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- Title
Gastrointestinal Carriage of Antimicrobial Resistance in School-Aged Children in Three Municipalities of Timor-Leste.
- Authors
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
- Abstract
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.
- Subjects
TIMOR-Leste; SCHOOL children; DRUG resistance in microorganisms; CITIES &; towns; CHILD mortality; COMMUNITY-acquired infections
- Publication
Antibiotics (2079-6382), 2022, Vol 11, Issue 9, p1262
- ISSN
2079-6382
- Publication type
Article
- DOI
10.3390/antibiotics11091262