Community Fecal Carriage and Molecular Epidemiology of Extended-Spectrum β-Lactamase- and Carbapenemase-Producing Escherichia coli from Healthy Children in the Central South China

Figures & data

Table 1 Prevalence of Antimicrobial Susceptibility of ESBL-EC Vs CP-EC from Healthy Children

Antimicrobial Agent	ESBL-EC (N=118)			CP-EC (N=3)
	No. (%) S	No. (%) I	No. (%) R	No. (%) S	No. (%) I	No. (%) R
CZO	0 (0)	17 (14.4)	101 (85.6)	0 (0)	0 (0)	3 (100)
CXM	3 (2.5)	3 (2.5)	112 (95.0)	0 (0)	0 (0)	3 (100)
CRO	0 (0)	1 (0.8)	117 (99.2)	0 (0)	0 (0)	3 (100)
CAZ	88 (74.6)	0 (0)	30 (25.4)	0 (0)	0 (0)	3 (100)
FEP	66 (55.9)	29 (24.6)	23 (19.5)	0 (0)	3 (100)	0 (0)
FOX	108 (91.6)	1 (0.8)	9 (7.6)	0 (0)	0 (0)	3 (100)
AMK	114 (96.6)	0 (0)	4 (3.4)	3 (100)	0 (0)	0 (0)
GEN	90 (76.3)	7 (5.9)	21 (17.8)	2 (66.7)	1 (33.3)	0 (0)
TZP	117 (99.2)	1 (0.8)	0 (0)	0 (0)	2 (66.7)	1 (33.3)
MEM	118 (100)	0 (0)	0 (0)	0 (0)	0 (0)	3 (100)
TGC	118 (100)	0 (0)	0 (0)	3 (100)	0 (0)	0 (0)
ATM	63 (53.4)	21 (17.8)	34 (28.8)	2 (66.7)	1 (33.3)	0 (0)
AMP	0 (0)	0 (0)	118 (100)	0 (0)	0 (0)	3 (100)
SAM	51 (43.2)	51 (43.2)	16 (13.6)	0 (0)	0 (0)	3 (100)
COL	116 (98.3)	0 (0)	2 (1.7)	3 (100)	0 (0)	0 (0)
MNO	96 (81.4)	13 (11.0)	9 (7.6)	3 (100)	0 (0)	0 (0)
SXT	48 (40.7)	0 (0)	70 (59.3)	0 (0)	0 (0)	3 (100)
LVX	63 (53.4)	7 (5.9)	48 (40.7)	1 (33.3)	1 (33.3)	1 (33.3)
NIT	117 (99.2)	1 (0.8)	0 (0)	2 (66.7)	1 (33.3)	0 (0)
CSL	116 (98.3)	2 (1.7)	0 (0)	0 (0)	1 (33.3)	2 (66.7)

Abbreviations: ESBL-EC, extended-spectrum β-lactamase-producing Escherichia coli; CP-EC, carbapenemase-producing E. coli; R, resistant; I, intermediate; S, susceptible; CZO, cefazolin; CXM, cefuroxime; CRO, ceftriaxone; CAZ, ceftazidime; FEP, cefepime; FOX, cefoxitin; AMK, amikacin; GEN, gentamicin; TZP, piperacillin/tazobactam; MEM, meropenem; TGC, tigecycline; ATM, aztreonam; AMP, ampicillin; SAM, ampicillin-sulbactam; COL, colistin; MNO, minocycline; SXT, trimethoprim/sulphamethoxazole; LVX, levofloxacin; NIT, nitrofurantoin; CSL, cefoperazone/sulbactam.

Table 2 Prevalence of Resistant Genes Among 118 ESBL-EC from Healthy Children

Resistant Genes	No. (%) of Strains			P-value^a
	Total (n=118)	ST131 (n=12)	Non-ST131 (n=106)
ESBL-encoding genes
CTX-M-1 group
blaCTX-M-15	29 (24.6)	1 (8.3)	28 (26.4)	0.289
blaCTX-M-55	5 (4.2)	0 (0)	5 (4.7)	1.000
CTX-M-9 group
blaCTX-M-14	32 (27.1)	1 (8.3)	31 (29.2)	0.176
blaCTX-M-27	29 (24.6)	10 (83.3)	19 (17.9)	<0.001
blaCTX-M-65	10 (8.5)	0 (0)	10 (9.4)	1.000
blaCTX-M-110	2 (1.7)	0 (0)	2 (1.9)	1.000
blaCTX-M-213	5 (4.2)	0 (0)	5 (4.7)	1.000
blaCTX-M-24	1 (0.8)	0 (0)	1 (0.9)	1.000
CTX-M-2 group	0 (0)	0 (0)	0 (0)	NA
CTX-M-8 group	0 (0)	0 (0)	0 (0)	NA
CTX-M-25 group	0 (0)	0 (0)	0 (0)	NA
CTX-M-1/CTX-M-9 group
blaCTX-M-14+blaCTX-M-15	1 (0.8)	0 (0)	1 (0.9)	1.000
blaCTX-M-15+blaCTX-M-213	1 (0.8)	0 (0)	1 (0.9)	1.000
blaCTX-M-15+blaCTX-M-27	2 (1.7)	0 (0)	2 (1.9)	1.000
SHV	1 (0.8)	0 (0)	1 (0.9)	1.000
TEM	54 (45.8)	7 (58.3)	47 (44.3)	0.379
Fluoroquinolones-resistance genes
qnrA	0 (0)	0 (0)	0 (0)
qnrB	2 (1.7)	0 (0)	2 (1.9)	1.000
qnrC	0 (0)	0 (0)	0 (0)
qnrS	26 (22.0)	0 (0)	26 (24.5)	0.353
aac (6’)-Ib	4 (3.4)	0 (0)	4 (3.8)	1.000
qepA	0 (0)	0 (0)	0 (0)
Colistin-resistance gene
mcr-1	1 (0.8)	0 (0)	1 (0.9)	1.000

Note: ^aP- value < 0.05 are bolded.

Abbreviations: NA, not available; bla, beta-lactamase; ESBL, extended-spectrum beta-lactamase.

Table 3 Prevalence of Virulence Traits Among 118 ESBL-EC from Healthy Children

Virulence Genes	No. (%) of Strains			P-value^a
	Total (n=118)	ST131 (n=12)	Non-ST131 (n=106)
Adhesin-associated
papAH	14 (11.8)	1 (8.3)	13 (12.3)	1.000
papEF	23 (19.5)	2 (16.6)	21 (19.8)	1.000
papC	21 (17.8)	2 (16.6)	19 (17.9)	1.000
papG allele I	0 (0)	0 (0)	0 (0)	NA
papGII/III	5 (4.2)	1 (8.3)	4 (3.8)	0.421
papG allele II	14 (11.9)	2 (16.6)	12 (11.3)	0.634
sfa/focDE	7 (5.9)	0 (0)	7 (6.6)	1.000
afa/draBC	11 (9.3)	1 (8.3)	10 (9.4)	1.000
sfaS	3 (2.5)	0 (0)	3 (2.8)	1.000
focG	3 (2.5)	0 (0)	3 (2.8)	1.000
fimH	104 (88.1)	12 (100.0)	92 (86.8)	0.356
nfaE	2 (1.7)	0 (0)	2 (1.9)	1.000
gafD	0 (0)	0 (0)	0 (0)	NA
Capsule-associated
kpsMTII	72 (61.0)	11 (91.7)	61 (57.5)	0.027
kpsMTIII	2 (1.7)	0 (0)	2 (1.9)	1.000
kpsMT K5	33 (27.9)	6 (50.0)	27 (25.4)	0.092
kpsMT K1	34 (28.8)	3 (25.0)	31 (29.2)	1.000
Toxin-associated
cdtB	0 (0)	0 (0)	0 (0)	NA
cnf1	0 (0)	0 (0)	2 (1.9)	NA
hlyA	4 (3.4)	1 (8.3)	3 (2.8)	0.353
Siderophore-associated
iutA	64 (54.2)	10 (83.3)	54 (50.9)	0.037
fyuA	86 (72.9)	12 (100.0)	74 (70.0)	0.035
Others
cvaC	10 (8.5)	0 (0)	10 (9.4)	0.596
PAI	45 (38.1)	11 (91.7)	34 (32.1)	<0.001
traT	77 (65.3)	12 (100.0)	65 (61.3)	0.008
rfc	2 (1.7)	1 (8.3)	1 (0.9)	0.194
Virulence score^†	4.2 (0–15)	7 (5–11)	5 (0–15)	0.003
ExPEC	62 (52.5)	9 (75.0)	53 (50.0)	0.132

Notes: ^aP-value < 0.05 are bolded; ^†median (range); ExPEC, extraintestinal pathogenic E.coli, E.coli containing two of these five virulence genes (papAH/papC, sfa/focDC, afa/draBC, iutA, kpsMT II) is defined as ExPEC.

Abbreviations: NA, not available; ExPEC, extraintestinal pathogenic E. coli.