Fecal Colonization With Multidrug-Resistant E-coli Among Healthy Infants in Rural Bangladesh

• Type of Material: Article
• Authors: Mohammad Aminul Islam, International Centre for Diarrhoeal Disease Research, Bangladesh; Mohammed Badrul Amin, International Centre for Diarrhoeal Disease Research, Bangladesh; Subarna Roy, International Centre for Diarrhoeal Disease Research, Bangladesh; Muhammad Asaduzzaman, International Centre for Diarrhoeal Disease Research, Bangladesh; Md. Rayhanul Islam, International Centre for Diarrhoeal Disease Research, Bangladesh; Tala Navab-Daneshmand, Oregon State University; Mia Catharine Mattioli, Centers for Disease Control and Prevention, Atlanta; Molly L. Kile, Oregon State University; Karen Levy, Emory University; Timothy R. Julian, Swiss Federal Institute of Aquatic Science and Technology
• Language: English
• Date: 2019-04-02
• Publisher: FRONTIERS MEDIA SA
• Publication Version: Final Published Version
• Copyright Statement: © 2019 Islam, Amin, Roy, Asaduzzaman, Islam, Navab-Daneshmand, Mattioli, Kile, Levy and Julian.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3389/fmicb.2019.00640
• Title of Journal or Parent Work: Frontiers in Microbiology
• Volume: 10
• Start Page: 640
• End Page: 640
• Grant/Funding Information: KL was supported by National Institute for Allergy and Infectious Diseases grant number K01AI103544.
• Keywords: PERSISTENCE; Science & Technology; DYNAMICS; YOUNG-CHILDREN; ANTIBIOTIC-RESISTANCE; ESBL; LACTAMASE-PRODUCING ENTEROBACTERIACEAE; Microbiology; Life Sciences & Biomedicine; E. coli; multidrug-resistant; TETRACYCLINE; RISK; colonization; COUNTRIES; EXPOSURE; third generation cephalosporins; DISEASE
• Research Categories: Health Sciences, Pharmacology; Biology, Microbiology; Health Sciences, Public Health

Abstract

Third generation cephalosporins (3GC) are one of the main choices for treatment of infections caused by multidrug-resistant (MDR) Gram-negative bacteria. Due to their overuse, an increasing trend of resistance to 3GC has been observed in developing countries. Here, we describe fecal colonization of 3GC-resistant (3GCr) Escherichia coli in healthy infants (1-12 months old) living in rural areas of Bangladesh. We found that stool samples of 82% of infants (n = 100) were positive for 3GCr E. coli with a mean ± standard deviation of 6.21 ± 1.32 log10 CFU/g wet weight of stool. 3GCr E. coli encompasses an average one third (33%) of the total E. coli of stool. Almost 77% (n = 63) of these 3GCr E. coli were MDR (or resistant to ≥3 classes of antibiotics). Around 90% (n = 74) of 3GCr E. coli were extended spectrum beta-lactamase (ESBL)-producing in which blaCTX-M-group-1 was the predominant (96%, n = 71) ESBL-gene followed by blaTEM (41%, n = 30) and blaOXA-1 (11%, n = 8). A significant proportion (26.5%, n = 22) of 3GCr E. coli was pathogenic, comprising two types, enteroaggregative (EAEC, n = 19) and enteropathogenic (EPEC, n = 3). Colonization of 3GCr E. coli in infant guts was not associated with demographic characteristics such as age, sex, mode of delivery, maternal and infant antibiotic use, disease morbidity, and feeding practices. The high rate of colonization of 3GCr E. coli in infants' guts is a serious public health concern which needs immediate attention and warrants further studies to explore the cause.