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dc.contributor.authorMedina, Anicia M.*
dc.contributor.authorRivera, Fulton P.*
dc.contributor.authorPons, Maria J*
dc.contributor.authorRiveros, Maribel*
dc.contributor.authorGomes, Cláudia*
dc.contributor.authorBernal, María*
dc.contributor.authorMeza, Rina*
dc.contributor.authorMaves, Ryan C.*
dc.contributor.authorHuicho, Luis*
dc.contributor.authorChea Woo, Elsa*
dc.contributor.authorLanata, Claudio F.*
dc.contributor.authorGil, Ana I.*
dc.contributor.authorOchoa, Theresa J.*
dc.contributor.authorRuiz, Joaquim*
dc.date.accessioned2016-05-12T15:10:45Zes_PE
dc.date.available2016-05-12T15:10:45Zes_PE
dc.date.issued2015-08es_PE
dc.identifier.citationComparative analysis of antimicrobial resistance in enterotoxigenic Escherichia coli isolates from two paediatric cohort studies in Lima, Peru 2015, 109 (8):493 Transactions of The Royal Society of Tropical Medicine and Hygienees_PE
dc.identifier.issn0035-9203es_PE
dc.identifier.issn1878-3503es_PE
dc.identifier.doi10.1093/trstmh/trv054es_PE
dc.identifier.urihttp://hdl.handle.net/10757/609204es_PE
dc.descriptionEl texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.es_PE
dc.description.abstractBackground 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.
dc.formatapplication/pdfes_PE
dc.language.isoenges_PE
dc.publisherOxford University Presses_PE
dc.relation.urlhttp://trstmh.oxfordjournals.org/lookup/doi/10.1093/trstmh/trv054es_PE
dc.rightsinfo:eu-repo/semantics/embargoedAccesses_PE
dc.sourceUniversidad Peruana de Ciencias Aplicadas (UPC)es_PE
dc.sourceRepositorio Académico - UPCes_PE
dc.subjectAntibiotic resistancees_PE
dc.subjectChildrenes_PE
dc.subjectDiarrhoeaes_PE
dc.subjectEnterotoxigenic Escherichia colies_PE
dc.subjectPerues_PE
dc.titleComparative analysis of antimicrobial resistance in enterotoxigenic Escherichia coli isolates from two paediatric cohort studies in Lima, Perues_PE
dc.typeinfo:eu-repo/semantics/articlees_PE
dc.identifier.journalTransactions of The Royal Society of Tropical Medicine and Hygiene (Trans R Soc Trop Med Hyg.)es_PE
dc.description.peer-reviewRevisión por pareses_PE
dc.contributor.emailjoruiz@clinic.ub.eses_PE
html.description.abstractBackground 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.


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