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Frequency of bystander exposure to antibiotics for enteropathogenic bacteria among young children in low-resource settings

Children in low-resource settings carry enteric pathogens asymptomatically and are frequently treated with antibiotics, resulting in opportunities for pathogens to be exposed to antibiotics when not the target of treatment (i.e., bystander exposure). We quantified the frequency of bystander antibiot...

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Autores principales: Rogawski McQuade, Elizabeth T., Brennhofer, Stephanie A., Elwood, Sarah E., McMurry, Timothy L., Lewnard, Joseph A., Mduma, Estomih R., Shrestha, Sanjaya, Iqbal, Najeeha, Bessong, Pascal O., Kang, Gagandeep, Kosek, Margaret, Lima, Aldo A. M., Ahmed, Tahmeed, Liu, Jie, Houpt, Eric R., Platts-Mills, James A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: National Academy of Sciences 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9457395/
https://www.ncbi.nlm.nih.gov/pubmed/36037372
http://dx.doi.org/10.1073/pnas.2208972119
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author Rogawski McQuade, Elizabeth T.
Brennhofer, Stephanie A.
Elwood, Sarah E.
McMurry, Timothy L.
Lewnard, Joseph A.
Mduma, Estomih R.
Shrestha, Sanjaya
Iqbal, Najeeha
Bessong, Pascal O.
Kang, Gagandeep
Kosek, Margaret
Lima, Aldo A. M.
Ahmed, Tahmeed
Liu, Jie
Houpt, Eric R.
Platts-Mills, James A.
author_facet Rogawski McQuade, Elizabeth T.
Brennhofer, Stephanie A.
Elwood, Sarah E.
McMurry, Timothy L.
Lewnard, Joseph A.
Mduma, Estomih R.
Shrestha, Sanjaya
Iqbal, Najeeha
Bessong, Pascal O.
Kang, Gagandeep
Kosek, Margaret
Lima, Aldo A. M.
Ahmed, Tahmeed
Liu, Jie
Houpt, Eric R.
Platts-Mills, James A.
author_sort Rogawski McQuade, Elizabeth T.
collection PubMed
description Children in low-resource settings carry enteric pathogens asymptomatically and are frequently treated with antibiotics, resulting in opportunities for pathogens to be exposed to antibiotics when not the target of treatment (i.e., bystander exposure). We quantified the frequency of bystander antibiotic exposures for enteric pathogens and estimated associations with resistance among children in eight low-resource settings. We analyzed 15,697 antibiotic courses from 1,715 children aged 0 to 2 y from the MAL-ED birth cohort. We calculated the incidence of bystander exposures and attributed exposures to respiratory and diarrheal illnesses. We associated bystander exposure with phenotypic susceptibility of E. coli isolates in the 30 d following exposure and at the level of the study site. There were 744.1 subclinical pathogen exposures to antibiotics per 100 child-years. Enteroaggregative Escherichia coli was the most frequently exposed pathogen, with 229.6 exposures per 100 child-years. Almost all antibiotic exposures for Campylobacter (98.8%), enterotoxigenic E. coli (95.6%), and typical enteropathogenic E. coli (99.4%), and the majority for Shigella (77.6%), occurred when the pathogens were not the target of treatment. Respiratory infections accounted for half (49.9%) and diarrheal illnesses accounted for one-fourth (24.6%) of subclinical enteric bacteria exposures to antibiotics. Bystander exposure of E. coli to class-specific antibiotics was associated with the prevalence of phenotypic resistance at the community level. Antimicrobial stewardship and illness-prevention interventions among children in low-resource settings would have a large ancillary benefit of reducing bystander selection that may contribute to antimicrobial resistance.
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spelling pubmed-94573952022-09-09 Frequency of bystander exposure to antibiotics for enteropathogenic bacteria among young children in low-resource settings Rogawski McQuade, Elizabeth T. Brennhofer, Stephanie A. Elwood, Sarah E. McMurry, Timothy L. Lewnard, Joseph A. Mduma, Estomih R. Shrestha, Sanjaya Iqbal, Najeeha Bessong, Pascal O. Kang, Gagandeep Kosek, Margaret Lima, Aldo A. M. Ahmed, Tahmeed Liu, Jie Houpt, Eric R. Platts-Mills, James A. Proc Natl Acad Sci U S A Biological Sciences Children in low-resource settings carry enteric pathogens asymptomatically and are frequently treated with antibiotics, resulting in opportunities for pathogens to be exposed to antibiotics when not the target of treatment (i.e., bystander exposure). We quantified the frequency of bystander antibiotic exposures for enteric pathogens and estimated associations with resistance among children in eight low-resource settings. We analyzed 15,697 antibiotic courses from 1,715 children aged 0 to 2 y from the MAL-ED birth cohort. We calculated the incidence of bystander exposures and attributed exposures to respiratory and diarrheal illnesses. We associated bystander exposure with phenotypic susceptibility of E. coli isolates in the 30 d following exposure and at the level of the study site. There were 744.1 subclinical pathogen exposures to antibiotics per 100 child-years. Enteroaggregative Escherichia coli was the most frequently exposed pathogen, with 229.6 exposures per 100 child-years. Almost all antibiotic exposures for Campylobacter (98.8%), enterotoxigenic E. coli (95.6%), and typical enteropathogenic E. coli (99.4%), and the majority for Shigella (77.6%), occurred when the pathogens were not the target of treatment. Respiratory infections accounted for half (49.9%) and diarrheal illnesses accounted for one-fourth (24.6%) of subclinical enteric bacteria exposures to antibiotics. Bystander exposure of E. coli to class-specific antibiotics was associated with the prevalence of phenotypic resistance at the community level. Antimicrobial stewardship and illness-prevention interventions among children in low-resource settings would have a large ancillary benefit of reducing bystander selection that may contribute to antimicrobial resistance. National Academy of Sciences 2022-08-29 2022-09-06 /pmc/articles/PMC9457395/ /pubmed/36037372 http://dx.doi.org/10.1073/pnas.2208972119 Text en Copyright © 2022 the Author(s). Published by PNAS. https://creativecommons.org/licenses/by/4.0/This open access article is distributed under Creative Commons Attribution License 4.0 (CC BY) (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Biological Sciences
Rogawski McQuade, Elizabeth T.
Brennhofer, Stephanie A.
Elwood, Sarah E.
McMurry, Timothy L.
Lewnard, Joseph A.
Mduma, Estomih R.
Shrestha, Sanjaya
Iqbal, Najeeha
Bessong, Pascal O.
Kang, Gagandeep
Kosek, Margaret
Lima, Aldo A. M.
Ahmed, Tahmeed
Liu, Jie
Houpt, Eric R.
Platts-Mills, James A.
Frequency of bystander exposure to antibiotics for enteropathogenic bacteria among young children in low-resource settings
title Frequency of bystander exposure to antibiotics for enteropathogenic bacteria among young children in low-resource settings
title_full Frequency of bystander exposure to antibiotics for enteropathogenic bacteria among young children in low-resource settings
title_fullStr Frequency of bystander exposure to antibiotics for enteropathogenic bacteria among young children in low-resource settings
title_full_unstemmed Frequency of bystander exposure to antibiotics for enteropathogenic bacteria among young children in low-resource settings
title_short Frequency of bystander exposure to antibiotics for enteropathogenic bacteria among young children in low-resource settings
title_sort frequency of bystander exposure to antibiotics for enteropathogenic bacteria among young children in low-resource settings
topic Biological Sciences
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9457395/
https://www.ncbi.nlm.nih.gov/pubmed/36037372
http://dx.doi.org/10.1073/pnas.2208972119
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