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. 2022 Mar;54(1):59-69.
doi: 10.3947/ic.2021.0102. Epub 2021 Dec 27.

High Prevalence of blaCTX-M in Fecal Commensal Escherichia coli from Healthy Children

Katherine Alcedo  1 , Joaquim Ruiz  2 , Theresa J Ochoa  1   3   4 , Maribel Riveros  1   3   5
Affiliations

High Prevalence of blaCTX-M in Fecal Commensal Escherichia coli from Healthy Children

Katherine Alcedo et al. Infect Chemother. 2022 Mar.

Abstract

Background: Antibiotic-resistant Escherichia coli can colonize the intestinal tract of healthy children, causing concern when antibiotic resistance is related to the presence of transferable mechanisms, such as extended-spectrum β-lactamases (ESBLs).

Materials and methods: Fecal samples from 41 healthy children from two villages of rural Peru were cultured on ceftriaxone-disks. ESBL production was confirmed with double disk synergy. In all ESBL-produced isolates, antibiotic susceptibility to 12 antibacterial agents was established by disk diffusion, while clonal relationships were determined by repetitive extragenic palindromic-polymerase chain reaction (REP-PCR). Presence of ST131 was determined using PCR.

Results: Ceftriaxone-resistant microorganisms were recovered from 39 samples belonging to 22 out of 41 children (53.7%). Of these, 80 ceftriaxone-resistant and two ceftriaxone-intermediate E. coli from inside ceftriaxone-halos were confirmed as ESBL-producers. All isolates were multidrug-resistant. In 79/80 (98.8%) ceftriaxone-resistant isolates, the presence of blaCTX-M was detected alone (58 isolates, or together with other β-lactamase (blaTEM, 17 isolates; blaOXA-1-like, 3 isolates; blaTEM + blaOXA-1-like, 1 isolate), while in one isolate no such ESBL was identified. The two ceftriaxone-intermediate isolates recovered from the same sample, carried a blaTEM and blaSHV respectively. Thirty-four different clones were identified, with 4 clones being recovered from different samples from the same child. Twelve clones were disseminated among different children, including 5 clones disseminated between both villages. Two clones, accounting for 3 isolates and both recovered from the same children, belonged to E. coli ST131.

Conclusion: This study demonstrates high prevalence of ESBL-carriers among healthy children living in a rural area of Peru, stressing the need for continuous surveillance and search for public health control measures.

Keywords: Antibiotic-resistance; Commensal; Escherichia coli; Extended-spectrum β-lactamases; Healthy carriers.

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Conflict of interest statement

No conflict of interest

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