Fecal carriage of ESBL-producing in Egyptian patients admitted to the Medical Research Institute hospital, Alexandria University.

Commensal ESBL-producing represent a reservoir for resistance genes therefore, their detection is crucial to restrain the spread of beta-lactam resistance. Hence, the aim of the present study was phenotypic and genotypic characterization of commensal ESBL-producing obtained from the stool of patients at the time of admission and at the time of discharge from the Medical Research Institute hospital. A total of 70 isolates were collected from 35 patients and were categorized into Group A (samples obtained on admission) and Group B (samples obtained at the time of discharge). Phenotypically, 30 isolates were ESBL producers (40% of isolates collected on admission and 45.7% of the strains obtained at the time of discharge were ESBL producers). Most of them harbored one to three plasmids with sizes ranging from one kbp to ten kbp. Upon genotypic investigation, was the most detected gene in 80% of ESBL strains, followed by in 53.3% and the least detected was in only 13.3%. By comparing group A and group B, ten patients were found to carry commensal ESBL-producing , in two patients these isolates carried ESBL genes that were identical on admission and on discharge. However, in eight patients, these isolates carried different ESBL genes, which were newly harbored during hospital stay. The high abundance of MDR commensal 48.57% together with the presence of 42.86% ESBL-producing commensal among our isolates represents an alarming threat, as they are frequently associated with the increased risk of infection, higher costs and longer hospital stay.