title: The extended spectrum β-lactamases (ESBL) and virulence genes of intestinal enteroaggregative Escherichia coli (EAEC) in healthy elderly individuals.
abstract: OBJECTIVE
  to analyze the detection rate of intestinal enteroaggregative Escherichia coli (EAEC) in healthy elderly (≥60 years) individuals in the Hangzhou area of China, and to investigate the extended spectrum β-lactamases and virulence genes of EAEC.
  
  
  METHODS
  Stool specimens provided by healthy elderly individuals were cultured on blood agar, SS, and MAC plates. The bacterial strains were identified using Vitek-2 Compact automatic microorganism identification system and mass spectrometry. The resistance phenotypes of the bacteria were determined using the double-disk synergy method. The resistance genes and the EAEC virulence gene, astA and aggR, were amplified by PCR and compared to the sequences available in Gen Bank.
  
  
  RESULTS
  Among the 1050 healthy volunteers, the majority of bacteria were E. coli, accounting for 960 strains, with an ESBL-positive rate of 36.3% (348/960). The EAEC detection rate was 10% (96/960); among them, 84 strains were astA, the detection rate of which was 8.75%; 12 strains were aggR, the detection rate of which was 1.25%. The ESBL-positive rate of EAEC strains were 56.25% (54/96), all of which carried the CTX-M type, with the CTX-M-14 predominating at 66.7% (36/54).
  
  
  CONCLUSIONS
  The ESBL-positive rate of intestinal E. coli in healthy elderly individuals in the Hangzhou area of China was higher than the rate detected in other regions of china; and there was a high rate of antibiotic resistance among the intestinal EAEC in healthy elderly individuals. The results of this study suggest that EAEC is not only a pathogenic bacteria detected in diarrhea patients, but can also be present in healthy individuals, and high-resistance clinical strains have spread to the healthy population in the Hangzhou area. So vigilance is critical.
authors.affiliation: The First Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou 310006, Zhejiang, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Laboratory Medicine, Yancheng People's First Hospital Yancheng 224006, Jiangsu, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wu
authors.affiliation: The First Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou 310006, Zhejiang, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Cao
keywords: Enterobacteriaceae; Healthy elderly; enteroaggregative Escherichia coli; extended spectrum β-lactamases