SAN DIEGO – Third-generation cephalosporin-resistant Escherichia coli infection carriage was present in 4.2% of healthy children who underwent stool testing, especially in young children and in those with a household member who traveled internationally within the last year.
Those are key findings from a multicenter study which set out to examine the epidemiology of antibiotic-resistant E. coli colonization in healthy children.
“Overall, the results suggest that there is circulation and spread of third-generation cephalosporin-resistant Escherichia coli infection at the community and global level,” Dr. Shamim M. Islam said at an annual scientific meeting on infectious diseases.
Dr. Islam of the department of pediatrics at the State University of New York at Buffalo characterized the management of extended-spectrum beta-lactamase infections as “particularly complicated in children given limited antibiotic options. ESBL [Extended spectrum beta-lactamase]–producing Enterobacteriaceae infections are steadily rising, including in the community setting.”
As part of the Centers for Disease Control and Prevention’s New Vaccine Surveillance Network acute gastroenteritis project, the researchers enrolled 520 healthy children ranging in age from 14 days to 11 years during well-child visits in Oakland, Calif.; Kansas City, Mo.; and Nashville, Tenn., between December of 2013 and March of 2015. Dr. Islam and his associates administered a four-question survey to parents of the children, including questions about recent antibiotic use in the child and travel and hospitalization history of all members of their household. They collected stool samples from the children and used chromogenic commercial media technology to screen for ESBL-producing bacteria, and also performed confirmatory testing.
Dr. Islam reported that third-generation cephalosporin-resistant E. coli was present in 4.2% of overall stools, with a range from 3.4% to 5.1% among the three study sites. It was found to be more prevalent in children younger than age 5, compared with those aged 5 and older (4.9% vs. 1.7%, respectively; P = .21).
At the Oakland site, 50% of children carrying third-generation cephalosporin-resistant E. coli isolates had a household member who traveled internationally in the past year, compared with 11% of noncarriers (P = .05), while international travel at the other two sites was low. Combined results from those two sites indicated that 18.2% of children carrying third-generation cephalosporin-resistant E. coli isolates had a household member who traveled internationally in the past year, compared with 6.1% of noncarriers (P = .07).
Going forward, the researchers are planning to conduct further genetic and molecular characterization of the isolates they found with mutliplex pCR and whole-genome sequencing. “We’re going to continue surveillance of bacterial carriage at our current three sites for another year to try and expand our risk factor analysis to include more dietary risk factors and more antibiotic exposure,” Dr. Islam said.
IDWeek marks the combined annual meetings of the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the HIV Medicine Association, and the Pediatric Infectious Diseases Society. The researchers reported having no financial disclosures.