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

被引:28
作者
Huang, I-Fei [1 ,2 ,3 ]
Lee, Wei-Yang [4 ]
Wang, Jiun-Ling [5 ,6 ]
Hung, Chih-Hsin [7 ,8 ]
Hu, Hong-Hsiang [1 ]
Hung, Wan-Yu [7 ,8 ]
Hung, Yun-Ju [1 ]
Chen, Wen-Chi [2 ,9 ]
Shen, Ying-Tso [1 ]
Cheng, Ming-Fang [1 ,2 ,10 ]
机构
[1] Kaohsiung Vet Gen Hosp, Dept Pediat, 386 Ta Chung 1st Rd, Kaohsiung 81362, Taiwan
[2] Natl Yang Ming Univ, Sch Med, Taipei, Taiwan
[3] Chung Hwa Univ Med Technol, Tainan, Taiwan
[4] Kaohsiung Municipal United Hosp, Dept Pediat, Kaohsiung, Taiwan
[5] Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Dept Internal Med, Coll Med, Tainan, Taiwan
[6] Natl Cheng Kung Univ, Dept Med, Coll Med, Tainan, Taiwan
[7] I Shou Univ, Dept Chem Engn, Kaohsiung, Taiwan
[8] I Shou Univ, Inst Biotechnol & Chem Engn, Kaohsiung, Taiwan
[9] Kaohsiung Vet Gen Hosp, Dept Med, Div Gastroenterol, Kaohsiung, Taiwan
[10] Fooyin Univ, Kaohsiung, Taiwan
关键词
Escherichia coli; Fecal carriage; Multidrug-resistant; Extended-spectrum; beta-lactamase; Children; LACTAMASE-PRODUCING ENTEROBACTERIACEAE; HEALTHY-CHILDREN; RISK-FACTORS; ANTIMICROBIAL RESISTANCE; CHANGING EPIDEMIOLOGY; ANTIBIOTIC-RESISTANCE; BETA-LACTAMASES; MULTIPLEX PCR; STRAINS; EMERGENCE;
D O I
10.1186/s12876-018-0807-x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: The 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. Methods: In 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. Results: Among 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 beta-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. Conclusions: 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. 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.
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