jmbReview Transfer of Antimicrobial-Resistant Escherichia coli and Resistance Genes in a Child Care Center

More than 80% of urinary tract infections in children are caused by Escherichia coli [1], and approximately 8% of children from 1 month to 11 years old experience infections from E. coli [2]. As the number of antimicrobial agents to treat E. coli urinary tract infection has increased, the occurrence of resistant bacteria has also increased [3]. Antimicrobial-resistant bacteria can cause a serious health risk, especially in children [4]. Children at a child care facility may play a role as a reservoir of resistant bacteria, and they can transfer resistant bacteria to family and community members, resulting in spread of resistance [46]. Some reports have described higher detection rates of methicillin-resistant Staphylococcus aureus (MRSA) and trimethoprim-resistant E. coli in children attending child care facilities than in those who do not attend a child care facility [7-9]. Adcock et al. highlighted that resistant strains are spread to families and communities through person-toperson contact [5]. However, no study has investigated the transfer of antibiotic-resistance genes or antibiotic-resistant bacteria between healthy children and teachers in a child care facility. Transfer of antimicrobial-resistant bacteria and resistance genes may be a great risk not only to children and teachers, but also to the local community. Therefore, this study aimed to investigate the actual transmission of antibioticresistant bacteria and antibiotic-resistant genes in a child care facility.