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J Pediatr Infect Dis 2021; 16(04): 178-182
DOI: 10.1055/s-0041-1730995
Original Article

Investigation of High-Risk ST131 Clone in Extended Spectrum β-Lactamase–Producing Escherichia coli Isolates in Children

Mehmet E. Bulut 
1   Department of Medical Microbiology, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
,
Gülen Hürkal 
1   Department of Medical Microbiology, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
,
Nazan Dalgıç 
2   Division of Pediatric Infectious Diseases, Health Sciences University, Sariyer Etfal Training and Research Hospital, Istanbul, Turkey
› Author Affiliations Funding None.
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Abstract

Objective Antimicrobial resistance poses a serious threat to children's health. In recent years, high-risk Escherichia coli ST131 has become an important target for global surveillance studies. The E.coli ST131 clone is associated with extended spectrum β-lactamase (ESBL) production, as well as multidrug resistance and treatment failure. Studies on this clone in the pediatric age group are limited. We aim to investigate the rate of high-risk E. coli ST131 clone in ESBL-positive E. coli isolates obtained from pediatric patients.

Methods A total of 292 ESBL-positive E. coli isolates from clinical samples of pediatric patients was included in the study. MALDI-TOF MS system was used for bacterial identification. Susceptibility tests were performed using BD Phoenix automated system. ST131 detection was done by MALDI-TOF-MS. Fisher's exact test was used to compare the groups (significance <0.05).

Results A total of 292 isolates was analyzed. The high-risk ST131 clone was detected in 117 (40%) of the 292 ESBL-positive isolates. ST131 rates were found to be significantly higher in children under the age of 5 years compared with children over the age of 5 years (49.3 vs. 31.1%, p = 0.0019). Ciprofloxacin resistance was higher in ST131 isolates (45.6 vs. 31.7%; p < 0.05).

Conclusion The rate of the ST131 clone was found to be high in the pediatric population. The significantly high rate of resistance to ciprofloxacin, which is not commonly used in the pediatric population, in ST131 isolates reveals the importance of the spread of high-risk clones for the development of resistance.

Keywords

pediatric infection - Escherichia coli ST131 - ESBL - high-risk clone

Ethical Approval

This study was approved by the University of Health Sciences, Sisli Hamidiye Etfal, Training and Research Hospital ethics committee, resolution 2945.




Publication History

Received: 09 November 2020

Accepted: 29 March 2021

Article published online:
15 June 2021

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