The extended spectrum β-lactamases (ESBL) and virulence genes of intestinal enteroaggregative Escherichia coli (EAEC) in healthy elderly individuals.

Aim: to analyze the detection rate of intestinal enteroaggregative Escherichia coli (EAEC) in healthy elderly (≥60 years) individuals in the Hangzhou area of China, and to investigate the extended spectrum β-lactamases and virulence genes of EAEC.

Methods: Stool specimens provided by healthy elderly individuals were cultured on blood agar, SS, and MAC plates. The bacterial strains were identified using Vitek-2 Compact automatic microorganism identification system and mass spectrometry. The resistance phenotypes of the bacteria were determined using the double-disk synergy method. The resistance genes and the EAEC virulence gene, astA and aggR, were amplified by PCR and compared to the sequences available in Gen Bank.

Results: Among the 1050 healthy volunteers, the majority of bacteria were E. coli, accounting for 960 strains, with an ESBL-positive rate of 36.3% (348/960). The EAEC detection rate was 10% (96/960); among them, 84 strains were astA, the detection rate of which was 8.75%; 12 strains were aggR, the detection rate of which was 1.25%. The ESBL-positive rate of EAEC strains were 56.25% (54/96), all of which carried the CTX-M type, with the CTX-M-14 predominating at 66.7% (36/54).

Conclusions: The ESBL-positive rate of intestinal E. coli in healthy elderly individuals in the Hangzhou area of China was higher than the rate detected in other regions of china; and there was a high rate of antibiotic resistance among the intestinal EAEC in healthy elderly individuals. The results of this study suggest that EAEC is not only a pathogenic bacteria detected in diarrhea patients, but can also be present in healthy individuals, and high-resistance clinical strains have spread to the healthy population in the Hangzhou area. So vigilance is critical.