Household contacts were key factor for children's colonization with resistant Escherichia coli in community setting

J Clin Epidemiol. 2007 Nov;60(11):1149-55. doi: 10.1016/j.jclinepi.2007.01.016. Epub 2007 Jul 25.


Objective: In young children infections with resistant Escherichia coli (E. coli) can lead to life-threatening situations. Epidemiological data on the prevalence and major determinants of carriage of antibiotic resistant E. coli among children in the community setting are sparse.

Study design and setting: In a population-based study from Germany, stool samples were obtained from children aged 6 months to 4 years attending a pediatrician for a regular health screening (N=568) or an acute infection (N=316), as well as from their parents (N=1,594) and siblings (N=624). E. coli was cultured, and minimal inhibitory concentrations to various antibiotics were tested. We determined prevalences of E. coli resistance to commonly prescribed antibiotics and their association with potential risk factors.

Results: Prevalence of E. coli resistance was 16.6%, 8.7%, and 11.6% for ampicillin, cotrimoxazole, and doxycycline, respectively. Strong associations were found with antibiotic resistance among siblings (odds ratios [95% confidence intervals] for ampicillin, doxycycline, and cotrimoxazole resistance: 4.4 [1.8-10.8], 8.0 [3.0-21.2], and 10.8 [3.5-32.7], respectively).

Conclusion: Resistance prevalences in this community-based study were much lower than those reported from the clinical sector. Household contacts seem to be the key factor for children;s colonization with resistant E. coli in the community setting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Ampicillin Resistance
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents / therapeutic use
  • Child, Preschool
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / transmission
  • Doxycycline / therapeutic use
  • Drug Resistance, Bacterial
  • Drug Resistance, Multiple, Bacterial
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / transmission
  • Feces / microbiology
  • Female
  • Germany / epidemiology
  • Humans
  • Infant
  • Male
  • Parents
  • Patient Acceptance of Health Care
  • Prevalence
  • Risk Factors
  • Siblings
  • Socioeconomic Factors
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use


  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Doxycycline