Methods: Healthy children between 14 days and 11 years of age were enrolled during well- child visits in Oakland, Kansas City, and Nashville, between 12/2013 and 3/2015. Recent antibiotic use in the child and travel and hospitalization history of all members of the subject’s household were queried in a brief risk factor survey. Stool specimens collected from subjects were screened for ESBL-P bacteria using CHROMagarTMESBL media. Confirmation of antibiotic-resistance patterns of putative ESBL-P bacterial colonies was performed by double-disc synergy testing on Mueller-Hinton agar following standard guidelines. Bacterial identification was confirmed by MALDI-TOF mass spectrometry.
Results: Stool specimens were collected from 520 enrollees. Overall, 3rd generation cephalosporin-resistant E.coli (3GC-R Ec) carriage was 4.2% and ranged from 3.4% to 5.1% among the study sites. 3GC-R Ec carriage was 5.2% in children <5 years of age vs. 2.2% in those ≥5 years (p=0.14). In Oakland, 50% of 3GC-R Ec carriers had a household (HH) member who travelled internationally in the last year compared to 11% of non-carriers (p=0.05). International travel at the other 2 sites was infrequent at 3.6%; overall, 18.2% of 3GC-R Ec carriers vs. 6.1% of non-carriers had a HH member who travelled internationally (p=0.07). No other assessed risk factor approached significance. ESBL production was confirmed in 83% of 3GC-R Ec (3.5% of all enrollees).
Conclusion: 3GC-R Ec intestinal isolates, including ESBL-P, were found in 4% of healthy US children. Younger age and international travel among household members increased the risk of 3GC-R Ec carriage, whereas healthcare-related exposures did not. These findings support that 3GC-R Ec dissemination may occur at the community and global level.
R. Chohan, None
J. D. Chappell, None
R. Mchenry, None
A. Dighe, None
N. Kanwar, None
N. Halasa, Sanofi Pasteur: Grant Investigator , Grant recipient , Research grant and Research support
Gilead: Grant Investigator , Research support
Pfizer: Grant Investigator , Grant recipient , Research grant and Research support
Baxter: Grant Investigator , Grant recipient , Research grant and Research support
Biocryst: Grant Investigator , Research support
M. E. Wikswo, None
D. Payne, None
P. H. Azimi, None
O. Gomez-Duarte, None