • Maria Deli (Biological Research Center, HAS, Hungary)
  • Olgica Djurković-Djaković (University of Belgrade, Serbia)
  • Jean-Dennis Docquier (University of Siena, Italy)
  • Anna Erdei (Eötvös Loránd University, Hungary)
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  • Georgina L. Hold (University of Aberdeen, United Kingdom)
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  • Michal Toborek (University of Miami, USA)
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