[Antibiotic-resistant fecal Escherichia coli in healthy children. Induced by the use of antibiotics?].

OBJECTIVE

To determine the rate of antibiotic resistance of fecal E. coli from healthy children and to infer if it is acquired environmentally or induced by antibiotic use.

MATERIAL AND METHODS

Cross sectional study in children from schools and day care centers in Leon, Mexico. Prior antibiotic use (60 days) was questioned to the parents. A single fecal sample was cultured and an isolated colony suggestive of E. coli was submitted to biochemical identification and testing of disk susceptibility to 12 antibiotics.

RESULTS

Four hundred fifty-six isolates were studied from children of 10 institutions, with ages ranging from 3 to 72 months (mean, 42.41). Use of antibiotics was referred in 242 children (53.07%). The antibiotics more commonly used were trimethoprim/sulfa, ampicillin, and penicillin (34, 20.5, and 18%). The highest rate of resistance was found for tetracycline, ampicillin, and trimethoprim/sulfa (64.4, 52.63, and 46.05%). The resistance to ciprofloxacin, amikacin, gentamicin, and ceftriaxone was less than 5%. Resistance to five or more antimicrobials was found in 93 isolates (20.39%); this rate was higher in isolates from children who received antibiotics (59/242, 24.38% vs. 34/214, 15.89%) (p = .025; OR 1.71, IC 95% 1.04-2.81).

CONCLUSIONS

The study suggests that saprophyte bacteria acquires resistance through both, use of antibiotics and from the environment. These results support the concept that antimicrobial resistance must be considered as a public health problem.