<abstract xmlns="http://www.w3.org/1999/xhtml"><p><italic>Escherichia coli</italic> infections are becoming increasingly difficult to treat because of emerging antimicrobial resistance, mostly to expanded-spectrum cephalosporins, due to the production of extended-spectrum β-lactamases (ESBLs).Despite extensive studies of ESBL- producing <italic>E.coli</italic> in adult patients, there is a lack of information about the epidemiology and spread of ESBL organisms in pediatric population. The aim of this study was to examine the gastrointestinal tract as an endogenous reservoir for the respiratory tract colonization with ESBL- <italic>E. coli</italic> in children, hospitalized because of the severity of the respiratory illness. The study group consists of 40 children with ESBL-producing <italic>E. coli</italic> strains isolated from the sputum and from the rectal samples. A control group of 15 <italic>E. coli</italic> isolated from rectal swabs of healthy children were included in the analysis. The comparison of the strains was done by using antimicrobial susceptibility patterns of the stains, and pulsed field gel electrophoresis was performed for molecular typing, using XbaI digestion. 90% of the compared pairs of strains in the study group were with identical antimicrobial susceptibility patterns and indistinguishable in 79.2% by the obtained PFGE – profiles.33.3% (5/15) of confirmed <italic>E. coli</italic> strains from the control group were found to be ESBL – producers. Resulting band profiles of all isolates demonstrated presence of 12 pulsotypes, with 100% similarity within the pulsotypes. Although, some isolates obtained from different patients were genetically indistinguishable, these strains were not hospital acquired, as none of the patients satisfied the criteria for hospital acquired pneumonia, and there was a lack of an obvious transmission chain. All ESBL –<italic>E. coli</italic> isolated from sputum in clinical cases were obtained from patients under the age of one. According to the resistance profile of the compared pairs and the PFGE comparison of all isolates, it can be concluded that the gastrointestinal tract is the main reservoir of ESBL-<italic>E. coli</italic>. Small age in infants is a risk factor for translocation of bacteria, enabling the colonization of the respiratory tract.</p></abstract>

Escherichia coli infections are becoming increasingly difficult to treat because of emerging antimicrobial resistance, mostly to expanded-spectrum cephalosporins, due to the production of extended-spectrum β-lactamases (ESBLs).Despite extensive studies of ESBL- producing E.coli in adult patients, there is a lack of information about the epidemiology and spread of ESBL organisms in pediatric population. The aim of this study was to examine the gastrointestinal tract as an endogenous reservoir for the respiratory tract colonization with ESBL- E. coli in children, hospitalized because of the severity of the respiratory illness. The study group consists of 40 children with ESBL-producing E. coli strains isolated from the sputum and from the rectal samples. A control group of 15 E. coli isolated from rectal swabs of healthy children were included in the analysis. The comparison of the strains was done by using antimicrobial susceptibility patterns of the stains, and pulsed field gel electrophoresis was performed for molecular typing, using XbaI digestion. 90% of the compared pairs of strains in the study group were with identical antimicrobial susceptibility patterns and indistinguishable in 79.2% by the obtained PFGE – profiles.33.3% (5/15) of confirmed E. coli strains from the control group were found to be ESBL – producers. Resulting band profiles of all isolates demonstrated presence of 12 pulsotypes, with 100% similarity within the pulsotypes. Although, some isolates obtained from different patients were genetically indistinguishable, these strains were not hospital acquired, as none of the patients satisfied the criteria for hospital acquired pneumonia, and there was a lack of an obvious transmission chain. All ESBL –E. coli isolated from sputum in clinical cases were obtained from patients under the age of one. According to the resistance profile of the compared pairs and the PFGE comparison of all isolates, it can be concluded that the gastrointestinal tract is the main reservoir of ESBL-E. coli. Small age in infants is a risk factor for translocation of bacteria, enabling the colonization of the respiratory tract.

Pulsed-Field Gel Electrophoresis Used for Typing of Extended-Spectrum-β-Lactamases- Producing <italic>Escherichia coli</italic> Isolated from Infant ҆S Respiratory and Digestive System

Department of Clinical Microbiology, Institute for Respiratory Diseases in Children

Department of Molecular Microbiology, Faculty of Veterinary Medicine, Food Institute

University Ss Cyril and Methodius in Skopje

French Agency for Food, Environmental and Occupational Health and Safety

Pediatric Department, Institute for Respiratory Diseases in Children

Department of Microbiology, Faculty of Veterinary Medicine, Food Institute

Nephrology Department, University Children’s Hospital

Macedonian Veterinary Review

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Pulsed-Field Gel Electrophoresis Used for Typing of Extended-Spectrum-β-Lactamases- Producing  Isolated from Infant ҆S Respiratory and Digestive System

Escherichia coli infections are becoming increasingly difficult to treat because of emerging antimicrobial resistance, mostly to expanded-spectrum...

Pulsed-Field Gel Electrophoresis Used for Typing of Extended-Spectrum-β-Lactamases- Producing Escherichia coli Isolated from Infant ҆S Respiratory and Digestive System

Published Online: Oct 29, 2018

Page range: 133 - 141

Received: Sep 14, 2017

Accepted: Jan 22, 2018

DOI: https://doi.org/10.2478/macvetrev-2018-0016

Keywords
ESBL-producing, resistance profile, GUT colonization, PFGE- typing

© 2018 Gorica Popova et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Pulsed-Field Gel Electrophoresis Used for Typing of Extended-Spectrum-β-Lactamases- Producing Escherichia coli Isolated from Infant ҆S Respiratory and Digestive System

Published Online: Oct 29, 2018

Page range: 133 - 141

Received: Sep 14, 2017

Accepted: Jan 22, 2018

DOI: https://doi.org/10.2478/macvetrev-2018-0016

KeywordsESBL-producing, resistance profile, GUT colonization, PFGE- typing

© 2018 Gorica Popova et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
ESBL-producing, resistance profile, GUT colonization, PFGE- typing