ORIGINAL_ARTICLE Escherichia coli infections are becoming increasingly difficult to treat because of emerging antimicrobial resistance, mostly to expanded-spectrum cephalosporins, due to the production of extended-spectrum β-lactamases (ESBLs).Despite extensive studies of ESBL- producing E.coli in adult patients, there is a lack of information about the epidemiology and spread of ESBL organisms in pediatric population. The aim of this study was to examine the gastrointestinal tract as an endogenous reservoir for the respiratory tract colonization with ESBL- E. coli in children, hospitalized because of the severity of the respiratory illness. The study group consists of 40 children with ESBL-producing E. coli strains isolated from the sputum and from the rectal samples. A control group of 15 E. coli isolated from rectal swabs of healthy children were included in the analysis. The comparison of the strains was done by using antimicrobial susceptibility patterns of the stains, and pulsed field gel electrophoresis was performed for molecular typing, using XbaI digestion. 90% of the compared pairs of strains in the study group were with identical antimicrobial susceptibility patterns and indistinguishable in 79.2% by the obtained PFGE – profiles.33.3% (5/15) of confirmed E. coli strains from the control group were found to be ESBL – producers. Resulting band profiles of all isolates demonstrated presence of 12 pulsotypes, with 100% similarity within the pulsotypes. Although, some isolates obtained from different patients were genetically indistinguishable, these strains were not hospital acquired, as none of the patients satisfied the criteria for hospital acquired pneumonia, and there was a lack of an obvious transmission chain. All ESBL –E. coli isolated from sputum in clinical cases were obtained from patients under the age of one. According to the resistance profile of the compared pairs and the PFGE comparison of all isolates, it can be concluded that the gastrointestinal tract is the main reservoir of ESBL-E. coli. Small age in infants is a risk factor for translocation of bacteria, enabling the colonization of the respiratory tract. https://macvetrev.mk/Files/Article/2020/10.2478/macvetrev-2018-0016/macvetrev-2018-0016.pdf 2018-10-15T09:00:00 133 141 10.2478/macvetrev-2018-0016 ESBL-producing Escherichia coli resistance profile GUT colonization PFGE- typing Gorica Popova gorica.popova@yahoo.com false 1 Department of Clinical Microbiology, Institute for Respiratory Diseases in Children, Skopje, Republic of Macedonia LEAD_AUTHOR Dean Jankuloski false 2 Department of Molecular Microbiology, Faculty of Veterinary Medicine, Food Institute,University Ss Cyril and Methodius in Skopje, Republic of Macedonia AUTHOR Benjamin Felix false 3 French Agency for Food, Environmental and Occupational Health and Safety, Laboratory for Food Safety, Paris, France AUTHOR Katerina Boskovska false 4 Pediatric Department, Institute for Respiratory Diseases in Children, Skopje, Republic of Macedonia AUTHOR Biljana Stojanovska - Dimzovska false 5 Department of Microbiology, Faculty of Veterinary Medicine, Food Institute, University Ss Cyril and Methodius in Skopje AUTHOR Velibor Tasic false 6 Nephrology Department, University Children, s Hospital, Skopje, Republic of Macedonia AUTHOR Katerina Blagoevska false 7 Department of Molecular Microbiology, Faculty of Veterinary Medicine, Food Institute,University Ss Cyril and Methodius in Skopje, Republic of Macedonia AUTHOR Akil, I., Yilmaz, O., Kuruepe, S., Deqwrli, K., Kavukcu, S. 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