• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文学位 >Antibiotic resistant E. coli in children in rural Tanzania: Characterizing spatial and temporal patterns and risk factors for resistance.
【24h】

Antibiotic resistant E. coli in children in rural Tanzania: Characterizing spatial and temporal patterns and risk factors for resistance.

机译：坦桑尼亚农村地区儿童的抗生素耐药性大肠杆菌：表征耐药性的时空格局和危险因素。

获取原文
获取原文并翻译 | 示例
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background: Diarrheal infections are a significant cause of morbidity and mortality in young children in low-income countries. Enteroaggregative, enteropathogenic, and enterotoxigenic E. coli contribute significantly to the burden of diarrheal infections. Antibiotic resistance is increasingly common among bacterial pathogens including pathogenic E. coli. We monitored resistance to seven antibiotics in pathogenic and nonpathogenic fecal E. coli collected from young children participating in the PRET+ Study in rural Tanzania.;Methods: Mass drug treatment with azithromycin (MDA) was administered in 4 villages and four geographically matched communities served as controls. Rectal swabs were collected during cross-sectional surveys performed at baseline, 1-, 3-, and 6-months after MDA. Diarrheal stool samples were collected during the first 4 months of the study. E. coli isolated from fecal specimens were screened for susceptibility to azithromycin by E-test and erythromycin, ampicillin, amoxicillin/clavulanic acid, chloramphenicol, ciprofloxacin, and trimethoprim/sulfamethoxazole by disk diffusion. Diarrheagenic E. coli strains were identified using a multiplex polymerase chain reaction assay. We used logistic regression, hierarchical cluster analysis and spatial analysis techniques to assess the impact of antibiotic exposure and characterize the longitudinal patterns of carriage of antibiotic-resistant and pathogenic E. coli strains.;Results: MDA exposure was highly associated with azithromycin resistance carriage at 1-, 3-, and 6-months post-MDA. Carriage of ampicillin and trimethoprim/sulfamethoxazole resistant isolates was highly prevalent and ciprofloxacin resistance was rare. Resistance to nearly all antibiotics tested and multi-drug resistance occurred more frequently in pathogenic isolates. We found significant spatial and temporal variability in antibiotic-resistant and pathogenic E. coli carriage, but did not find consistent, statistically significant evidence of spatial clustering of antibiotic resistant or pathogenic E. coli in this population.;Conclusions: Our study supports the hypothesis that MDA results in significantly increased macrolide resistance carriage. While MDA is effective for trachoma elimination, it is not without costs; thus it is essential to monitor resistance. The suggested linkage between resistance and virulence in E. coli suggests hygiene and sanitation interventions could play a dual role in controlling transmission of pathogenic and antibiotic resistant strains. Broader study of human, animal, water and environmental samples may fill gaps in our understanding of antibiotic-resistant and pathogenic E. coli transmission.
机译：背景：腹泻感染是低收入国家幼儿发病和死亡的重要原因。肠集合性，肠致病性和产肠毒素的大肠杆菌对腹泻感染的负担有很大贡献。在包括病原性大肠杆菌在内的细菌病原体中，抗生素耐药性越来越普遍。我们监测了从参与坦桑尼亚农村地区PRET +研究的幼儿收集的致病性和非致病性粪便大肠杆菌中对7种抗生素的抗药性。方法：在4个村庄进行了阿奇霉素（MDA）大规模药物治疗，并在四个地理上相匹配的社区中进行了研究控件。在MDA基线，1、3和6个月时进行横断面调查期间收集直肠拭子。在研究的前4个月中收集腹泻的粪便样本。通过E-test对粪便标本中分离出的大肠杆菌进行敏感性检测，通过纸片扩散法对红霉素，氨苄青霉素，阿莫西林/克拉维酸，氯霉素，环丙沙星和甲氧苄啶/磺胺甲恶唑对阿奇霉素的敏感性进行筛选。使用多重聚合酶链反应测定法鉴定了腹泻性大肠杆菌菌株。我们使用逻辑回归，层次聚类分析和空间分析技术评估了抗生素暴露的影响并表征了耐药性和病原性大肠杆菌菌株携带的纵向模式。结果：MDA暴露与阿奇霉素耐药性携带高度相关。 MDA之后的1、3和6个月。氨苄西林和耐甲氧苄氨嘧啶/磺胺甲基异恶唑的分离株高度流行，对环丙沙星的耐药性很少见。在致病性分离物中，几乎所有测试的抗生素耐药性和多药耐药性发生率更高。我们发现抗生素抗性和致病性大肠杆菌的运输具有明显的时空变异性，但没有发现该人群中抗生素抗性或致病性大肠杆菌的空间聚集的一致的，统计上显着的证据。结论：我们的研究支持该假设MDA导致大环内酯类抗药性显着提高。虽然MDA可以有效消除沙眼，但并非没有代价。因此，监控电阻至关重要。大肠杆菌中耐药性和毒力之间的联系暗示，卫生和卫生干预措施可以在控制病原性和抗生素耐药性菌株的传播中发挥双重作用。对人类，动物，水和环境样品的更广泛研究可能填补了我们对抗生素耐药性和病原性大肠杆菌传播的理解的空白。

著录项

  • 作者

    Seidman, Jessica Couvillion.;

  • 作者单位

    The Johns Hopkins University.;

  • 授予单位 The Johns Hopkins University.;
  • 学科 Public health.;Microbiology.;Statistics.;African studies.
  • 学位 Ph.D.
  • 年度 2013
  • 页码 160 p.
  • 总页数 160
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号