Title : Risk factors and Antimicrobial Susceptibility Pattern of Extraintestinal Pathogenic Escherichia Coli Isolates Recovered from community children in Southern Taiwan.
Abstract:
Abstract:
Background: Extraintestinal pathogenic Escherichia coli (ExPEC) can cause many kinds of human extra-intestinal infections, which lead to a huge amount of medical cost around the world. Human intestinal tract has been identified as one of reservoirs for ExPEC and the genetic information of E.coli can be exchanged horizontally. Understanding epidemiologic data about fecal carriages of ExPEC could enable us to increase the possibility to control the spread of ExPEC–associated diseases. Therefore, we aimed to investigate risk factors and antimicrobial susceptibility pattern of fecal carriages of ExPEC among community children in Southern Taiwan. Method: We collected 504 non-duplicated stool samples April 2016 to Feb 2019 at pediatric department of a medical center in Southern Taiwan. All samples and questionnaire were collected within 3 days after admission. The contents of the questionnaire included demographic data, diet habits, travel history, and medical history. ExPEC was defined as E.coli isolates having at least three of the following five genes: S and F1C fimbriae (focG+sfaS), kpsM II, papA, afa and iutA. Antimicrobial susceptibility testing was determined by the VITEK 2 system. Results: 107 ExPEC were isolated from 21.2% of these fecal samples. After multivariate analysis, chicken and duck consumption had significant association with fecal carriages of ExPEC (aOR 1.59, 95% CI 1.01-2.48, p=0.044). Subjects who drank boiled and filtered water had lower risk with fecal carriages of ExPEC (aOR 0.62, 95% CI 0.40-0.96, p= 0.033). ExPEC isolates had significantly higher resistant rates to gentamycin, ciprofloxacin, minocycline and sulfamethoxazole-trimethoprim than non-ExPEC isolates. Extended-spectrum β-lactamases was also more common in ExPEC isolates than non-ExPEC isolates. However, all ExPEC isolates were susceptible to ertapenem, imipenem, amikacin and tigecycline.
Conclusion: Diet and drinking water are associated with the risk of fecal carriages of ExPEC. The results provided evidence that food and drinking water may play a role in transmission route of ExPEC in human.
