High incidence of multidrug resistant Escherichia coli producing CTX-M-type ESBLs colonizing the intestine of Jordanian infants


  • May A. Abuh Salah The Jordan University, Amman
  • Eman F. Badran Department of Pathology-Microbiology, Faculty of Medicine, The University of Jordan, Amman, Jordan.
  • Asem A. Shehabi Department of Pedatrics , Faculty of Medicine, The University of Jordan, Amman, Jordan


ESBL, E.coli, Class I integrons, Jordanian Infants


Background. This prospective study investigated major characteristics of E.coli colonizing the intestine of out-patient and in-patient infants, especially their association with CTX-M-type  extended spectrum  β-Lactamases (ESBLs), integrons and  fluoroquinolone resistance genes (gyrAandparC) .

Method. A total of 288 stool samples were collected from infants aged less than 1 year which were admitted at the pediatric department, Jordan University Hospital, Amman. The E.coli isolates were investigated using antimicrobial susceptibility tests and PCR for detection of CTX-M genes and integrons .  

Results. A total of 170 (59%) infants were colonized with E.coli, including 73 (42.9%) females and 97 (57.1%) males.  A significant difference was observed between gender and age groups according to the presence or absence of E.coli (P= 0.001). Multidrug resistant (MDR) accounted for 52 (30.6%) of the isolates and all were ESBL producers. The detection rate of CTX-M genes among  MDR E.coli isolates was 49 (94.2%), CTX-M group 1 accounted for  41 (87.8%) of the  isolates and 30(73.2%) were CTX-M-15 producers.  Only Class I integron was detected in 20/52 (38.5%) of  MDR  E. coli isolates, and resistance to fluoroquinolones accounted for 45/52(86.5%) of these isolates . A total of 33/52 (63.5%) of MDR E.coli isolates were resistant to  potential Quinolone resistance genes (parC) and (gyrA) in association with CTX-M group.

Conclusion. This study demonstrates that formula-fed infants, vaginal delivery and old age of infants were higher and significant associated with colonization of E .coli. High incidence of CTX-M  ESBL-producing E. coli was found in association with  fluoroquinolones-resistance and Class I integrons colonizing the intestine of Jordanian infants

Author Biographies

Eman F. Badran, Department of Pathology-Microbiology, Faculty of Medicine, The University of Jordan, Amman, Jordan.

Department of Pathology-Microbiology, Faculty of  Medicine, The University of Jordan, Amman, Jordan.

Asem A. Shehabi, Department of Pedatrics , Faculty of Medicine, The University of Jordan, Amman, Jordan

Department of Pedatrics , Faculty of  Medicine, The University of Jordan, Amman, Jordan


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