Wilmore, SMS;
Kranzer, K;
Williams, A;
Makamure, B;
Nhidza, AF;
Mayini, J;
Bandason, T;
... Ferrand, RA; + view all
(2017)
Carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae in HIV-infected children in Zimbabwe.
Journal of Medical Microbiology
, 66
(5)
pp. 609-615.
10.1099/jmm.0.000474.
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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 (86.6 %) 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 (13.7 %); 50 % of all ESBL-Es were resistant to amoxicillin-clavulanate, 100 % to co-trimoxazole, 45.8 % to chloramphenicol, 91.6 % to ceftriaxone, 20.8 % to gentamicin and 62.5 % to ciprofloxacin. ESBL-Es variously encoded CTX-M, OXA, TEM and SHV enzymes. The odds of ESBL-E carriage were 8.5 times (95 % CI 2.2–32.3) higher in those on ART for less than one year (versus longer) and 8.5 times (95 % CI 1.1–32.3) higher in those recently hospitalized for a chest infection. Conclusion. We found a 13.7 % 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.
| Type: | Article |
|---|---|
| Title: | Carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae in HIV-infected children in Zimbabwe |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1099/jmm.0.000474 |
| Publisher version: | http://doi.org/10.1099/jmm.0.000474 |
| Language: | English |
| Additional information: | This work is licensed under a Creative Commons Attribution 3.0 License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/3.0/ |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Microbiology, antimicrobial resistance, Africa, extended-spectrum, beta-lactamase Enterobacteriaceae, ESBL, HIV, ESCHERICHIA-COLI, FECAL CARRIAGE, RESISTANCE, COMMUNITY, AFRICA |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1556989 |
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