title: Antibiotic Susceptibilities and Genetic Characteristics of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Isolates from Stools of Pediatric Diarrhea Patients in Surabaya, Indonesia.
abstract: The purpose of this study was to investigate extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli isolates from pediatric (aged 0 to 3 years) diarrhea patients in Surabaya, Indonesia, where this kind of survey is rare; our study included assessment of their antibiotic susceptibilities, as well as ESBL typing, multilocus sequence typing (MLST), and diarrheagenic E. coli (DEC)-typing. ESBL-producing E. coli were detected in 18.8% of all the samples. Many ESBL-producing E. coli had significantly lower susceptibility to gentamicin (p ＜ 0.0001) and the quinolones nalidixic acid (p＝0.004) and ciprofloxacin (p ＜ 0.0001) than non-producers. In ESBL-producing E. coli, 84.0% of strains expressed CTX-M-15 alone or in combination with other ESBL types. MLST revealed that 24.0% of ESBL-producers had sequence type 617, all of which expressed the CTX-M-15 gene; we also detected expression of 3 DEC-related genes: 2 enteroaggregative E. coli genes and 1 enteropathogenic E. coli gene. In conclusion, CTX-M-15-type ESBL-producing E. coli ST617 appear to have spread to Indonesia.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital.|Institute of Tropical Disease, Airlangga University.
authors.forename: Eddy
authors.initials: E
authors.lastname: Bagus Wasito
authors.affiliation: Department of Urology, Kobe University Graduate School of Medicine.|Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University.|Division of Infectious Diseases, Department of International Health, Kobe University Graduate School of Health Science.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Shigemura
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University.|Division of Infectious Diseases, Department of International Health, Kobe University Graduate School of Health Science.
authors.forename: Kayo
authors.initials: K
authors.lastname: Osawa
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Airlangga University.
authors.forename: Alpha
authors.initials: A
authors.lastname: Fardah
authors.affiliation: Division of Infectious Diseases, Department of International Health, Kobe University Graduate School of Health Science.
authors.forename: Akiho
authors.initials: A
authors.lastname: Kanaida
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University.|Institute of Tropical Disease, Airlangga University.
authors.forename: Dadik
authors.initials: D
authors.lastname: Raharjo
authors.affiliation: Department of Microbiology, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital.|Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University.
authors.forename: K
authors.initials: K
authors.lastname: Kuntaman
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital.
authors.forename: Usman
authors.initials: U
authors.lastname: Hadi
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University.|Institute of Tropical Disease, Airlangga University.
authors.forename: Sugeng
authors.initials: S
authors.lastname: Harijono
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Airlangga University.
authors.forename: Subijanto
authors.initials: S
authors.lastname: Marto Sudarmo
authors.affiliation: Department of Clinical Laboratory, Kobe University Hospital.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Bacteriology II, National Institute of Infectious Diseases.
authors.forename: Keigo
authors.initials: K
authors.lastname: Shibayama
authors.affiliation: Department of Urology, Kobe University Graduate School of Medicine.
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University.|Center for Infectious Diseases, Kobe University Graduate School of Medicine.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Shirakawa
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D004403:Dysentery / Q000453:epidemiology / Q000382:microbiology*; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects* / Q000201:enzymology* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D005243:Feces / Q000382:microbiology*; D005260:Female; D005838:Genotype; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases
keywords: CTX-M-15; ST617; diarrheagenic Escherichia coli; extended-spectrum beta-lactamase (ESBL)