Fecal Carriage of Multi-drug Resistant Escherichia coli in Healthy Children: a Community-based Study

Abstract

Introduction: Escherichia coli is enteric Gram-negative bacilli, earlier recognized as non-invasive commensal. Invasive strains of E. coli have been identified and are associated with a variety of human infections. Increasing drug resistance among E. coli has been reported. Multidrug resistance is the ability of an organism to resist at least one agent in three or more antimicrobial categories. The aim of this study was to detect fecal carriage of MDR E. coli isolates among healthy school children. Methods: A total of 139 stool samples were collected from Rastriya Secondary School, Purano Tudikhel, Pokhara-1. Isolation, identification, and Antibiotic susceptibility test pattern of E. coli isolates were done by standard microbiological techniques. Further Extended Spectrum Beta-Lactamase test was performed by Combined Disc Test and data analysis was done by using Microsoft Excel. Results: A total of 106 E. coli were isolated from the stool samples. MDR E. coli were found to be 8 (7.55%) and 7 E. coli isolates were resistant to Ceftazidime which was further tested for ESBL and 5 isolates were found to be ESBL producers. The resistance of E. coli to Ampicillin, Nitrofurantoin, Ceftriaxone, Ceftazidime, Ciprofloxacin, and Gentamicin was 27.36%, 43%, 10.38%, 6.60%, 6.60%, and 2.83% respectively. Only one isolate was resistant to all antibiotics used except Imipenem. Conclusion: E. coli is the main Gram-negative bacteria isolated from the stool sample and identified as the main carrier of antimicrobial resistance in species comparison of Enterobacteriaceae isolated from fecal samples. Therefore, quick surveillance is needed in order to effectively handle such MDR strains. The E. coli population susceptible to all antibiotics used was a much more diverse group than the resistant and ESBL-producing E. coli.