4.6 Article

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

期刊

ANTIBIOTICS-BASEL
卷 11, 期 9, 页码 -

出版社

MDPI
DOI: 10.3390/antibiotics11091262

关键词

AMR; colonisation; multidrug-resistant; E; coli; Enterobacterales; ESBL; third-generation cephalosporins

资金

  1. Fleming Fund Country Grant for Timor-Leste [FF/17/233]

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This study investigated the carriage of ESBL-producing antibiotic-resistant Enterobacterales in healthy children in Timor-Leste. The results showed high rates of carriage of antibiotic-resistant organisms among school-aged children, with higher rates in urban areas compared to rural areas. This highlights the need for antibiotic guidelines that consider the possibility of antimicrobial resistance.
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 beta-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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