Carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae in HIV-infected children in Zimbabwe.
J Med Microbiol
; 66(5): 609-615, 2017 May.
Article
em En
| MEDLINE
| ID: mdl-28513417
ABSTRACT
BACKGROUND:
Antimicrobial resistance is an emerging global health issue. Data on the epidemiology of multidrug-resistant organisms are scarce for Africa, especially in HIV-infected individuals who often have frequent contact with healthcare. We investigated the prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) carriage in stool among HIV-infected children attending an HIV outpatient department in Harare, Zimbabwe.METHODS:
We recruited children who were stable on antiretroviral therapy (ART) attending a HIV clinic from August 2014 to June 2015. Information was collected on antibiotic use and hospitalization. Stool was tested for ESBL-E through combination disc diffusion. API20E identification and antimicrobial susceptibility was performed on the positive samples followed by whole genome sequencing.RESULTS:
Stool was collected from 175/202 (86.6â%) children. Median age was 11 [inter-quartile range (IQR) 9-12] years. Median time on ART was 4.6 years (IQR 2.4-6.4). ESBL-Es were found in 24/175 samples (13.7â%); 50â% of all ESBL-Es were resistant to amoxicillin-clavulanate, 100â% to co-trimoxazole, 45.8â% to chloramphenicol, 91.6â% to ceftriaxone, 20.8â% to gentamicin and 62.5â% to ciprofloxacin. ESBL-Es variously encoded CTX-M, OXA, TEM and SHV enzymes. The odds of ESBL-E carriage were 8.5 times (95â% CI 2.2-32.3) higher in those on ART for less than one year (versus longer) and 8.5 times (95â% CI 1.1-32.3) higher in those recently hospitalized for a chest infection.CONCLUSION:
We found a 13.7â% prevalence of ESBL-E carriage in a population where ESBL-E carriage has not been described previously. Antimicrobial resistance (AMR) in Africa merits further study, particularly given the high HIV prevalence and limited diagnostic and therapeutic options available.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Beta-Lactamases
/
Portador Sadio
/
Infecções por HIV
/
Enterobacteriaceae
/
Infecções por Enterobacteriaceae
Tipo de estudo:
Prevalence_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Female
/
Humans
/
Male
País/Região como assunto:
Africa
Idioma:
En
Revista:
J Med Microbiol
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Reino Unido