Carriage of antibiotic-resistant bacteria by healthy children

Abstract

The frequency of carriage of antibiotic-resistant bacteria in healthy 7- and 8-year-old children in Bristol was studied. Children born in Avon between 1 April 1991 and 31 December 1992, attending the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) 7 year follow-up clinic, formed the study population. Carriage was estimated using mouth and stool samples. None of 105 children on whom information was available had received tetracycline, chloramphenicol, ciprofloxacin or an extended-spectrum cephalosporin in the previous year. Staphylococcus aureus was isolated from mouthwashes from 200 (37.1%) of 539 children sampled. Six (3%) of the isolates were resistant to chloramphenicol or tetracycline and four (2%) were methicillin resistant. Haemophilus spp. were isolated from 369 (72%) of 513 samples and 63 (17%) were ampicillin resistant, 49 (13.3%) were erythromycin resistant and seven (1.9%) were tetracycline resistant. Branhamella catarrhalis was isolated from 333 (74%) of 450 samples. Twenty-eight (8.4%) were erythromycin resistant and 14 (4.2%) strains were tetracycline resistant. Group A beta-haemolytic streptococci were isolated from 17 of 507 children sampled. One (5.9%) was tetracycline resistant. Stool samples were returned from 335 (62%) of 539 children from whom they were requested. Eleven per cent of samples yielded Gram-negative bacilli with high-level resistance to chloramphenicol, which was frequently linked to resistance to ampicillin, spectinomycin and streptomycin. Isolates demonstrating resistance to the third-generation cephalosporin ceftazidime were recovered from 17 subjects (3.2%). Six (35%) of 17 isolates possessed extended-spectrum beta-lactamases. Healthy children carry bacteria resistant to antibiotics to which children are not usually exposed. Resistance to ceftazidime, chloramphenicol and tetracycline may be co-selected by exposure to other antibiotics used in children or may be acquired from family members, pets, other children or food. These results suggest that antibiotic-resistant bacteria are widely disseminated and may be acquired by children before exposure to specific selection pressure.

Effect of Amoxicillin Use on Oral Microbiota in Young Children

“…Amoxicillin is not only heavily used in medicine but is also frequently prescribed in dentistry and at present is recommended for the chemoprophylaxis of infective endocarditis prior to specific dental procedures (4). The oral microbiota is an important reservoir of antibiotic-resistant bacteria, and several studies have shown that amoxicillin-resistant bacteria are carried in the oral cavity (13,16,19). Indeed, in a previous study (19), all of the children investigated were shown to harbor a diverse community of amoxicillin-resistant bacteria in their oral cavities.…”

Dramatic Increase in Prevalence of Fecal Carriage of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae during Nonoutbreak Situations in Spain

“…Patients with fecal carriage of ESBL-producing bacterial isolates have been investigated previously during nosocomial outbreaks (12,17,38), but the number of prospective longitudinal studies conducted in the hospital setting during nonoutbreak situations or in the community remains scarce (5,28,29). Moreover, to the best of our knowledge, the rate of fecal carriage of ESBL-producing bacterial isolates during different and distant periods of time in the same location has not been investigated previously.…”

Clinical and Molecular Analysis of Extended-Spectrum β-Lactamase-Producing Enterobacteria in the Community Setting

“…Several recent data have suggested that ESBLE are currently emerging within the community (6, 8, 9, 11, 12, 14, 16, 17, 19, 20, 22-24, 27, 28, 30, 31, 33). However, most of these studies simply noted the incidence of ESBLEinduced infections (9,11,12,14,16,19,27) or ESBLE digestive carriage (16,(22)(23)(24)33). Others have described clinical cases in greater detail (6,31) or identified the risk factors for ESBLE acquisition (8).…”