“Enhanced acquisition of antibiotic-resistant intestinal E. coli during the first year of life assessed in a prospective cohort study”

Antimicrobial Resistance & Infection Control

Thomas Müller¹  Benjamin Hetzer¹  Ludwig Knabl²  Peter Kreidl²  Daniel Rudolf Geisler-Moroder²  Dorothea Orth-Höller²  Özcan Sesli²  Jeanett Holzknecht²  Reinhard Würzner²  Michaela Lackner²  Somporn Chotinaruemol³  Orawan Boonpala³  Peninnah Oberdorfer³  Damia Noce⁴  Martina Prelog⁵  Alexander Mellmann⁶  Noppadon Akarathum⁷ 

[1] 0000 0000 8853 2677, grid.5361.1, Department of Pediatrics I, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria;0000 0000 8853 2677, grid.5361.1, Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Schöpfstraße 41/III, 6020, Innsbruck, Austria;0000 0000 9039 7662, grid.7132.7, Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand;0000 0001 1089 6435, grid.418908.c, Center for Biomedicine, European Academy of Bolzano/Bozen (EURAC), Affiliated to the University of Lübeck, Via Galvani 31, 39100, Bolzano, Italy;0000 0001 1378 7891, grid.411760.5, Department of Pediatrics, University Hospital Würzburg, Josef-Schneider-Strasse 2, 97080, Würzburg, Germany;0000 0004 0551 4246, grid.16149.3b, Institute of Hygiene, University Hospital Münster, Robert-Koch-Strasse 41, 48149, Münster, Germany;0000 0004 0576 2573, grid.415836.d, Sanpathong Hospital, Ministry of Public Health, Chiang Mai, Thailand;

关键词: Escherichia coli;    Antibiotic resistance;    Multiresistance;    Transmission;    Persistence;    Children;    Neonates;   

DOI  :  10.1186/s13756-019-0522-6

来源: publisher

【 摘 要 】

BackgroundIncreasing bacterial resistance to antibiotics is a serious problem worldwide. We sought to record the acquisition of antibiotic-resistant Escherichia coli (E. coli) in healthy infants in Northern Thailand and investigated potential determinants.MethodsStool samples from 142 infants after birth, at ages 2wk, 2mo, 4 to 6mo, and 1y, and parent stool samples were screened for E. coli resistance to tetracycline, ampicillin, co-trimoxazole, and cefazoline by culture, and isolates were further investigated for multiresistance by disc diffusion method. Pulsed-field gel electrophoresis was performed to identify persistent and transmitted strains. Genetic comparison of resistant and transmitted strains was done by multilocus sequence typing (MLST) and strains were further investigated for extra- and intra-intestinal virulence factors by multiplex PCR.ResultsForty-seven (33%) neonatal meconium samples contained resistant E. coli. Prevalence increased continuously: After 1y, resistance proportion (tetracycline 80%, ampicillin 72%, co-trimoxazole 66%, cefazoline 35%) almost matched those in parents. In 8 infants (6%), identical E. coli strains were found in at least 3 sampling time points (suggesting persistence). Transmission of resistant E. coli from parents to child was observed in only 8 families. MLST showed high diversity. We could not identify any virulence genes or factors associated with persistence, or transmission of resistant E. coli. Full-term, vaginal birth and birth in rural hospital were identified as risk factors for early childhood colonization with resistant E. coli.ConclusionOne third of healthy Thai neonates harboured antibiotic-resistant E. coli in meconium. The proportion of resistant E. coli increased during the first year of life almost reaching the value in adults. We hypothesize that enhancement of infection control measures and cautious use of antibiotics may help to control further increase of resistance.

【 授权许可】

CC BY