Publication: Epidemiology of paediatric gastrointestinal colonisation by extended spectrum cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae isolates in north-west Cambodia
Issued Date
2019-03-12
Resource Type
ISSN
14712180
Other identifier(s)
2-s2.0-85062851190
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMC Microbiology. Vol.19, No.1 (2019)
Suggested Citation
J. J. Van Aartsen, C. E. Moore, C. M. Parry, P. Turner, N. Phot, S. Mao, K. Suy, T. Davies, A. Giess, A. E. Sheppard, T. E.A. Peto, N. P.J. Day, D. W. Crook, A. S. Walker, N. Stoesser Epidemiology of paediatric gastrointestinal colonisation by extended spectrum cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae isolates in north-west Cambodia. BMC Microbiology. Vol.19, No.1 (2019). doi:10.1186/s12866-019-1431-9 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51090
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Epidemiology of paediatric gastrointestinal colonisation by extended spectrum cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae isolates in north-west Cambodia
Abstract
© 2019 The Author(s). Background: Extended-spectrum cephalosporin resistance (ESC-R) in Escherichia coli and Klebsiella pneumoniae is a healthcare threat; high gastrointestinal carriage rates are reported from South-east Asia. Colonisation prevalence data in Cambodia are lacking. The aim of this study was to determine gastrointestinal colonisation prevalence of ESC-resistant E. coli (ESC-R-EC) and K. pneumoniae (ESC-R-KP) in Cambodian children/adolescents and associated socio-demographic risk factors; and to characterise relevant resistance genes, their genetic contexts, and the genetic relatedness of ESC-R strains using whole genome sequencing (WGS). Results: Faeces and questionnaire data were obtained from individuals < 16 years in north-western Cambodia, 2012. WGS of cultured ESC-R-EC/KP was performed (Illumina). Maximum likelihood phylogenies were used to characterise relatedness of isolates; ESC-R-associated resistance genes and their genetic contexts were identified from de novo assemblies using BLASTn and automated/manual annotation. 82/148 (55%) of children/adolescents were ESC-R-EC/KP colonised; 12/148 (8%) were co-colonised with both species. Independent risk factors for colonisation were hospitalisation (OR: 3.12, 95% CI [1.52-6.38]) and intestinal parasites (OR: 3.11 [1.29-7.51]); school attendance conferred decreased risk (OR: 0.44 [0.21-0.92]. ESC-R strains were diverse; the commonest ESC-R mechanisms were bla CTX-M 1 and 9 sub-family variants. Structures flanking these genes were highly variable, and for bla CTX-M-15, - 55 and - 27 frequently involved IS26. Chromosomal bla CTX-M integration was common in E. coli. Conclusions: Gastrointestinal ESC-R-EC/KP colonisation is widespread in Cambodian children/adolescents; hospital admission and intestinal parasites are independent risk factors. The genetic contexts of bla CTX-M are highly mosaic, consistent with rapid horizontal exchange. Chromosomal integration of bla CTX-M may result in stable propagation in these community-associated pathogens.