Journal article
Colonization with Enterobacteriaceae producing ESBLs in children attending pre-school childcare facilities in the Lao People's Democratic Republic.
- Abstract:
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Objectives
Intestinal carriage constitutes an important reservoir of antimicrobial-resistant bacteria, with some of the highest rates reported from Asia. Antibiotic resistance has been little studied in Laos, where some antibiotics are available without restriction, but others such as carbapenems are not available.
Patients and methods
We collected stools from 397 healthy children in 12 randomly selected pre-school childcare facilities in and around Vientiane. Colonization with ESBL-producing Enterobacteriaceae (ESBLE) and carbapenemase-producing Enterobacteriaceae (CPE) was detected using a disc diffusion screening test and ESBLE were characterized using WGS. Risk factor data were collected by questionnaire.
Results
Ninety-two children (23%) were colonized with ESBLE, mainly Escherichia coli carrying blaCTX-M and Klebsiella pneumoniae carrying blaSHV or blaCTX-M, which were frequently resistant to multiple antibiotic classes. Although residence in Vientiane Capital, foreign travel, higher maternal level of education, antibiotic use in the preceding 3 months and attending a childcare facility with a ‘good’ level of hygiene were all associated with ESBLE colonization on univariable analysis, a significant association remained only for antibiotic use when a stepwise approach was used with a multivariate random-effects model. WGS analysis suggested transmission in both childcare facilities and community settings.
Conclusions
The high prevalence of paediatric colonization with ESBLE in Laos, one of the highest reported in Asia, is probably the result of inappropriate antibiotic use. Paediatric colonization with CPE was not identified in this study, but it is important to continue to monitor the spread of antibiotic-resistant Enterobacteriaceae in Laos.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, pdf, 280.4KB, Terms of use)
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- Publisher copy:
- 10.1093/jac/dkv021
Authors
- Publisher:
- Oxford University Press
- Journal:
- Journal of Antimicrobial Chemotherapy More from this journal
- Volume:
- 70
- Issue:
- 6
- Pages:
- 1893-1897
- Publication date:
- 2015-06-01
- DOI:
- EISSN:
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1460-2091
- ISSN:
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0305-7453
- Language:
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English
- Keywords:
- Pubs id:
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pubs:507983
- UUID:
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uuid:5802c1b3-3dce-4c40-a42f-06d51b18e9c2
- Local pid:
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pubs:507983
- Source identifiers:
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507983
- Deposit date:
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2015-12-26
Terms of use
- Copyright holder:
- Stoesser et al
- Copyright date:
- 2015
- Notes:
- #The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/ 4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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