High Fecal Carriage of Multidrug Resistant Bacteria in the Community among Children in Northwestern Tanzania.
High Fecal Carriage of Multidrug Resistant Bacteria in the Community among Children in Northwestern Tanzania.
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DOI：
10.3390/pathogens11030379
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发表时间：
2022-03-21
期刊：
影响因子：
--
通讯作者：
Mshana SE
中科院分区：
文献类型：
--
作者：
Msanga DR;Silago V;Massoza T;Kidenya BR;Balandya E;Mirambo MM;Sunguya B;Mmbaga BT;Lyamuya E;Bartlet J;Mshana SE
多药耐药（MDR）细菌的定植与患有合并症的儿童随后的侵入性感染有关。本研究旨在确定坦桑尼亚姆万扎5岁以下HIV-和HIV+儿童的耐药性特征和与MDR病原体定植相关的因素。共招募了399名（HIV-255和HIV+ 144）儿童，并对MDR细菌的存在进行了调查。儿童的中位[IQR]年龄为19（10-36）个月。在27株鼻腔定植的金黄色葡萄球菌中，16株（59.5%）对甲氧西林耐药，而直肠拭子中132/278株（47.2%）肠杆菌科细菌对第三代头孢菌素耐药，其中69.7%（92/132）表现出超广谱β-内酰胺酶（ESBL）表型。对庆大霉素、阿莫西林/克拉维酸和美罗培南耐药的比例在艾滋病毒阳性儿童中明显高于艾滋病毒阴性儿童。最近一个月抗生素使用史OR 2.62 [1.1，6.9]（p = 0.04）和过去三个月来自同一家庭的亲属住院史OR 3.73 [1.1，13.2]（p = 0.03）独立预测ESBL直肠定植。HIV阳性儿童粪便携带的分离株对不常用的抗生素有明显的耐药性。有必要加强抗菌药物管理和感染预防和控制（IPC）计划，以防止MDR病原体在儿童中的出现和传播。
Colonization of multidrug resistant (MDR) bacteria is associated with subsequent invasive infections in children with comorbidities. This study aimed to determine the resistance profile and factors associated with MDR pathogen colonization among HIV−and HIV+ children below five years of age in Mwanza, Tanzania. A total of 399 (HIV− 255 and HIV+ 144) children were enrolled and investigated for the presence of MDR bacteria. The median [IQR] age of children was 19 (10–36) months. Out of 27 Staphylococcus aureus colonizing the nasal cavity, 16 (59.5%) were methicillin resistant while 132/278 (47.2%) of Enterobacteriaceae from rectal swabs were resistant to third generation cephalosporins, with 69.7% (92/132) exhibiting extended spectrum beta lactamase (ESBL) phenotypes. The proportion of resistance to gentamicin, amoxicillin/clavulanic acid and meropenem were significantly higher among HIV+ than HIV− children. A history of antibiotic use in the last month OR 2.62 [1.1, 6.9] (p = 0.04) and history of a relative admitted from the same household in the past three months OR 3.73 [1.1, 13.2] (p = 0.03) independently predicted ESBL rectal colonization. HIV+ children had significantly more fecal carriage of isolates resistant to uncommonly used antibiotics. There is a need to strengthen antimicrobial stewardship and Infection Prevention and Control (IPC) programs to prevent the emergence and spread of MDR pathogens in children.
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影响因子：
33.7
作者：
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通讯作者：
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作者：
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3.7
作者：
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通讯作者：
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