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Comparative analysis of antimicrobial resistance in enterotoxigenic Escherichia coli isolates from two paediatric cohort studies in Lima, Peru

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dc.contributor.author Medina, Anicia M.
dc.contributor.author Rivera, Fulton P.
dc.contributor.author Pons, Maria J.
dc.contributor.author Riveros Ramirez, Maribel Denise
dc.contributor.author Gomes, Claudia
dc.contributor.author Bernal, Maria
dc.contributor.author Meza, Rina
dc.contributor.author Maves, Ryan C.
dc.contributor.author Huicho Oriundo, Luis
dc.contributor.author Chea-Woo, Elsa
dc.contributor.author Lanata, Claudio F.
dc.contributor.author Gil, Ana I.
dc.contributor.author Ochoa Woodell, Theresa Jean
dc.contributor.author Ruiz, Joaquim
dc.date.accessioned 2019-02-06T14:57:42Z
dc.date.available 2019-02-06T14:57:42Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5498
dc.description.abstract BACKGROUND: Antibiotic resistance is increasing worldwide, being of special concern in low- and middle-income countries. The aim of this study was to determine the antimicrobial susceptibility and mechanisms of resistance in 205 enterotoxigenic Escherichia coli (ETEC) isolates from two cohort studies in children <24 months in Lima, Peru. METHODS: ETEC were identified by an in-house multiplex real-time PCR. Susceptibility to 13 antimicrobial agents was tested by disk diffusion; mechanisms of resistance were evaluated by PCR. RESULTS: ETEC isolates were resistant to ampicillin (64%), cotrimoxazole (52%), tetracycline (37%); 39% of the isolates were multidrug-resistant. Heat-stable toxin producing (ETEC-st) (48%) and heat-labile toxin producing ETEC (ETEC-lt) (40%) had higher rates of multidrug resistance than isolates producing both toxins (ETEC-lt-st) (21%), p<0.05. Only 10% of isolates were resistant to nalidixic acid and none to ciprofloxacin or cefotaxime. Ampicillin and sulfamethoxazole resistance were most often associated with blaTEM (69%) and sul2 genes (68%), respectively. Tetracycline resistance was associated with tet(A) (49%) and tet(B) (39%) genes. Azithromycin inhibitory diameters were </=15 mm in 36% of isolates, with 5% of those presenting the mph(A) gene. CONCLUSIONS: ETEC from Peruvian children are often resistant to older, inexpensive antibiotics, while remaining susceptible to ciprofloxacin, cephalosporins and furazolidone. Fluoroquinolones and azithromycin remain the drugs of choice for ETEC infections in Peru. However, further development of resistance should be closely monitored. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartofseries Transactions of the Royal Society of Tropical Medicine and Hygiene
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Child, Preschool en_US
dc.subject Infant en_US
dc.subject Cohort Studies en_US
dc.subject Peru/epidemiology en_US
dc.subject Children en_US
dc.subject Antibiotic resistance en_US
dc.subject Double-Blind Method en_US
dc.subject Microbial Sensitivity Tests en_US
dc.subject Real-Time Polymerase Chain Reaction en_US
dc.subject Anti-Bacterial Agents/therapeutic use en_US
dc.subject Azithromycin/therapeutic use en_US
dc.subject Diarrhea/drug therapy/epidemiology/microbiology en_US
dc.subject Diarrhoea en_US
dc.subject Enterotoxigenic Escherichia coli en_US
dc.subject Enterotoxigenic Escherichia coli/drug effects/isolation & purification en_US
dc.subject Escherichia coli Infections/complications/drug therapy/microbiology en_US
dc.subject Fluoroquinolones/therapeutic use en_US
dc.title Comparative analysis of antimicrobial resistance in enterotoxigenic Escherichia coli isolates from two paediatric cohort studies in Lima, Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1093/trstmh/trv054
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn 1878-3503

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