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dc.contributor.authorLopez-Siles, Mireia 
dc.contributor.authorMoure García, Zaira 
dc.contributor.authorMuadica, Aly Salimo 
dc.contributor.authorSanchez-Prieto, Sergio 
dc.contributor.authorCruces Fernández, Raquel 
dc.contributor.authorÁvila, Alicia 
dc.contributor.authorLara Fuella, Noelia 
dc.contributor.authorKöster, Pamela Carolina 
dc.contributor.authorDashti, Alejandro 
dc.contributor.authorOteo-Iglesias, Jesus 
dc.contributor.authorCarmena, David 
dc.contributor.authorMcConnell, Michael J
dc.identifier.citationFront Microbiol. 2023 Jun 9;14:1035291.es_ES
dc.description.abstractBackground: Extended-spectrum ß-lactamase-producing Enterobacterales (ESBL-E) are a serious threat among emerging antibiotic resistant bacteria. Particularly, the number of cases of ESBL-E infections reported in children has been increasing in recent years, and approved antibiotic treatments for this age group are limited. However, information regarding the prevalence of colonization in European children, risk factors associated with colonization, and the characteristics of the colonizing strains is scarce. The aims of this study were to determine the prevalence of ESBL-E colonization in fecal samples of apparently healthy schoolchildren, to identify lifestyle routines associated with colonization, and to characterize clonal relationships and mechanisms of resistance in ESBL-E isolates. Methods: A cohort of 887 healthy children (3-13 years old) from seven primary and secondary schools in the Madrid metropolitan area was recruited between April-June 2018, and sociodemographic information and daily habits were collected. Fecal samples were screened for ESBL-E carriage in selective medium. ESBL-E isolates were further characterized by assessing molecular epidemiology (PFGE and MLST), ESBL gene carriage, and antibiotic resistance profile. This information was analyzed in conjunction with the metadata of the participants in order to identify external factors associated with ESBL-E carriage. Results: Twenty four ESBL-E, all but one Escherichia coli, were detected in 23 children (prevalence: 2.6%; 95% CI: 1.6-3.6%). Of these, seven contained the blaCTX-M-14 allele, five the blaCTX-M-15, five the blaSHV-12, three the blaCTX-M-27, three the blaCTX-M-32, and one the blaCTX-M-9. Significant clonal diversity was observed among the isolates that grouped into 22 distinct clusters (at <85% similarity of PFGE profile). ESBL-producing E. coli isolates belonged to 12 different STs, with ST10 (25%) and ST131 (17%) being the most frequent. Apart from ß-lactams, resistance to trimethoprim/sulfamethoxazole (46%), ciprofloxacin (33%), levofloxacin (33%), tobramycin (21%), and gentamicin (8%) were the most frequently detected. Conclusion: The prevalence of ESBL-E in the studied cohort of children was lower than the average colonization rate previously detected in Europe for both children and adults. E. coli was the main ESBL-producing species detected and CTX-M were the most frequently identified ESBLs. High ST diversity suggests polyclonal dissemination. Compared to other STs, ST131 isolates were associated with resistance to various antimicrobials.es_ES
dc.description.sponsorshipML-S was supported by the Sara Borrell Program of the Instituto de Salud Carlos III (ISCIII) (CD17CIII/00017). ZM was supported by the Río Hortega Program of the ISCIII. AÁ was supported by the Garantía Juvenil Program of the Comunidad Autónoma de Madrid. SS was supported by the Miguel Servet program of ISCIII (CPII18CIII/00005). This study was funded by the ISCIII, Ministry of Economy and Competitiveness (Spain), under projects PI16CIII/00024, PI18CIII/00030, MPY380/18, and MPY516/19.es_ES
dc.publisherFrontiers Media es_ES
dc.subjectExtended-spectrum ß-lactamase (ESBL)es_ES
dc.subjectFecal carriagees_ES
dc.subjectMultidrug resistance (MDR) bacteriaes_ES
dc.titleFecal carriage of extended-spectrum beta-lactamase-producing Enterobacterales in healthy Spanish schoolchildrenes_ES
dc.typeresearch articlees_ES
dc.rights.licenseAtribución 4.0 Internacional*
dc.contributor.funderInstituto de Salud Carlos III es_ES
dc.contributor.funderComunidad de Madrid (España) es_ES
dc.contributor.funderMinisterio de Economía y Competitividad (España) es_ES
dc.identifier.journalFrontiers in microbiologyes_ES
dc.repisalud.centroISCIII::Centro Nacional de Microbiologíaes_ES
dc.rights.accessRightsopen accesses_ES
dc.relation.projectFISinfo:fis/Instituto de Salud Carlos III/Programa Estatal de Fomento de la Investigación Científica y Técnica de Excelencia/Subprograma Estatal de Generación de Conocimiento/ISCIII 2016 Modalidad Proyectos de Investigacion en Salud Intramurales. (2016)/PI16CIII/00024es_ES
dc.relation.projectFISinfo:fis/Instituto de Salud Carlos III/Programa Estatal de Fomento de la Investigación Científica y Técnica de Excelencia/Subprograma Estatal de Generación de Conocimiento/PI18-ISCIII Modalidad Proyectos de Investigacion en Salud Intramurales. (2018)/PI18CIII/00030es_ES

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