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