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


de Lastours, Victoire; Malosh, Ryan E.; Aiello, Allison E.; & Foxman, Betsy (2015). Prevalence of Escherichia coli Carriage in the Oropharynx of Ambulatory Children and Adults with and without Upper Respiratory Symptoms. Annals of the American Thoracic Society, 12(3), 461-463.


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 (1, 2). 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 (1, 2). This is particularly true since the recent global emergence and spread of E. coli strains producing extended-spectrum b-lactamases, which constitute a major public health concern (3). 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 (4, 5). Yet little is known about oropharyngeal colonization by E. coli, with most studies dating back 30 years ago (6-9). 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. coli using quantitative PCR (qPCR), which is more sensitive than culture. Methods: Using a collection of oropharyngeal samples from participants in two community cohort studies ongoing in Southeast Michigan during the 2012-2013 and 2013-2014 influenza season, the Household Influenza Vaccination Effectiveness Study (HIVE) (10) and the eX-FLU study (11), we estimated the prevalence of E. coli oropharyngeal carriage among 589 subjects. HIVE participants (range, 2-70 yr old) were recruited among households with at least two children (for details, see Reference 10). eX-FLU participants were college students (aged 18-21 yr; mean, 19.2 yr) living in dormitories and enrolled using a social network referral model. Students suffering from upper respiratory symptoms defined as cough and fever/feverishness, body aches, or chills (cough plus one of fever/feverishness, chills, or body aches) were requested to provide samples at onset. Their healthy social contacts (no illness in the previous 14 d) were also sampled.


Reference Type

Journal Article

Year Published


Journal Title

Annals of the American Thoracic Society


de Lastours, Victoire
Malosh, Ryan E.
Aiello, Allison E.
Foxman, Betsy