Multidrug-resistant commensal Escherichia coli in children, Peru and Bolivia - PubMed (original) (raw)

doi: 10.3201/eid1206.051258.

Lucia Pallecchi, Marta Benedetti, Connie Fernandez, Yolanda Vallejos, Elisa Guzman, Ana Liz Villagran, Antonia Mantella, Chiara Lucchetti, Filippo Bartalesi, Marianne Strohmeyer, Angela Bechini, Herlan Gamboa, Hugo Rodríguez, Torkel Falkenberg, Göran Kronvall, Eduardo Gotuzzo, Franco Paradisi, Gian Maria Rossolini

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Multidrug-resistant commensal Escherichia coli in children, Peru and Bolivia

Alessandro Bartoloni et al. Emerg Infect Dis. 2006 Jun.

Abstract

Using a rapid screening method, we investigated the prevalence of fecal carriage of antimicrobial drug-resistant Escherichia coli in 3,174 healthy children from 4 urban settings in Peru and Bolivia. High resistance rates were observed for ampicillin (95%), trimethoprim-sulfamethoxazole (94%), tetracycline (93%), streptomycin (82%), and chloramphenicol (70%). Lower resistance rates were observed for nalidixic acid (35%), kanamycin (28%), gentamicin (21%), and ciprofloxacin (18%); resistance to ceftriaxone and amikacin was uncommon (<0.5%). In a random sample of 1,080 resistant E. coli isolates, 90% exhibited a multidrug-resistance (MDR) phenotype. The 2 most common MDR phenotypes (ampicillin/tetracycline/trimethoprim-sulfamethoxazole and ampicillin/tetracycline/trimethoprim-sulfamethoxazole/chloramphenicol) could be transferred en bloc in conjugation experiments. The most common acquired resistance genes were blaTEM, tet(A), tet(B), drfA8, sul1, sul2, and catI. These findings underscore the magnitude of the problem of antimicrobial drug resistance in low-resource settings and the urgent need for surveillance and control of this phenomenon.

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Figures

Figure 1

Figure 1

Flow chart of microbiologic analysis of fecal samples. DPM, direct plating method.

Figure 2

Figure 2

Total prevalence, by age group, of fecal carriage of antimicrobial drug–resistant Escherichia coli among 3,174 children in 4 urban areas of Bolivia and Peru. Ceftriaxone and amikacin were not considered in these analyses because their resistance rates were too low.

Figure 3

Figure 3

Frequency of resistance phenotypes in 1,080 randomly selected antimicrobial drug–resistant Escherichia coli isolates from 4 urban areas of Bolivia and Peru. Black bars indicate the most frequent resistance and multidrug-resistance phenotype within each category: 1R, TET; 2R, AMP-SXT; 3R, AMP-TET-SXT; 4R, AMP-TET-SXT-CHL; 5R, AMP-TET-SXT-CHL-KAN; 6R, AMP-TET-SXT-CHL-NAL-CIP; 7R, AMP-TET-SXT-CHL-GEN-NAL-CIP; 8R, AMP-TET-SXT-CHL-KAN-GEN-NAL-CIP. AMP, ampicillin; TET, tetracycline; SXT, trimethoprim-sulfamethoxazole; CHL, chloramphenicol; KAN, kanamycin; GEN, gentamicin; NAL, nalidixic acid; CIP, ciprofloxacin.

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