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Am J Trop Med Hyg. 2019 Mar 4. doi: 10.4269/ajtmh.18-0542. [Epub ahead of print]

Extraintestinal Pathogenic Escherichia coli and Antimicrobial Drug Resistance in a Maharashtrian Drinking Water System.

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Environmental Health Sciences Department, School of Public Health, University of California, Berkeley, California.
Energy and Resources Group, University of California, Berkeley, California.
Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, California.


Although access to piped drinking water continues to increase globally, information on the prevalence and clonal composition of coliforms found in piped water systems in low-resource settings remains limited. From June to July 2016, we examined Escherichia coli isolates in domestic water from the distribution system in Alibag, a small town in India. We analyzed the isolates for drug resistance and genotyped them by multilocus sequence typing. Of 147 water samples, 51 contained coliforms, and 19 (37%) of the 51 were biochemically confirmed to contain E. coli. These samples contained 104 E. coli isolates-all resistant to ampicillin. Resistance to ceftazidime was observed in 52 (50%) isolates, cefotaxime in 59 (57%), sulfamethoxazole-trimethoprim in 46 (44%), ciprofloxacin in 30 (29%), and gentamicin in two (2%). Thirty-eight (36%) belonged to sequence types recognized as extraintestinal pathogenic E. coli (ExPEC); 19 (50%) of these 38 ExPEC belonged to known uropathogenic E. coli lineages. This exploratory field research shows the extent to which "improved" drinking water is a potential source of E. coli strains capable of causing extraintestinal infections.


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