Advertisement

 

 

Correlates of multi-drug non-susceptibility in enteric bacteria isolated from Kenyan children with acute diarrhea.

Correlates of multi-drug non-susceptibility in enteric bacteria isolated from Kenyan children with acute diarrhea.
Author Information (click to view)

Brander RL, Walson JL, John-Stewart GC, Naulikha JM, Ndonye J, Kipkemo N, Rwigi D, Singa BO, Pavlinac PB,


Brander RL, Walson JL, John-Stewart GC, Naulikha JM, Ndonye J, Kipkemo N, Rwigi D, Singa BO, Pavlinac PB, (click to view)

Brander RL, Walson JL, John-Stewart GC, Naulikha JM, Ndonye J, Kipkemo N, Rwigi D, Singa BO, Pavlinac PB,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

PLoS neglected tropical diseases 2017 10 0211(10) e0005974 doi 10.1371/journal.pntd.0005974

Abstract
BACKGROUND
Reduced antimicrobial susceptibility threatens treatment efficacy in sub-Saharan Africa, where data on the burden and correlates of antibiotic resistance among enteric pathogens are limited.

METHODS
Fecal samples from children aged 6 mos-15 yrs presenting with acute diarrhea in western Kenya were cultured for bacterial pathogens. HIV-uninfected children with identified Shigella or Salmonella species or pathogenic Escherichia coli (EPEC, ETEC, EAEC or EIEC) were included in this cross-sectional sub-study. Non-susceptibility to ampicillin, ceftriaxone, ciprofloxacin, cotrimoxazole, and tetracycline was determined using MicroScan Walkaway40 Plus. Multivariable log-binomial regression was used to identify correlates of multi-drug non-susceptibility (MDNS, non-susceptibility to ≥ 3 of these antibiotics).

RESULTS
Of 292 included children, median age was 22.5 mos. MDNS was identified in 62.5% of 318 isolates. Non-susceptibility to cotrimoxazole (92.8%), ampicillin (81.3%), and tetracycline (75.0%) was common. Young age (6-24 mos vs. 24-59 mos adjusted prevalence ratio [aPR] = 1.519 [95% confidence interval: 1.19, 1.91]), maternal HIV (aPR = 1.29 [1.01, 1.66]); and acute malnutrition (aPR = 1.28 [1.06, 1.55]) were associated with higher prevalence of MDNS, as were open defecation (aPR = 2.25 [1.13, 4.50]), household crowding (aPR = 1.29 [1.08, 1.53]) and infrequent caregiver hand-washing (aPR = 1.50 [1.15, 1.95]).

CONCLUSIONS
Young age, HIV exposure, acute malnutrition and poor sanitation may increase risk of antibiotic non-susceptible enteric pathogen infections among children in Kenya.

Submit a Comment

Your email address will not be published. Required fields are marked *

2 × three =

[ HIDE/SHOW ]