One hundred twelve fecal samples of healthy children were recovered in Portugal during October 2007 and February 2008 and were tested for extended-spectrum beta-lactamases (ESBLs) containing Escherichia coli isolates and vancomycin-resistant enterococci (VRE). Three of the 112 fecal samples (2.7%) harbored ESBL-positive E. coli isolates and the bla(CTX-M-1), bla(TEM-52), and bla(SHV-12) genes were identified in these isolates. The bla(TEM-52)-containing isolate showed a phenotype of multiresistance that included fluoroquinolones, tetracycline, trimethoprim-sulfamethoxazole, and chloramphenicol; sul1, sul3, and cmlA genes were detected in this isolate, in addition to two amino acid changes in GyrA (Ser83Leu + Asp87Asn) and one in ParC protein (Ser80Ile). The ESBL isolates corresponded to phylogroup A (one isolate), B1 (one isolate), and D (one isolate). vanA-containing Escherichia faecium isolates were detected in 13 of the 112 fecal samples (11.6%), and vanC-1 isolates were found in 2 samples. A diversity of resistance genes [(tet(M), tet(L), erm(B), aph(3')-IIIa, ant(6)-Ia, catA, and vat(E)] were found in VRE isolates. These results show that the intestinal tract of healthy children constitutes a reservoir of ESBL-containing E. coli and VRE isolates.

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From stool specimens of 118 healthy children's (1-14 years) in Portugal 92 E. coli and 101 Enterococcu s spp. strains have been isolated. Almost half (40.2%) of the E. coli isolates were resistant to ampicillin, 25.0% were resistant to tetracycline and 26.1% were resistant to streptomycin. Resistance genes detected by specific PCR included bla(TEM) and/or bla(SHV) and/or bla(CTX-M) (33 of 37 ampicillin and/or cefotaxime resistant isolates), tet (A) and/or tet (B) (16 of 23 tetracycline-resistant isolates), aad A (19 of 24 streptomycin-resistant isolates), cml A (in the two chloramphenicol-resistant isolates), aac (3)-II with/without aac (3)-IV (in the four gentamicin-resistant isolates), sul 1 and/or sul 2 and/or sul 3 (in all trimethoprim/sulfamethoxazole resistant isolates). The majority of the resistant E. coli isolates (69.1%) belonged to phylogenetic group B2. Of the enterococci isolates E. faecium (n = 53), E. faecalis (n = 41), E. hirae (n = 4) and E. durans (n = 3) more than one-fourth (28.7%) of the isolates were resistant to tetracycline; 21.8% were resistant to erythromycin and 8.9% were resistant to kanamycin. Resistance genes detected by PCR in enterococci included aph (3)'-IIIa (in all kanamycin-resistant isolates), aac (6') (in all gentamicin-resistant isolates), tet (M) and/or tet (L) (26 of 29 tetracycline-resistant isolates), erm (B) (17 of 22 erythromycin-resistant isolates). This survey showed that faecal bacteria such as E. coli and enterococci of healthy growing children's could be a reservoir of antimicrobial resistance genes.