Pervasive Intestinal Carriage with Multiple Species of Extended-Spectrum Cephalosporin-Resistant Enterobacterales in Children Admitted for Severe Acute Malnutrition at a Tertiary Hospital in Malawi.
IF 1.6 4区 医学Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Thomas Holowka, Arrington Ashford, Trieu-Vi Khuu, Alisher Bimagambetov, Courtney N Dial, Alexander Kondwani, Amazing-Grace Tepeka, Kevin Alby, Jonathan J Juliano, Anthony J Garcia-Prats, Tisungane Mvalo, Bryan J Vonasek, Emily J Ciccone, Luther A Bartelt
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引用次数: 0
Abstract
Malnutrition is a leading risk factor for community-derived Enterobacterales bacteremia, which has a high rate of mortality in children in sub-Saharan Africa (SSA). International guidelines recommend the use of antibiotics, such as amoxicillin, for children with uncomplicated severe acute malnutrition (SAM), as well as parenteral broad-spectrum antibiotics, such as cephalosporins, for children with SAM who are admitted to the hospital. However, rising rates of infection with extended-spectrum cephalosporin-resistant Enterobacterales (ESCR-E) in SSA call this practice into question. To determine ESCR-E colonization rates, culture-based screening was performed on stool specimens collected from a cohort of children admitted to a hospital in Lilongwe, Malawi, for SAM. Of 188 individuals screened, 80.3% were positive for ESCR-E colonization, and 38.3% were colonized with multiple ESCR-E species. These findings reveal that high rates of ESCR-E colonization exist in some populations of malnourished children in SSA, and guideline-directed empiric antibiotic treatment may need to be reevaluated in this setting.
期刊介绍：
The American Journal of Tropical Medicine and Hygiene, established in 1921, is published monthly by the American Society of Tropical Medicine and Hygiene. It is among the top-ranked tropical medicine journals in the world publishing original scientific articles and the latest science covering new research with an emphasis on population, clinical and laboratory science and the application of technology in the fields of tropical medicine, parasitology, immunology, infectious diseases, epidemiology, basic and molecular biology, virology and international medicine.
The Journal publishes unsolicited peer-reviewed manuscripts, review articles, short reports, images in Clinical Tropical Medicine, case studies, reports on the efficacy of new drugs and methods of treatment, prevention and control methodologies,new testing methods and equipment, book reports and Letters to the Editor. Topics range from applied epidemiology in such relevant areas as AIDS to the molecular biology of vaccine development.
The Journal is of interest to epidemiologists, parasitologists, virologists, clinicians, entomologists and public health officials who are concerned with health issues of the tropics, developing nations and emerging infectious diseases. Major granting institutions including philanthropic and governmental institutions active in the public health field, and medical and scientific libraries throughout the world purchase the Journal.
Two or more supplements to the Journal on topics of special interest are published annually. These supplements represent comprehensive and multidisciplinary discussions of issues of concern to tropical disease specialists and health issues of developing countries
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