Multidrug-resistant commensal Escherichia coli in children, Peru and Bolivia.
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.
Bartoloni
Alessandro
A
Clinica Malattie Infettive, Dipartimento Area Critica Medico Chirurgica, Universitá di Firenze, Florence, Italy. bartoloni@unifi.it
Pallecchi
Lucia
L
Benedetti
Marta
M
Fernandez
Connie
C
Vallejos
Yolanda
Y
Guzman
Elisa
E
Villagran
Ana Liz
AL
Mantella
Antonia
A
Lucchetti
Chiara
C
Bartalesi
Filippo
F
Strohmeyer
Marianne
M
Bechini
Angela
A
Gamboa
Herlan
H
Rodríguez
Hugo
H
Falkenberg
Torkel
T
Kronvall
Göran
G
Gotuzzo
Eduardo
E
Paradisi
Franco
F
Rossolini
Gian Maria
GM
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
D004269:DNA, Bacterial