Fecal Colonization With Multidrug-Resistant E. coli Among Healthy Infants in Rural Bangladesh

Abstract

Third generation cephalosporins (3GC) are one of the main choices for treatment of infections caused by multidrug-resistant (MDR) Gram-negative bacteria. Due to their overuse, an increasing trend of resistance to 3GC has been observed in developing countries. Here, we describe fecal colonization of 3GC-resistant (3GCr) Escherichia coli in healthy infants (1–12 months old) living in rural areas of Bangladesh. We found that stool samples of 82% of infants ( n = 100) were positive for 3GCr E. coli with a mean ± standard deviation of 6.21 ± 1.32 log 10 CFU/g wet weight of stool. 3GCr E. coli encompasses an average one third (33%) of the total E. coli of stool. Almost 77% ( n = 63) of these 3GCr E. coli were MDR (or resistant to ≥3 classes of antibiotics). Around 90% ( n = 74) of 3GCr E. coli were extended spectrum beta-lactamase (ESBL)-producing in which bla CTX–M–group–1 was the predominant (96%, n = 71) ESBL-gene followed by bla TEM (41%, n = 30) and bla OXA–1 (11%, n = 8). A significant proportion (26.5%, n = 22) of 3GCr E. coli was pathogenic, comprising two types, enteroaggregative (EAEC, n = 19) and enteropathogenic (EPEC, n = 3). Colonization of 3GCr E. coli in infant guts was not associated with demographic characteristics such as age, sex, mode of delivery, maternal and infant antibiotic use, disease morbidity, and feeding practices. The high rate of colonization of 3GCr E. coli in infants’ guts is a serious public health concern which needs immediate attention and warrants further studies to explore the cause.

Molecular characterization of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae among the pediatric population in Qatar

“…A total of 327 ESBL producers were sequenced, 255 E. coli and 72 K. pneumoniae (Additional le 1 We further assessed the association between co-production of TEM-1B and OXA-1 enzymes and nonsusceptibility to amoxicillin/clavulanate and piperacillin/tazobactam, after excluding the confounding in uence of other β-lactamases active against β-lactamase inhibitors, namely plasmid-mediated AmpC β- [18][19][20][21][22]. In contrast, our NICU had a variety genotypes of both species without subsequent signi cant cross-transmission, suggesting a sporadic colonisation/infection within a group that is at particular high risk for ESBL acquisition [23].…”

Longitudinal assessment of antibiotic resistance gene profiles in gut microbiomes of infants at risk of eczema

“…In particular, the prevalence of ESBL E. coli has been reported to be as high as 50% in the Vietnamese general population (13), and even higher among infants hospitalized in a neonatal intensive care unit in Taiwan (14,15). In a recent study of healthy infants from Bangladesh, 82% had stool samples containing third generation cephalosporin-resistant E coli, the majority of which were multidrugresistant and ESBL-producers (16).…”

Methanol extract of <i>Lonicera caerulea</i> var. <i>emphyllocalyx</i> fruit has anti-motility and anti-biofilm activity against enteropathogenic <i>Escherichia coli</i>

“…EPEC has only a human reservoir of infection (4). The increased prevalence of EPEC strains that produce extended spectrum β-lactamase has led to a growing interest in the development of non-antibiotic treatment options (5,6). Lonicera caerulea var.…”