Novel Chlamydiaceae Disease in Captive Salamanders

health concern in industrialized and resource-poor settings. Few reports are available from Africa, although hospital-associated ESBL producers have been described in Cameroon and the Central African Republic (6,7). ESBL-producing bacteria have been recovered from different sources in the community, including food and companion animals (8,9), and 1 recent study from India reported that a substantial number of tap water samples were contaminated with carbapenemase blaNDM-1 producing organisms (10). Kinshasa is the second-largest city in sub-Saharan Africa. In 2008, of its estimated 8.7 million inhabitants, only 46%had access to safe drinking water, and 23% had access to improved sanitation facilities according to the World Bank. Opportunistic pathogens in drinking water and poor sanitary conditions may increase the risk of developing infectious enterocolitis for consumers, especially for those who are immunocompromised. It can eventually lead to chronic intestinal carriage of multidrugresistant organisms. The presence of ESBL producers in the intestinal fl ora could also lead to horizontal transfer of drug resistance genes from commensal fl ora to enteric pathogens. This emergence of ESBL-producing bacteria and further communityassociated infections poses a public threat, especially in low-resource countries where surveillance is suboptimal and empiric treatment of invasive infections often includes third-generation cephalosporins.