title: Antibiotic resistance among Escherichia coli isolates from stool samples of children aged 3 to 14 years from Ujjain, India.
abstract: BACKGROUND
  Antibiotic resistance is a major global public health concern, particularly in settings where few treatment options are available. Limited research has been done on antibiotic resistance in Escherichia coli of Indian children at community level. Therefore we studied antibiotic resistance patterns in E. coli isolates from stool samples of children aged 3-14 years from Ujjain, Central India, to investigate associations of resistance with demographic variables.
  
  
  METHODS
  Children, 3-14 years of age, were included from 30 randomly selected villages of Palwa demographic surveillance site, Ujjain, India. Parents were interviewed using a questionnaire, and stool samples were collected from participating children. E. coli were isolated from stool samples (n = 529), and susceptibility testing to 18 different antibiotics was done using standard methods.
  
  
  RESULTS
  The proportions of isolates resistant to various antibiotics were, nalidixic acid, (45%), tetracycline (37%), ampicillin (37%), sulfamethoxazole/trimethoprim (29%) and amoxicillin/clavulanic acid (29%). No isolates were resistant to imipenem. Overall, 72% of isolates were resistant to at least one antibiotic and 33% were multi-drug resistant. High rates of cross-resistance were seen for 15 (83%) of the antibiotics studied. E. coli isolates from children with literate mothers were more resistant to penicillins and fluoroquinolones. ESBL-producers comprised 9% of the isolates.
  
  
  CONCLUSIONS
  Antibiotic resistance and cross-resistance were common in E. coli from stools of children. Resistance rates were associated with maternal literacy.
authors.affiliation: Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. vishaldiwan@hotmail.com.
authors.forename: Pragya
authors.initials: P
authors.lastname: Shakya
authors.forename: Peter
authors.initials: P
authors.lastname: Barrett
authors.forename: Vishal
authors.initials: V
authors.lastname: Diwan
authors.forename: Yogyata
authors.initials: Y
authors.lastname: Marothi
authors.forename: Harshada
authors.initials: H
authors.lastname: Shah
authors.forename: Neeraj
authors.initials: N
authors.lastname: Chhari
authors.forename: Ashok J
authors.initials: AJ
authors.lastname: Tamhankar
authors.forename: Ashish
authors.initials: A
authors.lastname: Pathak
authors.forename: Cecilia Stålsby
authors.initials: CS
authors.lastname: Lundborg
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008826:Microbial Sensitivity Tests
chemical_list: D000900:Anti-Bacterial Agents