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Gastrointestinal Carriage of Antimicrobial Resistance in School-Aged Children in Three Municipalities of Timor-Leste

Invasive bacterial infections are a leading cause of death in children, primarily in low- and middle-income countries (LMIC). Links between carriage of antimicrobial-resistant organisms and more resistant infections have been established; however, little has been reported regarding community carriag...

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Autores principales: Oakley, Tessa, Le, Brandon, da Conceicao, Virginia, Marr, Ian, Maia, Carolina, Soares, Messias, Belo, Joana Correia, Sarmento, Nevio, da Silva, Endang, Amaral, Salvador, Vaz Nery, Susana, Lynar, Sarah, Francis, Joshua R., Yan, Jennifer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495830/
https://www.ncbi.nlm.nih.gov/pubmed/36140041
http://dx.doi.org/10.3390/antibiotics11091262
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author Oakley, Tessa
Le, Brandon
da Conceicao, Virginia
Marr, Ian
Maia, Carolina
Soares, Messias
Belo, Joana Correia
Sarmento, Nevio
da Silva, Endang
Amaral, Salvador
Vaz Nery, Susana
Lynar, Sarah
Francis, Joshua R.
Yan, Jennifer
author_facet Oakley, Tessa
Le, Brandon
da Conceicao, Virginia
Marr, Ian
Maia, Carolina
Soares, Messias
Belo, Joana Correia
Sarmento, Nevio
da Silva, Endang
Amaral, Salvador
Vaz Nery, Susana
Lynar, Sarah
Francis, Joshua R.
Yan, Jennifer
author_sort Oakley, Tessa
collection PubMed
description Invasive bacterial infections are a leading cause of death in children, primarily in low- and middle-income countries (LMIC). Links between carriage of antimicrobial-resistant organisms and more resistant infections have been established; however, little has been reported regarding community carriage of antibiotic-resistant organisms such as extended-spectrum β-lactamase (ESBL)-producing Enterobacterales in LMIC. The aim of this study was to determine colonic carriage of ESBL-producing fluoroquinolone- and aminoglycoside-resistant Enterobacterales in healthy children in three municipalities of Timor-Leste. In November 2020, 621 stool samples were collected from school-aged children and underwent screening for the presence of Enterobacterales species and antimicrobial resistance (AMR). Ciprofloxacin-resistant Gram-negative organisms were cultured from 16.5% (95% CI 6.2–26.9), and gentamicin resistance was identified in 6.8% (95% CI 2.8–10.7). Compared to the prevalence of ciprofloxacin resistance in Dili (36.1%), there was significantly lower prevalence in the rural municipalities of Ermera (12.9%; AOR 0.38, 95% CI 0.24–0.60, p < 0.001) and Manufahi (4.5%; AOR 0.07, 95% CI 0.01–0.51, p = 0.009). The overall cluster-adjusted prevalence of ESBL-producing bacteria was 8.3%, with no significant differences between municipalities. This study demonstrates high rates of carriage of AMR among school-aged children in Timor-Leste, with higher rates observed in Dili compared to rural municipalities. Empiric antibiotic guidelines should include recommendations for treating community-acquired infections that account for the possibility of antimicrobial resistance.
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spelling pubmed-94958302022-09-23 Gastrointestinal Carriage of Antimicrobial Resistance in School-Aged Children in Three Municipalities of Timor-Leste Oakley, Tessa Le, Brandon da Conceicao, Virginia Marr, Ian Maia, Carolina Soares, Messias Belo, Joana Correia Sarmento, Nevio da Silva, Endang Amaral, Salvador Vaz Nery, Susana Lynar, Sarah Francis, Joshua R. Yan, Jennifer Antibiotics (Basel) Article Invasive bacterial infections are a leading cause of death in children, primarily in low- and middle-income countries (LMIC). Links between carriage of antimicrobial-resistant organisms and more resistant infections have been established; however, little has been reported regarding community carriage of antibiotic-resistant organisms such as extended-spectrum β-lactamase (ESBL)-producing Enterobacterales in LMIC. The aim of this study was to determine colonic carriage of ESBL-producing fluoroquinolone- and aminoglycoside-resistant Enterobacterales in healthy children in three municipalities of Timor-Leste. In November 2020, 621 stool samples were collected from school-aged children and underwent screening for the presence of Enterobacterales species and antimicrobial resistance (AMR). Ciprofloxacin-resistant Gram-negative organisms were cultured from 16.5% (95% CI 6.2–26.9), and gentamicin resistance was identified in 6.8% (95% CI 2.8–10.7). Compared to the prevalence of ciprofloxacin resistance in Dili (36.1%), there was significantly lower prevalence in the rural municipalities of Ermera (12.9%; AOR 0.38, 95% CI 0.24–0.60, p < 0.001) and Manufahi (4.5%; AOR 0.07, 95% CI 0.01–0.51, p = 0.009). The overall cluster-adjusted prevalence of ESBL-producing bacteria was 8.3%, with no significant differences between municipalities. This study demonstrates high rates of carriage of AMR among school-aged children in Timor-Leste, with higher rates observed in Dili compared to rural municipalities. Empiric antibiotic guidelines should include recommendations for treating community-acquired infections that account for the possibility of antimicrobial resistance. MDPI 2022-09-16 /pmc/articles/PMC9495830/ /pubmed/36140041 http://dx.doi.org/10.3390/antibiotics11091262 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Oakley, Tessa
Le, Brandon
da Conceicao, Virginia
Marr, Ian
Maia, Carolina
Soares, Messias
Belo, Joana Correia
Sarmento, Nevio
da Silva, Endang
Amaral, Salvador
Vaz Nery, Susana
Lynar, Sarah
Francis, Joshua R.
Yan, Jennifer
Gastrointestinal Carriage of Antimicrobial Resistance in School-Aged Children in Three Municipalities of Timor-Leste
title Gastrointestinal Carriage of Antimicrobial Resistance in School-Aged Children in Three Municipalities of Timor-Leste
title_full Gastrointestinal Carriage of Antimicrobial Resistance in School-Aged Children in Three Municipalities of Timor-Leste
title_fullStr Gastrointestinal Carriage of Antimicrobial Resistance in School-Aged Children in Three Municipalities of Timor-Leste
title_full_unstemmed Gastrointestinal Carriage of Antimicrobial Resistance in School-Aged Children in Three Municipalities of Timor-Leste
title_short Gastrointestinal Carriage of Antimicrobial Resistance in School-Aged Children in Three Municipalities of Timor-Leste
title_sort gastrointestinal carriage of antimicrobial resistance in school-aged children in three municipalities of timor-leste
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495830/
https://www.ncbi.nlm.nih.gov/pubmed/36140041
http://dx.doi.org/10.3390/antibiotics11091262
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