{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T12:20:48Z","timestamp":1765369248534,"version":"3.41.2"},"reference-count":75,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Infect Dis (Auckl)"],"published-print":{"date-parts":[[2017,1,1]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> Childhood diarrheal diseases remain highly endemic in India, but the emergence of extended-spectrum \u03b2-lactamase (ESBL)-producing Escherichia coli among children with diarrhea in Bihar remains elusive. In this study, we determine and characterize ESBL-producing E coli pathotypes among hospitalized diarrheal preschool children living in low socioeconomic level communities in Bihar, India. <\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods:<\/jats:title><jats:p> The stool samples were collected everyday throughout the year for 2 consecutive years. In our study, we collected stool samples randomly from every fifth patient. Stool samples were collected from a total of 633 randomly selected diarrheal children (age: 0-60\u2009months) belonging to 17 communities and screened for identification of virulent diarrheagenic E coli (DEC) pathotype (viz, enteropathogenic E coli [EPEC], enteroaggregative E coli [EAEC], enterotoxigenic E coli [ETEC], enteroinvasive E coli [EIEC], and enterohemorrhagic E coli [EHEC]) by a multiplex polymerase chain reaction (PCR) assay. Furthermore, ESBLs were screened by conventional antibiotic resistance pattern testing and later characterized for the presence of \u03b2-lactamase ( bla) genes by PCR and DNA sequencing. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Diarrheagenic E coli was detected in 191 cases (30.2%) of the total 633 diarrheic children. Maximum occurrence of DEC was found in \u226412\u2009months age group (72.7%) with prevalence of the EAEC pathotype. Most isolates were resistant to ampicillin, ciprofloxacin, piperacillin, levofloxacin, ceftazidime, cefotaxime, ceftriaxone, and gentamicin, whereas over 96% of them were sensitive to amikacin. About 37.6% of total 191 DEC isolates were ESBL producers (n\u2009=\u200972), being prevalent among ETEC (n\u2009=\u200935; 18.32%), followed by EPEC (n\u2009=\u200921; 10.9%), EAEC (n\u2009=\u200913; 6.8%), and EIEC (n\u2009=\u20093; 1.57%). Interestingly, the commonest \u03b2-lactamase was CTX-M type ( bla<jats:sub>CTX-M<\/jats:sub>) in 86.1% (n\u2009=\u200962) of the ESBL isolates, followed by bla<jats:sub>SHV<\/jats:sub> (n\u2009=\u200949; 68%), bla<jats:sub>TEM<\/jats:sub> (n\u2009=\u200937; 51.8%), and bla<jats:sub>OXA<\/jats:sub> (n\u2009=\u200921; 29.1%) determinants. Resistance of ESBL isolates was mostly related to ampicillin (100%), ceftriaxone (98.1%), cefotaxime (92.4%), gentamicin (74.1%), and levofloxacin (73.2%), whereas best antimicrobial activities were observed for piperacillin-tazobactam, amikacin, meropenem, and imipenem. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> This study revealed that EAEC (72.1%) is the predominant pathotype in Bihar, significantly high in \u226412\u2009months age group children ( P\u2009=\u2009.04). Moreover, the widespread prevalence of ESBLs in children, especially the CTX-M type, is of great concern, which requires monitoring of infection control measures through efficient antimicrobial management and detection of ESBL-producing isolates. <\/jats:p><\/jats:sec>","DOI":"10.1177\/1178633617739018","type":"journal-article","created":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T04:28:11Z","timestamp":1510028891000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Molecular Epidemiology of Extended-Spectrum \u03b2-Lactamase\u2013Producing <i>Escherichia coli<\/i> Pathotypes in Diarrheal Children from Low Socioeconomic Status Communities in Bihar, India: Emergence of the CTX-M Type"],"prefix":"10.1177","volume":"10","author":[{"given":"Abhishek","family":"Mandal","sequence":"first","affiliation":[{"name":"Department of Molecular Biology, Rajendra Memorial Research Institute of Medical Sciences (ICMR), Patna, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhishek","family":"Sengupta","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences (AIIMS) Patna, Patna, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology, Rajendra Memorial Research Institute of Medical Sciences (ICMR), Patna, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Utpal K","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nalanda Medical College & Hospital, Patna, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil K","family":"Jaiswal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nalanda Medical College & Hospital, Patna, India"},{"name":"Current address: Department of Pediatrics, Patna Medical College and Hospital, Patna, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pradeep","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology, Rajendra Memorial Research Institute of Medical Sciences (ICMR), Patna, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sushmita","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences (AIIMS) Patna, Patna, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,11,6]]},"reference":[{"key":"bibr1-1178633617739018","unstructured":"www.who.int\/mediacentre\/factsheets\/fs330\/en\/."},{"key":"bibr2-1178633617739018","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60222-6"},{"key":"bibr3-1178633617739018","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60560-1"},{"key":"bibr4-1178633617739018","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES2013.18.37.20582"},{"key":"bibr5-1178633617739018","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-007-0290-8"},{"key":"bibr6-1178633617739018","doi-asserted-by":"publisher","DOI":"10.1086\/505867"},{"key":"bibr7-1178633617739018","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60844-2"},{"key":"bibr8-1178633617739018","first-page":"5745","volume":"42","author":"Nguyen TV","year":"2004","journal-title":"J ClinMicrobiol"},{"key":"bibr9-1178633617739018","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.37.11.3458-3464.1999"},{"key":"bibr10-1178633617739018","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.25.7.1143-1147.1987"},{"key":"bibr11-1178633617739018","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(11)70253-5"},{"key":"bibr12-1178633617739018","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ1013"},{"key":"bibr13-1178633617739018","doi-asserted-by":"publisher","DOI":"10.3201\/eid1611.090934"},{"key":"bibr14-1178633617739018","doi-asserted-by":"publisher","DOI":"10.1007\/s00284-010-9790-3"},{"key":"bibr15-1178633617739018","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-7-92"},{"key":"bibr16-1178633617739018","doi-asserted-by":"publisher","DOI":"10.1590\/S0074-02762007005000116"},{"key":"bibr17-1178633617739018","doi-asserted-by":"crossref","first-page":"289","DOI":"10.7883\/yoken.JJID.2009.289","volume":"62","author":"Usein CR","year":"2009","journal-title":"Jpn J Infect Dis"},{"key":"bibr18-1178633617739018","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2010.09-0412"},{"key":"bibr19-1178633617739018","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60222-6"},{"key":"bibr20-1178633617739018","unstructured":"WHO. 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