Oakley T

Le B

da Conceicao V

Marr I

Maia C

Soares M

Belo JC

Sarmento N

da Silva E

Amaral S

Vaz Nery S

Lynar, Sarah

Francis, Joshua

Yan, Jennifer

2022-09-16

Invasive bacterial infections are a leading cause of death in children, primarily in low- and middle-income countries (LMIC). Links between carriage of antimicrobial-resistant organisms and more resistant infections have been established; however, little has been reported regarding community carriage of antibiotic-resistant organisms such as extended-spectrum β-lactamase (ESBL)-producing Enterobacterales in LMIC. The aim of this study was to determine colonic carriage of ESBL-producing fluoroquinolone- and aminoglycoside-resistant Enterobacterales in healthy children in three municipalities of Timor-Leste. In November 2020, 621 stool samples were collected from school-aged children and underwent screening for the presence of Enterobacterales species and antimicrobial resistance (AMR). Ciprofloxacin-resistant Gram-negative organisms were cultured from 16.5% (95% CI 6.2-26.9), and gentamicin resistance was identified in 6.8% (95% CI 2.8-10.7). Compared to the prevalence of ciprofloxacin resistance in Dili (36.1%), there was significantly lower prevalence in the rural municipalities of Ermera (12.9%; AOR 0.38, 95% CI 0.24-0.60, p < 0.001) and Manufahi (4.5%; AOR 0.07, 95% CI 0.01-0.51, p = 0.009). The overall cluster-adjusted prevalence of ESBL-producing bacteria was 8.3%, with no significant differences between municipalities. This study demonstrates high rates of carriage of AMR among school-aged children in Timor-Leste, with higher rates observed in Dili compared to rural municipalities. Empiric antibiotic guidelines should include recommendations for treating community-acquired infections that account for the possibility of antimicrobial resistance.

Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste.

The Kirby Institute, University of New South Wales, Sydney 2052, Australia.

The Canberra Hospital, Canberra 2605, Australia.

National Health Laboratory, Dili, Timor-Leste.

Royal Darwin Hospital, Darwin 0810, Australia.

Antibiotics (Basel). 2022 Sep 16;11(9):1262. doi: 10.3390/antibiotics11091262.

0000-0003-3263-879X

0000-0002-2399-7785

0000-0001-9302-4543

https://pubmed.ncbi.nlm.nih.gov/36140041/?otool=iaurydwlib

https://hdl.handle.net/10137/12279

11

Gastrointestinal Carriage of Antimicrobial Resistance in School-Aged Children in Three Municipalities of Timor-Leste.

Journal Article

Publication