Children with Trimethoprim- and Ampicillin-Resistant Fecal Escherichia coli in Day Care Centers

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Abstract
We conducted a cross-sectional study of 79 children attending seven day care centers in Houston, Texas, to detect fecal gram-negative bacilli resistant to trimethoprim (TMpr) and ampicillin (AMpr). Fifteen children (19%) were colonized with TMprEscherichia coli; all but one strain were also resistant to sulfonamides. Most of the children with TMPrE. coli were clustered in center A, where 11 (37%) of 30 children were colonized; only four (8O%) of 49 children in the other six centers were colonized with TMPrE. coli (P < .005). The TMprE. coli isolates from 10 of the 11 children in Center A had a similar antibiogram, which included resistance to sulfonamides, ampicillin, and streptomycin; eight had a similar total plasmid pattern, an observation suggesting spread within the day care center. Children colonized with AMpr E. coli were present in all centers, although a higher percentage of children in center A were colonized than in the other centers combined (70% vs. 35%; P < .01).