TRIMETHOPRIM RESISTANT (TMPR) E. COLI IN STOOL SPECIMENS FROM CHILDREN IN DAY CARE CENTERS (DCC)

Abstract

In the U.S. E. coli are rarely resistant to multiple antimicrobial agents outside the hospital setting. In a recent pilot study, we demonstrated TMPR E. coli in 15 of 79 children (19%) in DCC, presumably due to frequent antimicrobial drug use and fecal oral transmission. Because of these findings we determined the proportion of resistant E. coli in stools from 203 children in 12 DCC, 41 children not in DCC, and 66 children newly entering DCCs. All children were < 24 months of age. 65 of 203 children (32%) had TMPR E. coli in stools compared with 2 of 41 children (5%) not in a DCC and 5 of 66 children (8%) newly entering a DCC. The proportion of children with TMPR E. coli varied from 0 in the smallest to 58% in the largest DCC. Predominant antibiograms were noted in individual centers; these antibiograms differed among centers. Total plasmid DNA detected by electrophoresis in 0.7% agarose gels were identical or similar in 3 centers where a large number of TMPR isolates were identified, but distinct from each other and from other DCC isolates. There was an association of TMPR E. coli with antimicrobial use In the 2 weeks prior to sampling. These findings extend our earlier observations of high levels of TMPR E. coli in DCC. TMPR E. coli in DCC may be common and appear to be related to the DCC size and prevalence of antimicrobial use. The role of DCC in the epidemiology of resistant human enteric bacteria remains to be determined.