High Frequency of Antimicrobial Drug Resistance of Diarrheagenic Escherichia coli in Infants in Peru

Abstract

In a prospective passive diarrhea surveillance cohort study of 1,034 infants of low socioeconomic communities in Lima, Peru, we determined the prevalence and antimicrobial drug susceptibility of the diarrheagenic Escherichia coli . The prevalence of diarrheagenic E. coli was 29% (161 of 557) in children with gastroenteritis and 30% (58 of 195) in the control group without diarrhea. The most common E. coli pathogens in diarrhea were enteroaggregative E. coli (EAEC) (14%), enteropathogenic E. coli (EPEC) (7%), diffusely adherent E. coli (DAEC) (4%), and enterotoxigenic E. coli (ETEC) (4%). Diarrheagenic E. coli as a group exhibited high levels of antimicrobial drug resistance in diarrheal cases to ampicillin (85%), cotrimoxazole (79%), tetracycline (65%), and nalidixic acid (28%). Among individual E. coli groups in patients with diarrhea, DAEC and EAEC exhibited significant higher frequencies of resistance to ampicillin, cotrimoxazole, tetracycline and nalidixic acid than EPEC and ETEC. Antimicrobial drug resistance to ampicillin and cotrimoxazole were more frequent in E. coli isolated from diarrheal samples than controls, which reflected greater antibiotic exposure in patients with gastroenteritis.

Molecular Detection of Diffusely Adherent Escherichia coli Strains Associated with Diarrhea in Shiraz, Iran

“…Another report from northern Iran (2014) showed that 79.4% of the isolated E. coli were resistant to cefixime (30). Studies from Peru, Vietnam, Brazil and Mexico have also reported greater resistance to ampicillin in E. coli (31)(32)(33)(34). Our findings are similar to those of the studies from Iran, Peru, Vietnam, Brazil and Mexico (29)(30)(31)(32)(33)(34).…”

“…Studies from Peru, Vietnam, Brazil and Mexico have also reported greater resistance to ampicillin in E. coli (31)(32)(33)(34). Our findings are similar to those of the studies from Iran, Peru, Vietnam, Brazil and Mexico (29)(30)(31)(32)(33)(34). It should be also noted that in many cases, antibiotic resistance is transmitted to humans, hospitalized patients and the hospital environment through other sources, including food plants, animals, fish, poultries, and other industries, in which antibiotics are used for different purposes and may lead to the emergence of resistant strains (35)(36)(37)(38).…”

Macrolide resistance mechanisms inEnterobacteriaceae: Focus on azithromycin

“…Nonetheless, to date no clinical resistance breakpoint has been established for the members of the Enterobacteriaceae family by either CLSI or EUCAST (CLSI, 2013;EUCAST, 2015). However, the isolation of highly azithromycin-resistant Enterobacteriaceae is increasing worldwide and the emergence of azithromycin-resistance has been observed among different members of this family in different geographical areas (Baker et al, 2015;Boumghar-Bourtchai et al, 2008;Bowen et al, 2015;Le Hello et al, 2013;Ochoa et al, 2009;Sj€ olund Karlsson et al, 2013;Vlieghe et al, 2012).…”

Enteroaggregative Escherichia coli in diarrheic children in Egypt: molecular characterization and antimicrobial susceptibility

“…However, antimicrobial therapy is recommended for severely ill patients and for those with risk factors for invasive infection after obtaining appropriate blood and fecal cultures [2]. High frequency of resistance to antimicrobial agents among DEC isolated from children with diarrhea has been reported from several developing countries [3,4]. With the exception of ETEC [5], there little information published on the susceptibility of DEC from Egypt to antibiotics.…”