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Prevalence and risk factors for persistent faecal carriage of extended spectrum beta-lactamase producing Escherichia coli in a paediatric community population.

Gabriel Lignieres·Philippe Bidet·André Birgy·Kevin La·Guillaume Geslain·Erick Denamur·Stéphane Béchet·Olivier Cotto·François Blanquart·Franck Thollot·François Corrard·Céline Courroux·Elsa Sobral·Robert Cohen·Corinne Levy·Stéphane Bonacorsi
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Abstract

OBJECTIVE: To investigate clinical and microbiological factors associated with persistent faecal carriage of extended spectrum beta-lactamase (ESBL) producing Escherichia coli in infants. METHODS: Between 2010 and 2022, children aged 3 months to 2 years old were sampled in a community setting in France, at two visits, V1 and V2, 3-24 months apart, to screen for prolonged faecal carriage of ESBL-producing E. coli. Patient clinical information and whole genome sequence of each isolate were used for association studies. RESULTS: A total of 4641 children were sampled. 375 (8%) carried an ESBL-producing Enterobacterales, among which 142 of ESBL-producing E. coli carriers were once again sampled at V2 and included in this study. 21.8% (n = 31/142) and 18.4% (n = 16/99) carried the same ESBL-producing E. coli clone for at least 3 and 6 months, respectively. B2 phylogroup, and among which ST131 clones were associated with an increased risk of persistent carriage. Multivariate analysis identified virulence associated genes involved in adhesion (papC/papGII allele and a tia-like gene) and encoding toxin (senB) as major risk factors for persistence. A genome wide association study highlighted the potential role of the frz metabolic operon, known to be involved in enterocytes adhesion/internalisation. CONCLUSION: Main extraintestinal pathogenic E. coli genomic features (phylogenetic background, adhesion properties) are associated with ESBL-producing E. coli gut colonisation persistence in infants, which could potentially lead to an increased risk of febrile urinary tract infection in these patients.

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ChildEscherichia coliExtended-spectrum beta-lactamaseGenome-wide association studyPersistent faecal carriageVirulence associated genesJournal Article

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Gabriel Lignieres, Philippe Bidet, André Birgy, Kevin La, Guillaume Geslain, Erick Denamur, Stéphane Béchet, Olivier Cotto, François Blanquart, Franck Thollot, François Corrard, Céline Courroux, Elsa Sobral, Robert Cohen, Corinne Levy, Stéphane Bonacorsi. 2026-09-11. Prevalence and risk factors for persistent faecal carriage of extended spectrum beta-lactamase producing Escherichia coli in a paediatric community population.. https://doi.org/10.1016/j.ijmm.2026.151734

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