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Research article - Peer-reviewed, 2019

Carriage of carbapenemase- and extended-spectrum cephalosporinase-producing Escherichia coli and Klebsiella pneumoniae in humans and livestock in rural Cambodia; gender and age differences and detection of bla(OXA-48 )in humans

Atterby, Clara; Osbjer, Kristina; Tepper, Viktoria; Rajala, Elisabeth; Hernandez, Jorge; Seng, Sokerya; Holl, Davun; Bonnedahl, Jonas; Borjesson, Stefan; Magnusson, Ulf; Jarhult, Josef D.


Objectives This study investigates the frequency and characteristics of carbapenemase-producing Escherichia coli/Klebsiella pneumoniae (CPE/K) and extended-spectrum cephalosporinase-producing E. coli/K. pneumoniae (ESCE/K) in healthy humans and livestock in rural Cambodia. Additionally, household practices as risk factors for faecal carriage of ESCE/K are identified. Methods Faecal samples were obtained from 307 humans and 285 livestock including large ruminants, pigs and poultry living in 100 households in rural Cambodia in 2011. Each household was interviewed, and multilevel logistic model determined associations between household practices/meat consumption and faecal carriage of ESCE/K. CPE and ESCE/K were detected and further screened for colistin resistance genes. Results CPE/K isolates harbouring bla(OXA-48 )were identified in two humans. The community carriage of ESCE/K was 20% in humans and 23% in livestock. The same ESBL genes: bla(CTX-M-15), bla(CTX-M-14), bla(CTX-M-27), bla(CTX-M-55), bla(SHV-2), bla(SHV-12), bla(SHV-28); AmpC genes: bla(CMY-2), bla(CMY-42,) bla(DHA-1); and colistin resistance genes: mcr-1-like and mcr-3-like were detected in humans and livestock. ESCE/K was frequently detected in women, young children, pigs and poultry, which are groups in close contact. The practice of burning or burying meat waste and not collecting animal manure indoors and outdoors daily were identified as risk factors for faecal carriage of ESCE/K. Conclusions Faecal carriage of E. coli and K. pneumoniae harbouring extended-spectrum cephalosporinase genes are common in the Cambodian community, especially in women and young children. Exposure to animal manure and slaughter products are risk factors for intestinal colonization of ESCE/K in humans.


AmpC; Cambodia; carbapenemase; colistin; ESBL; risk factors; rural population; zoonoses

Published in

Zoonoses and Public Health
2019, volume: 66, number: 6, pages: 603-617
Publisher: WILEY

Authors' information

Atterby, Clara
Uppsala University
Swedish University of Agricultural Sciences, Department of Clinical Sciences
Food and Agriculture Organization of the United Nations (FAO)
Tepper, Viktoria
ETH Zurich
Lindahl Rajala, Elisabeth (Rajala, Elisabeth)
Swedish University of Agricultural Sciences, Department of Clinical Sciences
Hernandez, Jorge
Linnaeus University
Seng, Sokerya
Food and Agr Org United Nations
Holl, Davun
Minist Agr Forestry and Fisheries
Bonnedahl, Jonas
Linnaeus University
Borjesson, Stefan
Linkoping University
Swedish University of Agricultural Sciences, Department of Clinical Sciences
Jarhult, Josef D.
Uppsala University

Sustainable Development Goals

SDG5 Gender equality
SDG3 Good health and well-being

UKÄ Subject classification

Public Health, Global Health, Social Medicine and Epidemiology

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