gms | German Medical Science

50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds)
12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie (dae)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie
Deutsche Arbeitsgemeinschaft für Epidemiologie

12. bis 15.09.2005, Freiburg im Breisgau

Resistant E. coli in toddlers: household contacts are the key factor

Meeting Abstract

  • Susanne Lietzau - Deutsches Zentrum für Alternsforschung, Heidelberg
  • Elke Raum - Deutsches Zentrum für Alternsforschung, Heidelberg
  • Heike von Baum - Medizinische Mikrobiologie und Hygiene, Ulm
  • Reinhard Marre - Medizinische Mikrobiologie und Hygiene, Ulm
  • Hermann Brenner - Deutsches Zentrum für Alternsforschung, Heidelberg

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. Deutsche Arbeitsgemeinschaft für Epidemiologie. 50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie. Freiburg im Breisgau, 12.-15.09.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05gmds126

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/gmds2005/05gmds102.shtml

Veröffentlicht: 8. September 2005

© 2005 Lietzau et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background

Antibiotic resistance is an emerging problem worldwide and applies also for E. coli. Especially in infants and small children, infections with resistant bacteria can lead to life threatening situations. Nevertheless, data on prevalence and determinants of antibiotic resistance in young children, particularly studies in the outpatient setting, are sparse.

Methods

From July 2002 to July 2003, children aged 6 months to 4 years who visited one of ten cooperating pediatricians in the city of Ulm for a regular health care screening or because of an acute infection in attendance of a parent were recruited for the study. The family members were also asked to participate. Data on known or suspected potential determinants of antibiotic resistance, as well as sociodemographic variables and lifestyle factors for all household members were obtained by a self-administered standardized questionnaire. In addition, medical data were obtained for the study children from medical charts. Stool samples were collected from children (N=883) who attended the pediatrician, theirs parents (N=1594) and siblings (N=624). E. coli was cultured and minimal inhibition concentrations to various antibiotics were tested. Prevalences of E. coli resistance to commonly prescribed antibiotics according to potential risk factors were ascertained. Multiple logistic regression was carried out to estimate the independent role of the various potential risk factors for E. coli resistance among the study population.

Results

In general, resistance prevalences were remarkably similar among children and adults. Prevalence of resistance was 16.6%, 8.7% and 11.6% for ampicillin, cotrimoxazol and doxycyclin among study children, respectively. Only few isolates carried cephalosporin, aminoglycoside or quinolone resistance. E. coli resistance in household members was the main risk factor for the colonization with resistant E. coli among study children. Especially strong associations were found with antibiotic resistance among siblings (OR (95% CI) for ampicillin, doxycyclin and cotrimoxazol resistance: 4.3 (1.8-10.0), 5.8 (2.1-16.0) and 12.2 (3.9-37.8), respectively), but also with antibiotic resistance in both parents.

Conclusion

Our study shows that E. coli resistance rates in Germany outside the clinical sector still seem to be relatively low and that there seem to be no major differences between the prevalence patterns in parents and children. The highest prevalence of E. coli resistance was found for ampicillin, more than 90% of isolates were susceptible to cotrimoxazol and only few isolates carried cephalosporin resistance. Household contacts seem to be the key factor for the colonization with resistant E. coli in children.