title: Gut Colonization of Healthy Children and Their Mothers With Pathogenic Ciprofloxacin-Resistant Escherichia coli.
abstract: BACKGROUND
  The reservoir of pathogenic ciprofloxacin-resistant Escherichia coli remains unknown.
  
  
  METHODS
  We conducted a prospective cohort study of 80 healthy twins and their mothers to determine the frequency of excretion of ciprofloxacin-resistant, potentially pathogenic E. coli. Stool specimens were cultured selectively for ciprofloxacin-resistant gram-negative bacteria. Isolates were categorized on the basis of additional resistance and virulence profiles. We also prospectively collected clinical metadata.
  
  
  RESULTS
  Fifteen children (19%) and 8 mothers (20%) excreted ciprofloxacin-resistant E. coli at least once. Overall, 33% of 40 families had at least 1 member whose stool specimen yielded ciprofloxacin-resistant E. coli on culture. Fifty-seven submitted stool specimens (2.8%) contained such organisms; clones ST131-H30 and ST405 accounted for 52 and 5 of the positive specimens, respectively. Length of hospital stay after birth (P = .002) and maternal colonization (P = .0001) were associated with subsequent childhood carriage of ciprofloxacin-resistant E. coli; antibiotic use, acid suppression, sex, mode of delivery, and maternal perinatal antibiotic use were not. Ciprofloxacin-resistant E. coli were usually resistant to additional antibiotic classes, and all had virulence genotypes typical of extraintestinal pathogenic E. coli.
  
  
  CONCLUSIONS
  Healthy children and their mothers commonly harbor ciprofloxacin-resistant E. coli with pathogenic potential.
authors.affiliation: Department of Pediatrics.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Gurnee
authors.affiliation: Department of Pediatrics.
authors.forename: I Malick
authors.initials: IM
authors.lastname: Ndao
authors.affiliation: Minneapolis Veterans Affairs Medical Center Department of Medicine, University of Minnesota, Minneapolis.
authors.forename: James R
authors.initials: JR
authors.lastname: Johnson
authors.affiliation: Minneapolis Veterans Affairs Medical Center Department of Medicine, University of Minnesota, Minneapolis.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Johnston
authors.affiliation: Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Gonzalez
authors.affiliation: Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Carey-Ann D
authors.initials: CA
authors.lastname: Burnham
authors.affiliation: Department of Pediatrics.
authors.forename: Carla M
authors.initials: CM
authors.lastname: Hall-Moore
authors.affiliation: Department of Pediatrics.
authors.forename: Jessica E
authors.initials: JE
authors.lastname: McGhee
authors.affiliation: Institute of Hygiene, University Hospital Muenster, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Mellmann
authors.affiliation: Department of Pediatrics.
authors.forename: Barbara B
authors.initials: BB
authors.lastname: Warner
authors.affiliation: Department of Pediatrics Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Phillip I
authors.initials: PI
authors.lastname: Tarr
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology*; D005838:Genotype; D064368:Healthy Volunteers; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D058889:Molecular Typing; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin
keywords: E. coli ST131-H30; E. coli ST405; ciprofloxacin-resistant E. coli; extra-intestinal pathogenic E. coli; urinary tract infections