Antimicrobial resistance including Extended Spectrum Beta Lactamases (ESBL) among E. coli isolated from kenyan children at hospital discharge.
<h4>Background</h4>Children who have been discharged from hospital in sub-Saharan Africa remain at substantial risk of mortality in the post-discharge period. Antimicrobial resistance (AMR) may be an important factor. We sought to determine the prevalence and risk factors associated with...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-03-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0010283 |
| _version_ | 1811248423561592832 |
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| author | Stephanie N Tornberg-Belanger Doreen Rwigi Michael Mugo Lynnete Kitheka Nancy Onamu Derrick Ounga Mame M Diakhate Hannah E Atlas Anna Wald R Scott McClelland Olusegun O Soge Kirkby D Tickell Samuel Kariuki Benson O Singa Judd L Walson Patricia B Pavlinac |
| author_facet | Stephanie N Tornberg-Belanger Doreen Rwigi Michael Mugo Lynnete Kitheka Nancy Onamu Derrick Ounga Mame M Diakhate Hannah E Atlas Anna Wald R Scott McClelland Olusegun O Soge Kirkby D Tickell Samuel Kariuki Benson O Singa Judd L Walson Patricia B Pavlinac |
| author_sort | Stephanie N Tornberg-Belanger |
| collection | DOAJ |
| description | <h4>Background</h4>Children who have been discharged from hospital in sub-Saharan Africa remain at substantial risk of mortality in the post-discharge period. Antimicrobial resistance (AMR) may be an important factor. We sought to determine the prevalence and risk factors associated with AMR in commensal Escherichia coli (E. coli) from Kenyan children at the time of discharge.<h4>Methodology/principle findings</h4>Fecal samples were collected from 406 children aged 1-59 months in western Kenya at the time of discharge from hospital and cultured for E. coli. Susceptibility to ampicillin, ceftriaxone, cefotaxime, ceftazidime, cefoxitin, imipenem, ciprofloxacin, gentamicin, combined amoxicillin/clavulanic acid, trimethoprim-sulfamethoxazole, azithromycin, and chloramphenicol was determined by disc diffusion according to guidelines from the Clinical and Laboratory Standards Institute (CLSI). Poisson regression was used to determine associations between participant characteristics and the presence of extended-spectrum beta-lactamases (ESBL) producing E. coli. Non-susceptibility to ampicillin (95%), gentamicin (44%), ceftriaxone (46%), and the presence of ESBL (44%) was high. Receipt of antibiotics during the hospitalization was associated with the presence of ESBL (aPR = 2.23; 95% CI: 1.29-3.83) as was being hospitalized within the prior year (aPR = 1.32 [1.07-1.69]). Open defecation (aPR = 2.02; 95% CI: 1.39-2.94), having a toilet shared with other households (aPR = 1.49; 95% CI: 1.17-1.89), and being female (aPR = 1.42; 95% CI: 1.15-1.76) were associated with carriage of ESBL E. coli.<h4>Conclusions/significance</h4>AMR is common among isolates of E. coli from children at hospital discharge in Kenya, including nearly half having detectable ESBL. |
| first_indexed | 2024-04-12T15:27:48Z |
| format | Article |
| id | doaj.art-1d50ebe174874322a84574ba4e949bd6 |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-04-12T15:27:48Z |
| publishDate | 2022-03-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-1d50ebe174874322a84574ba4e949bd62022-12-22T03:27:12ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352022-03-01163e001028310.1371/journal.pntd.0010283Antimicrobial resistance including Extended Spectrum Beta Lactamases (ESBL) among E. coli isolated from kenyan children at hospital discharge.Stephanie N Tornberg-BelangerDoreen RwigiMichael MugoLynnete KithekaNancy OnamuDerrick OungaMame M DiakhateHannah E AtlasAnna WaldR Scott McClellandOlusegun O SogeKirkby D TickellSamuel KariukiBenson O SingaJudd L WalsonPatricia B Pavlinac<h4>Background</h4>Children who have been discharged from hospital in sub-Saharan Africa remain at substantial risk of mortality in the post-discharge period. Antimicrobial resistance (AMR) may be an important factor. We sought to determine the prevalence and risk factors associated with AMR in commensal Escherichia coli (E. coli) from Kenyan children at the time of discharge.<h4>Methodology/principle findings</h4>Fecal samples were collected from 406 children aged 1-59 months in western Kenya at the time of discharge from hospital and cultured for E. coli. Susceptibility to ampicillin, ceftriaxone, cefotaxime, ceftazidime, cefoxitin, imipenem, ciprofloxacin, gentamicin, combined amoxicillin/clavulanic acid, trimethoprim-sulfamethoxazole, azithromycin, and chloramphenicol was determined by disc diffusion according to guidelines from the Clinical and Laboratory Standards Institute (CLSI). Poisson regression was used to determine associations between participant characteristics and the presence of extended-spectrum beta-lactamases (ESBL) producing E. coli. Non-susceptibility to ampicillin (95%), gentamicin (44%), ceftriaxone (46%), and the presence of ESBL (44%) was high. Receipt of antibiotics during the hospitalization was associated with the presence of ESBL (aPR = 2.23; 95% CI: 1.29-3.83) as was being hospitalized within the prior year (aPR = 1.32 [1.07-1.69]). Open defecation (aPR = 2.02; 95% CI: 1.39-2.94), having a toilet shared with other households (aPR = 1.49; 95% CI: 1.17-1.89), and being female (aPR = 1.42; 95% CI: 1.15-1.76) were associated with carriage of ESBL E. coli.<h4>Conclusions/significance</h4>AMR is common among isolates of E. coli from children at hospital discharge in Kenya, including nearly half having detectable ESBL.https://doi.org/10.1371/journal.pntd.0010283 |
| spellingShingle | Stephanie N Tornberg-Belanger Doreen Rwigi Michael Mugo Lynnete Kitheka Nancy Onamu Derrick Ounga Mame M Diakhate Hannah E Atlas Anna Wald R Scott McClelland Olusegun O Soge Kirkby D Tickell Samuel Kariuki Benson O Singa Judd L Walson Patricia B Pavlinac Antimicrobial resistance including Extended Spectrum Beta Lactamases (ESBL) among E. coli isolated from kenyan children at hospital discharge. PLoS Neglected Tropical Diseases |
| title | Antimicrobial resistance including Extended Spectrum Beta Lactamases (ESBL) among E. coli isolated from kenyan children at hospital discharge. |
| title_full | Antimicrobial resistance including Extended Spectrum Beta Lactamases (ESBL) among E. coli isolated from kenyan children at hospital discharge. |
| title_fullStr | Antimicrobial resistance including Extended Spectrum Beta Lactamases (ESBL) among E. coli isolated from kenyan children at hospital discharge. |
| title_full_unstemmed | Antimicrobial resistance including Extended Spectrum Beta Lactamases (ESBL) among E. coli isolated from kenyan children at hospital discharge. |
| title_short | Antimicrobial resistance including Extended Spectrum Beta Lactamases (ESBL) among E. coli isolated from kenyan children at hospital discharge. |
| title_sort | antimicrobial resistance including extended spectrum beta lactamases esbl among e coli isolated from kenyan children at hospital discharge |
| url | https://doi.org/10.1371/journal.pntd.0010283 |
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