Fecal carriage of multidrug-resistant Escherichia coli by community children in southern Taiwan

I-Fei Huang,Jiun-Ling Wang,Chih-Hsin Hung,Hong-Hsiang Hu,Wei-Yang Lee,Ying-Tso Shen,Ming-Fang Cheng,Wen-Chi Chen,Wan-Yu Hung,Yun-Ju Hung

doi:10.1186/s12876-018-0807-x

Abstract

BackgroundThe emergence of multidrug-resistant (MDR) Escherichia coli (E. coli), particularly E. coli sequence type ST131, is becoming a global concern. Commensal bacteria, an important reservoir of antibiotic resistance genes, facilitate the spread of such genes to pathogenic bacterial strains. The objective of the study is to investigate the fecal carriage of MDR E. coli and ST131 E. coli in community children in Southern Taiwan.MethodsIn this prospective study, stool samples from children aged 0–18 years were obtained within 3 days of hospitalization from October 2013 to September 2014. Children with a history of underlying diseases, antibiotic treatment, or hospitalization in the 3 months before specimen collection were excluded. E. coli colonies were selected and tested for antimicrobial susceptibility, and O25b-ST131, multilocus sequence typing, and blaCTX-M gene groups were detected.ResultsAmong 157 E. coli isolates, the rates of nonsusceptibility to ampicillin, amoxycillin + clavulanate, trimethoprim–sulfamethoxazole, and cefazolin were 70, 65.6, 47.1, and 32.5%, respectively. Twenty-nine (18.5%) isolates were nonsusceptible to ciprofloxacin. MDR E. coli accounted for 58 (37%) of all isolates. Thirteen (8.3%) isolates produced extended-spectrum β-lactamase (ESBL). Furthermore, 26 (16.6%) and 13 (8.3%) isolates were O25b and ST131 positive, respectively. Five (38.5%) of the 13 ESBL-producing E. coli belonged to blaCTX-M group 9, among which were CTXM-14 and 4 (80%) were O25b–ST131 positive. Compared with the non-ESBL and ciprofloxacin-susceptible groups, the ESBL and ciprofloxacin-nonsusceptible groups showed significantly higher rates of O25b–ST131 positivity.ConclusionsThe prevalence of the fecal carriage of nonsusceptible E. coli in children was high; among these E. coli, 37% were MDR, 18.5% were nonsusceptible to ciprofloxacin, and 8.3% produced ESBL. O25b–ST131 was the most common ESBL-producing E. coli clonal group present in the feces of children, and the ESBL and ciprofloxacin-nonsusceptible groups showed significantly higher rates of O25b–ST131 positivity.

Highlights

The emergence of multidrug-resistant (MDR) Escherichia coli (E. coli), E. coli sequence typeST131, is becoming a global concern
Five (38.5%) of the 13 Extended-spectrum β-lactamase (ESBL)-producing E. coli belonged to blaCTX-M group 9, among which were CTXM-14 and 4 (80%) were O25b–ST131 positive
The prevalence of the fecal carriage of nonsusceptible E. coli in children was high; among these E. coli, 37% were MDR, 18.5% were nonsusceptible to ciprofloxacin, and 8.3% produced ESBL

Summary

Introduction

The emergence of multidrug-resistant (MDR) Escherichia coli (E. coli), E. coli sequence type. An important reservoir of antibiotic resistance genes, facilitate the spread of such genes to pathogenic bacterial strains. The species of the Escherichia genus is heterogeneous, and this genus includes both commensal and pathogenic bacteria. Only some E. coli are pathological species, they cause infections in various organs, such as the urinary tract, biliary system, and central nervous †. The emergence of MDR E. coli is becoming a global concern, with particular emphasis on E. coli sequence type ST131, which is increasingly reported in urinary tract infections (UTIs). In 2008, E. coli ST131 was identified as a major clone associated with the spread of CTX-M-15 ESBL resistance [3,4,5].

Objectives

Methods

Results

Discussion

Conclusion