title: Multidrug-resistant commensal Escherichia coli in children, Peru and Bolivia.
abstract: Using a rapid screening method, we investigated the prevalence of fecal carriage of antimicrobial drug-resistant Escherichia coli in 3,174 healthy children from 4 urban settings in Peru and Bolivia. High resistance rates were observed for ampicillin (95%), trimethoprim-sulfamethoxazole (94%), tetracycline (93%), streptomycin (82%), and chloramphenicol (70%). Lower resistance rates were observed for nalidixic acid (35%), kanamycin (28%), gentamicin (21%), and ciprofloxacin (18%); resistance to ceftriaxone and amikacin was uncommon (<0.5%). In a random sample of 1,080 resistant E. coli isolates, 90% exhibited a multidrug-resistance (MDR) phenotype. The 2 most common MDR phenotypes (ampicillin/tetracycline/trimethoprim-sulfamethoxazole and ampicillin/tetracycline/trimethoprim-sulfamethoxazole/chloramphenicol) could be transferred en bloc in conjugation experiments. The most common acquired resistance genes were blaTEM, tet(A), tet(B), drfA8, sul1, sul2, and catI. These findings underscore the magnitude of the problem of antimicrobial drug resistance in low-resource settings and the urgent need for surveillance and control of this phenomenon.
authors.affiliation: Clinica Malattie Infettive, Dipartimento Area Critica Medico Chirurgica, Universitá di Firenze, Florence, Italy. bartoloni@unifi.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bartoloni
authors.forename: Lucia
authors.initials: L
authors.lastname: Pallecchi
authors.forename: Marta
authors.initials: M
authors.lastname: Benedetti
authors.forename: Connie
authors.initials: C
authors.lastname: Fernandez
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Vallejos
authors.forename: Elisa
authors.initials: E
authors.lastname: Guzman
authors.forename: Ana Liz
authors.initials: AL
authors.lastname: Villagran
authors.forename: Antonia
authors.initials: A
authors.lastname: Mantella
authors.forename: Chiara
authors.initials: C
authors.lastname: Lucchetti
authors.forename: Filippo
authors.initials: F
authors.lastname: Bartalesi
authors.forename: Marianne
authors.initials: M
authors.lastname: Strohmeyer
authors.forename: Angela
authors.initials: A
authors.lastname: Bechini
authors.forename: Herlan
authors.initials: H
authors.lastname: Gamboa
authors.forename: Hugo
authors.initials: H
authors.lastname: Rodríguez
authors.forename: Torkel
authors.initials: T
authors.lastname: Falkenberg
authors.forename: Göran
authors.initials: G
authors.lastname: Kronvall
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gotuzzo
authors.forename: Franco
authors.initials: F
authors.lastname: Paradisi
authors.forename: Gian Maria
authors.initials: GM
authors.lastname: Rossolini
mesh_terms: D001838:Bolivia; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D010568:Peru; D016133:Polymerase Chain Reaction; D015995:Prevalence; D014505:Urban Population
chemical_list: D004269:DNA, Bacterial