Background. The reservoir of pathogenic ciprofloxacin-resistant Escherichia coli remains unknown. Methods. We conducted a prospective cohort study of 80 healthy twins and their mothers to determine the frequency of excretion of ciprofloxacin-resistant, potentially pathogenic E. coli. Stool specimens were cultured selectively for ciprofloxacin-resistant gram-negative bacteria. Isolates were categorized on the basis of additional resistance and virulence profiles. We also prospectively collected clinical metadata. Results. Fifteen children (19%) and 8 mothers (20%) excreted ciprofloxacin-resistant E. coli at least once. Overall, 33% of 40 families had at least 1 member whose stool specimen yielded ciprofloxacin-resistant E. coli on culture. Fifty-seven submitted stool specimens (2.8%) contained such organisms; clones ST131-H30 and ST405 accounted for 52 and 5 of the positive specimens, respectively. Length of hospital stay after birth (P =.002) and maternal colonization (P =.0001) were associated with subsequent childhood carriage of ciprofloxacin-resistant E. coli; antibiotic use, acid suppression, sex, mode of delivery, and maternal perinatal antibiotic use were not. Ciprofloxacin-resistant E. coli were usually resistant to additional antibiotic classes, and all had virulence genotypes typical of extraintestinal pathogenic E. coli. Conclusions. Healthy children and their mothers commonly harbor ciprofloxacin-resistant E. coli with pathogenic potential.

Original languageEnglish
Pages (from-to)1862-1868
Number of pages7
JournalJournal of Infectious Diseases
Issue number12
StatePublished - Dec 15 2015


  • Ciprofloxacin-resistant E. coli
  • E. coli ST131-H30
  • E. coli ST405
  • Extra-intestinal pathogenic E. coli
  • Urinary tract infections


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