Gut carriage of antimicrobial resistance genes among young children in urban Maputo, Mozambique: Associations with enteric pathogen carriage and environmental risk factors.
Anti-Bacterial Agents
/ pharmacology
Bacteremia
/ epidemiology
Bacteria
/ drug effects
Diarrhea
/ diagnosis
Drug Resistance, Bacterial
Feces
/ microbiology
Female
Gastrointestinal Microbiome
Humans
Infant
Lincosamides
/ pharmacology
Male
Mozambique
/ epidemiology
Poverty
Prevalence
Risk Factors
Streptogramins
/ pharmacology
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
28
06
2019
accepted:
05
11
2019
entrez:
23
11
2019
pubmed:
23
11
2019
medline:
21
3
2020
Statut:
epublish
Résumé
Because poor sanitation is hypothesized as a major direct and indirect pathway of exposure to antimicrobial resistance genes (ARGs), we sought to determine a) the prevalence of and b) environmental risk factors for gut carriage of key ARGs in a pediatric cohort at high risk of enteric infections due to poor water, sanitation, and hygiene (WASH) conditions. We investigated ARGs in stool from young children in crowded, low-income settlements of Maputo, Mozambique, and explored potential associations with concurrent enteric pathogen carriage, diarrhea, and environmental risk factors, including WASH. We collected stool from 120 children <14 months old and tested specimens via quantal, multiplex molecular assays for common bacterial, viral, and protozoan enteric pathogens and 84 ARGs encoding potential resistance to 7 antibiotic classes. We estimated associations between ARG detection (number and diversity detected) and concurrently-measured enteric pathogen carriage, recently-reported diarrhea, and risk factors in the child's living environment. The most commonly-detected ARGs encoded resistance to macrolides, lincosamides, and streptogramins (100% of children); tetracyclines (98%); β-lactams (94%), aminoglycosides (84%); fluoroquinolones (48%); and vancomycin (38%). Neither concurrent diarrhea nor measured environmental (including WASH) conditions were associated with ARG detection in adjusted models. Enteric pathogen carriage and ARG detection were associated: on average, 18% more ARGs were detected in stool from children carrying bacterial pathogens than those without (adjusted risk ratio (RR): 1.18, 95% confidence interval (CI): 1.02, 1.37), with 16% fewer ARGs detected in children carrying parasitic pathogens (protozoans, adjusted RR: 0.84, 95% CI: 0.71, 0.99). We observed gut ARGs conferring potential resistance to a range of antibiotics in this at-risk cohort that had high rates of enteric infection, even among children <14 months-old. Gut ARGs did not appear closely correlated with WASH, though environmental conditions were generally poor. ARG carriage may be associated with concurrent carriage of bacterial enteric pathogens, suggesting indirect linkages to WASH that merit further investigation.
Identifiants
pubmed: 31756196
doi: 10.1371/journal.pone.0225464
pii: PONE-D-19-18243
pmc: PMC6874316
doi:
Substances chimiques
Anti-Bacterial Agents
0
Lincosamides
0
Streptogramins
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0225464Subventions
Organisme : NIEHS NIH HHS
ID : P30 ES019776
Pays : United States
Organisme : NIEHS NIH HHS
ID : P50 ES026071
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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