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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/34770
Title: Colonization with Enterobacteriaceae producing ESBLs in children attending pre-school childcare facilities in the Lao People's Democratic Republic
Authors: Nicole Stoesser
Sivilay Xayaheuang
Manivanh Vongsouvath
Koukeo Phommasone
Ivo Elliott
Carlos Del Ojo Elias
Derrick W. Crook
Paul N. Newton
Yves Buisson
Sue J. Lee
David A.B. Dance
Nuffield Department of Clinical Medicine
Institut de la Francophonie pour la Médecine Tropicale
Mahosot Hospital
Mahidol University
Keywords: Medicine;Pharmacology, Toxicology and Pharmaceutics
Issue Date: 1-Jan-2014
Citation: Journal of Antimicrobial Chemotherapy. Vol.70, No.6 (2014), 1893-1897
Abstract: © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. 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 bla<inf>CTX-M</inf> and Klebsiella pneumoniae carrying bla<inf>SHV</inf> or bla<inf>CTX-M</inf>, 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.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84930513513&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/34770
ISSN: 14602091
03057453
Appears in Collections:Scopus 2011-2015

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