Prevalence of Escherichia coli Carriage in the Oropharynx of Ambulatory Children and Adults with and without Upper Respiratory Symptoms

Escherichia coli is a common gut commensal and an important human pathogen that rarely causes pneumonia in the community. However, E. coli increasingly causes hospital-acquired pneumonia, particularly among intensive care unit (ICU) patients. E. coli pneumonia, similar to other hospital-acquired and ventilator-associated pneumonias, is responsible for longer ICU and hospital stays, high morbidity and mortality, and increased antibiotic consumption and hospital costs. This is particularly true since the recent global emergence and spread of E. coli strains producing extended-spectrum β-lactamases, which constitute a major public health concern. E. coli identified in protected bronchoalveolar lavage specimens from ICU patients with ventilator-acquired pneumonia is often genetically identical to the strains found in their dental plaque and oropharyngeal cavity. Yet little is known about oropharyngeal colonization by E. coli, with most studies dating back 30 years ago. Because no recent work has addressed E. coli carriage in the community, we aimed to fill this gap in the literature by estimating the E. coli carriage rates among otherwise healthy adults and children with and without upper respiratory symptoms. We detected E. coliusing quantitative PCR (qPCR), which is more sensitive than culture. Annals of the American Thoracic Society. 2015 Mar;12(3):461-3.