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Front. Microbiol. | doi: 10.3389/fmicb.2019.00640

Fecal colonization with multidrug-resistant E. coli among healthy infants in rural Bangladesh

 Mohammad A. Islam1*, Mohammed B. Amin1, Subarna Roy1,  Muhammad Asaduzzaman1, Md R. Islam1, Tala Navab-Daneshmand2, Mia C. Mattioli3, 4, Molly L. Kile5,  Karen Levy4 and  Timothy R. Julian6, 7, 8
  • 1International Centre for Diarrhoeal Disease Research (ICDDR), Bangladesh
  • 2School of Chemical, Biological, and Environmental Engineering, College of Engineering, Oregon State University, United States
  • 3Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention (CDC), United States
  • 4Department of Environmental Health, Rollins School of Public Health, Emory University, United States
  • 5School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, United States
  • 6Swiss Federal Institute of Aquatic Science and Technology, Switzerland
  • 7Swiss Tropical and Public Health Institute (Swiss TPH), Switzerland
  • 8Universität Basel, Switzerland

Third generation cephalosporins (3GC) are one of the main choices for treatment of infections caused by multidrug-resistant Gram-negative bacteria. Due to their overuse, an increasing trend of resistance to 3GC has been observed in developing countries. Here, we describe fecal colonization of 3GC-resistant (3GCr) E. coli in healthy infants (1-12 months old) living in rural areas of Bangladesh. We found that stool samples of 82% of infants (n=100) were positive for 3GCr E. coli with a mean ± standard deviation of 6.21 ± 1.32 log10 CFU/g wet weight of stool. 3GCr E. coli encompasses an average one third (33%) of the total E. coli of stool. Almost 77% (n=63) of these 3GCr E. coli were multidrug-resistant (or resistant to ≥3 classes of antibiotics). Around 90% (n=74) of 3GCr E. coli were extended spectrum beta-lactamase (ESBL)-producing in which blaCTX-M-group-1 was the predominant (96%, n=71) ESBL-gene followed by blaTEM (41%, n=30) and blaOXA-1 (11%, n=8). A significant proportion (26.5%, n=22) of 3GCr E. coli was pathogenic, comprising two types, enteroaggregative (EAEC, n=19) and enteropathogenic (EPEC, n=3). Colonization of 3GCr E. coli in infant guts was not associated with demographic characteristics such as age, sex, mode of delivery, maternal and infant antibiotic use, disease morbidity, and feeding practices. The high rate of colonization of 3GCr E. coli in infants’ guts is a serious public health concern which needs immediate attention and warrants further studies to explore the cause.

Keywords: colonization, Multidrug-resistant, E. coli, ESBL, Third-generation cephalosporins

Received: 14 Aug 2018; Accepted: 13 Mar 2019.

Edited by:

Patrícia Poeta, University of Trás-os-Montes and Alto Douro, Portugal

Reviewed by:

Jian-Hua Liu, South China Agricultural University, China
Peter Bergholz, North Dakota State University, United States
Xiaoqiang Liu, Northwest A&F University  

Copyright: © 2019 Islam, Amin, Roy, Asaduzzaman, Islam, Navab-Daneshmand, Mattioli, Kile, Levy and Julian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Mohammad A. Islam, International Centre for Diarrhoeal Disease Research (ICDDR), Dhaka, Bangladesh,