International Travel Factors May Influence Antibiotic-Resistant Enterobacteriaceae in Healthy Children

Overall, third generation cephalosporin-resistant E. coli (3GC-R Ec) carriage was 4.2% and ranged from 3.4% to 5.1% among the study sites.

SAN DIEGO  —  Four percent of healthy, young children carried strains of antibiotic-resistant Escherichia coli in their intestines, and the prevalence of the bacteria increased in households with younger children or someone who traveled internationally, according to an abstract presented today at IDWeek 2015. 

Health care related exposures did not increase the risk of E. coli in the children.

The findings support the theory that cephalosporin-resistant E. coli (3GC-R Ec) dissemination may occur at the community level, and provided insights to the increasing incidence of enterobacteriacease in various pediatric settings, according to Shamim Islam, MD, of , the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo, who presented the abstract today. 

The 15-month study examined the epidemiology of E. coli colonization in healthy U.S. children, “which to date has not been well characterized,” according to the researchers.

The study included healthy children between the ages of 14 days and 11 years during well-visits to doctors’ offices in Oakland, California, Kansas City, Missouri, and Nashville. Recent antibiotic use in the child and travel and hospitalization history of all members of the child’s household were queried in a brief risk factor survey. Stool specimens collected from 520 enrollees were screened for ESBL-P bacteria using CHROMagar TMESBL media. 

“Overall, 3GC-R Ec carriage was 4.2% and ranged from 3.4% to 5.1% among the study sites. 3GC-R Ec carriage was 4.9% in children younger than age 5, compared with 1.9% in those children ages 5 or older,” the researchers noted. They added that international travel likely played a role in colonization, explaining that in Oakland, about half of 3GC-R Ec carriers had a member of their home who had traveled in the last year compared to 11% of non-carriers.

Commenting on the findings to Infectious Disease Advisor, Dr Islam noted, “If we’re attributing [the colonization rate] to travel,” and he noted, the data are still limited, “then curbing broad spectrum antibiotic use in other settings may have an impact.” 


1. Islam S, Selvarangan R, Chappell JD, et al. Abstract 73. Antibiotic-Resistant Enterobacteriaceae Colonization in Healthy U.S. Children. Presented at ID Week, 2015. Oct. 7-12, 2015, San Diego.