Household contacts were key factor for children's colonization with resistant Escherichia coli in community setting

• Published in: Journal of clinical epidemiology 2007-11, Vol.60 (11), p.1149-1155
• Main Authors: Lietzau, Susanne, Raum, Elke, von Baum, Heike, Marre, Reinhard, Brenner, Hermann
• Format: Article
• Language: English
• Subjects: Age Distribution; Ampicillin Resistance; Anti-Bacterial Agents - therapeutic use; Anti-Infective Agents - therapeutic use; Antibiotic resistance; Antibiotics; Bacterial; Biological and medical sciences; Child, Preschool; Children; Children & youth; Colonization; Community-Acquired Infections - drug therapy; Community-Acquired Infections - epidemiology; Community-Acquired Infections - transmission; Doxycycline - therapeutic use; Drug Resistance, Bacterial; Drug Resistance, Multiple, Bacterial; E coli; Epidemiology; Escherichia coli; Escherichia coli Infections - drug therapy; Escherichia coli Infections - epidemiology; Escherichia coli Infections - transmission; Feces - microbiology; Female; General aspects; Germany - epidemiology; Household; Humans; Infant; Internal Medicine; Male; Medical sciences; Microbiology; Parents; Patient Acceptance of Health Care; Population studies; Prevalence; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Siblings; Socioeconomic Factors; Studies; Transmission; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/j.jclinepi.2007.01.016

Abstract Objective In young children infections with resistant Escherichia coli ( E. coli ) can lead to life-threatening situations. Epidemiological data on the prevalence and major determinants of carriage of antibiotic resistant E. coli among children in the community setting are sparse. Study Design and Setting In a population-based study from Germany, stool samples were obtained from children aged 6 months to 4 years attending a pediatrician for a regular health screening ( N = 568) or an acute infection ( N = 316), as well as from their parents ( N = 1,594) and siblings ( N = 624). E. coli was cultured, and minimal inhibitory concentrations to various antibiotics were tested. We determined prevalences of E. coli resistance to commonly prescribed antibiotics and their association with potential risk factors. Results Prevalence of E. coli resistance was 16.6%, 8.7%, and 11.6% for ampicillin, cotrimoxazole, and doxycycline, respectively. Strong associations were found with antibiotic resistance among siblings (odds ratios [95% confidence intervals] for ampicillin, doxycycline, and cotrimoxazole resistance: 4.4 [1.8–10.8], 8.0 [3.0–21.2], and 10.8 [3.5–32.7], respectively). Conclusion Resistance prevalences in this community-based study were much lower than those reported from the clinical sector. Household contacts seem to be the key factor for children`s colonization with resistant E. coli in the community setting.