Abstract
OBJECTIVES: Antimicrobial resistant extended-spectrum-β-lactamase-producing Enterobacteriaceae (ESBL-PE) have been shown to be present in healthy communities. This study examined healthy children from the rural Andean village of Llano del Hato, Mérida, Venezuela, who have had little or no antibiotic exposure to determine the prevalence of fecal carriage of ESBL-producing Escherichia coli (ESBL-EC). METHODS: A total of 78 fecal samples were collected in healthy children aged from 1 to 5 years. ESBL-EC were selected in MacConkey agar plates with cefotaxime and further confirmed by the VITEK 2 system. ESBL were phenotypically detected and presence of bla genes and their variants were confirmed by molecular assays. Determination of phylogenetic groups was performed by PCR amplification. Risk factors associated with fecal carriage of ESBL-EC-positive isolates were analyzed using standard statistical methods. RESULTS: Of the 78 children studied, 27 (34.6%) carried ESBL-EC. All strains harbored the bla(CTX-M-15) allele. Of these, 8 were co-producers of bla(TEM-1), bla(TEM-5), bla(SHV-5) or bla(SHV-12). Co-resistance to aminoglycosides and/or fluoroquinolones was observed in 9 strains. 51.9% of ESBL-EC isolates were classified within phylogroup A. A significant, positive correlation was found between age (≥2.5 - ≤5 years), food consumption patterns and ESBL-EC fecal carriage. CONCLUSION: This is the first study describing the high prevalence of fecal carriage of ESBL-EC expressing CTX-M-15- among very young, healthy children from a rural Andean village in Venezuela with scarce antibiotic exposure, underlining the importance of this population as a reservoir.