Study highlights growing antibiotic resistance in diarrheagenic E. coli in China

Diarrheagenic E. coli (DEC) is a major global cause of diarrheal diseases, with certain strains showing alarming levels of antibiotic resistance. The rise of these resistant strains has rendered many first-line treatments ineffective, significantly complicating the management of severe and prolonged diarrhea cases. The widespread overuse of antibiotics has further accelerated the emergence of multidrug-resistant (MDR) strains, which are resistant to a broad spectrum of antibiotics. In this context, continuous research is essential to monitor and mitigate the spread of AMR in DEC.

The study (DOI: 10.1186/s44280-024-00064-w) published in One Health Advances on October 30, 2024, highlights the growing concern of AMR in diarrheagenic E. coli in China. Conducted by researchers from the China National Center for Food Safety Risk Assessment and provincial research centers, the study analyzed E. coli isolates from 2016 to 2022, providing valuable insights into the evolving resistance patterns.

Over the seven-year study period, researchers analyzed 9,068 DEC collected from sporadic human diarrhea cases across 20 Chinese provinces. The results were striking: 89.3% of the isolates were resistant to at least one antimicrobial agent, with 60.3% exhibiting multidrug resistance. Notably, resistance to ampicillin was found in 68.2% of isolates, while resistance to imipenem remained relatively low at 1.6%. Additionally, resistance to cefoxitin and chloramphenicol demonstrated a concerning upward trend. The predominant pathotype was Enteroaggregative E. coli (EAEC), accounting for 47.3% of the isolates, with notable variations in resistance across different age groups—especially infants under one year, who showed higher resistance to several antibiotics. These detailed resistance profiles provide critical insights for refining clinical treatment strategies and highlight the urgent need for targeted interventions to curb the spread of resistant strains.

Dr. Yunchang Guo, the lead researcher, stressed the importance of continued monitoring and proactive efforts to address the growing issue of AMR.

Our findings underscore the urgent need for stricter antibiotic regulations in both humans and livestock, as well as the adoption of a 'One Health' approach to minimize the impact of foodborne infections caused by resistant DEC."

Dr. Yunchang Guo, lead researcher

The implications of this research are far-reaching, providing essential data for clinicians and policymakers to develop effective treatments and strategies against DEC infections. The particularly high resistance rates among infants highlight the critical need for ongoing surveillance of AMR in China. This study supports the broader effort to protect public health by addressing the global challenge of AMR and promoting interdisciplinary actions to prevent the spread of resistant pathogens.