Colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) and carbapenem-resistant Enterobacterales (CRE) in healthcare and community settings in Botswana: an antibiotic resistance in communities and hospitals (ARCH) study.

Autor:	Mannathoko N; University of Botswana, Gaborone, Botswana., Mosepele M; University of Botswana, Gaborone, Botswana., Gross R; Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Smith RM; Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA., Alby K; Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, USA., Glaser L; Department of Pathology and Laboratory Medicine, University Pennsylvania, Philadelphia, PA, USA., Richard-Greenblatt M; Department of Pathology and Laboratory Medicine, University Pennsylvania, Philadelphia, PA, USA., Dumm R; Department of Pathology and Laboratory Medicine, University Pennsylvania, Philadelphia, PA, USA., Sharma A; Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA., Jaskowiak-Barr A; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Cressman L; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Sewawa K; Botswana-University of Pennsylvania Partnership (BUP), Gaborone, Botswana., Cowden L; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Reesey E; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Otukile D; Botswana-University of Pennsylvania Partnership (BUP), Gaborone, Botswana., Paganotti GM; Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; University of Botswana, Gaborone, Botswana; Botswana-University of Pennsylvania Partnership (BUP), Gaborone, Botswana., Mokomane M; University of Botswana, Gaborone, Botswana., Lautenbach E; Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: ebbing@pennmedicine.upenn.edu.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2022 Sep; Vol. 122, pp. 313-320. Date of Electronic Publication: 2022 Jun 07.
DOI:	10.1016/j.ijid.2022.06.004
Abstrakt:	Objectives: Although extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) and carbapenem-resistant Enterobacterales (CRE) are a global challenge, data on these organisms in low- and middle-income countries are limited. In this study, we sought to characterize colonization data critical for greater antibiotic resistance surveillance efforts. Methods: This study was conducted in three hospitals and six clinics in Botswana. We conducted ongoing surveillance of adult patients in hospitals and clinics and adults and children in the community. All participants underwent rectal swab sampling to identify ESCrE and CRE. Results: Enrollment occurred from January 15, 2020, to September 4, 2020, but paused from April 2, 2020, to May 21, 2020, because of a countrywide COVID-19 lockdown. Of 5088 individuals approached, 2469 (49%) participated. ESCrE colonization prevalence was 30.7% overall (43% for hospital participants, 31% for clinic participants, 24% for adult community participants, and 26% for child community participants) (P <0.001). A total of 42 (1.7%) participants were colonized with CRE. CRE colonization prevalence was 1.7% overall (6.8% for hospital participants, 0.7% for clinic participants, 0.2% for adult community participants, and 0.5% for child community participants) (P <0.001). ESCrE and CRE prevalence varied substantially across regions and was significantly higher prelockdown versus postlockdown. Conclusions: ESCrE colonization was high in all settings in Botswana. CRE prevalence in hospitals was also considerable. Colonization prevalence varied by region and clinical setting and decreased after a countrywide lockdown. Competing Interests: Declaration of Competing Interest The authors report no conflicts of interest. (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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