Prevalence and factors associated with faecal carriage of extended-spectrum β-lactamase-producing Enterobacterales among peripartum women in the community in Cambodia.
Journal
The Journal of antimicrobial chemotherapy
ISSN: 1460-2091
Titre abrégé: J Antimicrob Chemother
Pays: England
ID NLM: 7513617
Informations de publication
Date de publication:
30 09 2022
30 09 2022
Historique:
received:
18
01
2022
accepted:
09
06
2022
pubmed:
7
7
2022
medline:
5
10
2022
entrez:
6
7
2022
Statut:
ppublish
Résumé
In Southeast-Asia, where many conditions associated with dissemination of ESBL-producing Enterobacterales (ESBL-E) in the community are met, data from the community are scarce but show high ESBL-E carriage prevalence. Maternal ESBL-E colonization is considered a risk factor for neonatal colonization, which is the first step towards developing neonatal sepsis. Despite this, ESBL-E carriage prevalence and its risk factors during pregnancy or postpartum remain undefined in Southeast-Asia. To estimate the prevalence of ESBL-E faecal colonization among peripartum women in the community of an urban and a rural area in Cambodia, to investigate ESBL-E genomic characteristics and to identify associated risk factors. Epidemiological data and faecal samples from 423 peripartum women were collected in an urban and rural areas in Cambodia (2015-16). Bacterial cultures, antibiotic susceptibility tests and ESBL gene sequencing were performed. Risk factor analysis was conducted using logistic regression. The prevalence of ESBL-E faecal carriage was 79.2% (95% CI 75.0%-82.8%) among which Escherichia coli (n = 315/335, 94.0%) were most frequent. All isolates were multidrug resistant. Among 318 ESBL-E, the genes most frequently detected were blaCTX-M-15 (41.5%), blaCTX-M-55 (24.8%), and blaCTX-M-27 (15.1%). Low income, undernutrition, multiparity, regular consumption of pork, dried meat, and raw vegetables, were associated with ESBL-E faecal carriage. The high prevalence of ESBL-E carriage observed among peripartum women in Southeast-Asia and the identified associated factors underline the urgent need for public health measures to address antimicrobial resistance, including a 'One Health' approach.
Sections du résumé
BACKGROUND
In Southeast-Asia, where many conditions associated with dissemination of ESBL-producing Enterobacterales (ESBL-E) in the community are met, data from the community are scarce but show high ESBL-E carriage prevalence. Maternal ESBL-E colonization is considered a risk factor for neonatal colonization, which is the first step towards developing neonatal sepsis. Despite this, ESBL-E carriage prevalence and its risk factors during pregnancy or postpartum remain undefined in Southeast-Asia.
OBJECTIVES
To estimate the prevalence of ESBL-E faecal colonization among peripartum women in the community of an urban and a rural area in Cambodia, to investigate ESBL-E genomic characteristics and to identify associated risk factors.
METHODS
Epidemiological data and faecal samples from 423 peripartum women were collected in an urban and rural areas in Cambodia (2015-16). Bacterial cultures, antibiotic susceptibility tests and ESBL gene sequencing were performed. Risk factor analysis was conducted using logistic regression.
RESULTS
The prevalence of ESBL-E faecal carriage was 79.2% (95% CI 75.0%-82.8%) among which Escherichia coli (n = 315/335, 94.0%) were most frequent. All isolates were multidrug resistant. Among 318 ESBL-E, the genes most frequently detected were blaCTX-M-15 (41.5%), blaCTX-M-55 (24.8%), and blaCTX-M-27 (15.1%). Low income, undernutrition, multiparity, regular consumption of pork, dried meat, and raw vegetables, were associated with ESBL-E faecal carriage.
CONCLUSIONS
The high prevalence of ESBL-E carriage observed among peripartum women in Southeast-Asia and the identified associated factors underline the urgent need for public health measures to address antimicrobial resistance, including a 'One Health' approach.
Identifiants
pubmed: 35794710
pii: 6633015
doi: 10.1093/jac/dkac224
pmc: PMC9525094
doi:
Substances chimiques
Anti-Bacterial Agents
0
beta-Lactamases
EC 3.5.2.6
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2658-2666Subventions
Organisme : MSDAVENIR
Organisme : Institut Pasteur
Investigateurs
Andrianirina Zafitsara Zo
(AZ)
Marguerite Diatta
(M)
Jean Baptiste Diouf
(JB)
Fatoumata Diene Sarr
(FD)
Joseph Faye
(J)
Sophie Goyet
(S)
Perlinot Herindrainy
(P)
Elsa Kermorvant-Duchemin
(E)
Siyin Lach
(S)
Veronique Ngo
(V)
Michael Padget
(M)
Feno Manitra Jacob Rakotoarimanana
(FMJ)
Bodonirina Tanjona Raheliarivao
(BT)
Frédérique Randrianirina
(F)
Abdoulaye Seck
(A)
Arnaud Tarantola
(A)
Armya Abdou Youssouf
(AA)
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.
Références
J Obstet Gynaecol. 2018 May;38(4):448-453
pubmed: 29402148
J Antimicrob Chemother. 2015;70(6):1893-7
pubmed: 25681128
Clin Infect Dis. 2016 Aug 1;63(3):310-8
pubmed: 27143671
Pathog Glob Health. 2014 Jul;108(5):235-45
pubmed: 25146935
Lancet Infect Dis. 2005 Aug;5(8):481-93
pubmed: 16048717
Antimicrob Agents Chemother. 2015;59(6):3652-5
pubmed: 25845871
BMC Infect Dis. 2013 May 02;13:199
pubmed: 23638834
J Chemother. 2013 Dec;25(6):324-7
pubmed: 24091027
PLoS Med. 2021 Sep 28;18(9):e1003681
pubmed: 34582450
Front Microbiol. 2016 Sep 05;7:1374
pubmed: 27656166
Eur J Clin Microbiol Infect Dis. 2018 Jan;37(1):69-75
pubmed: 28918585
J Antimicrob Chemother. 2017 Feb;72(2):589-595
pubmed: 27789683
J Obstet Gynaecol. 2020 Aug;40(6):739-748
pubmed: 32648533
Int J Infect Dis. 2017 Nov;64:58-66
pubmed: 28890179
PLoS Med. 2013 Aug;10(8):e1001502
pubmed: 23976885
PLoS Med. 2007 May;4(5):e115
pubmed: 17472433
J Glob Antimicrob Resist. 2019 Dec;19:338-347
pubmed: 31212106
Lancet. 2008 Jan 19;371(9608):243-60
pubmed: 18207566
Pediatr Infect Dis J. 2002 Nov;21(11):1029-33
pubmed: 12442024
Clin Microbiol Rev. 2013 Oct;26(4):744-58
pubmed: 24092853
Emerg Infect Dis. 2019 Jan;25(1):
pubmed: 30561323
Clin Microbiol Infect. 2012 Mar;18(3):268-81
pubmed: 21793988
Emerg Infect Dis. 2018 Aug;24(8):1490-1496
pubmed: 30014842
Lancet Infect Dis. 2011 May;11(5):381-93
pubmed: 21530894
Antimicrob Resist Infect Control. 2017 Mar 24;6:30
pubmed: 28352463
Appl Environ Microbiol. 2015 May 1;81(9):3115-20
pubmed: 25724954
J Perinatol. 2015 Nov;35(11):907-12
pubmed: 26507147
PLoS One. 2018 Mar 1;13(3):e0193325
pubmed: 29494706
J Antimicrob Chemother. 2014 Aug;69(8):2230-7
pubmed: 24729603