Alta prevalencia de mecanismos de resistencia antimicrobiana en un hospital rural etíope

IF 2.6 4区医学 Q2 PEDIATRICS

Anales de pediatria Pub Date : 2026-05-01 Epub Date: 2026-04-14 DOI:10.1016/j.anpedi.2026.504227

María Teresa Alvaredo-Carrillo , Elena Hidalgo Cardeñoso , Icíar Ochoa-Chamorro , Mieraf Fita , Habte Hussein-Elemo , Gebriel Tisyamo , Ramón Pérez-Tanoira

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Abstract

Introduction

To determine the prevalence of fecal carriage of antimicrobial resistance (AMR) genes in 40 pediatric inpatients managed in a rural hospital in Ethiopia (May-June 2024).

Patients and Methods

We conducted a prospective study in 40 pediatric inpatients managed at Gambo Rural General Hospital, Oromia, Ethiopia (May-June 2024). Stool samples were collected to assess for intestinal carriage and screened using the Allplex™ Entero-DR multiplex PCR assay for genes associated with carbapenemase-producing Enterobacterales (CPE), extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales, and vancomycin-resistant Enterococcus (VRE). We collected data on demographic and clinical characteristics and antibiotic exposure. The statistical analysis included the Mann-Whitney U and Fisher's exact tests.

Results

Fecal carriage of AMR genes was detected in 82.5% of patients. The most prevalent resistance mechanism was CTX-M (80.0%), followed by NDM (37.5%), vanA (32.5%), and VIM (10.0%). Testing did not detect KPC, OXA-48, IMP, or vanB genes. Malnutrition was present in 65% of the patients. There were no statistically significant differences in clinical outcomes (length of stay, severity) between patients with and without AMR genes (P > .05 in all comparisons; limited by the sample size of n = 40). Severe chronic malnutrition was less frequent among carbapenemase carriers (12.5% vs 62.5%; P = .033). This exploratory finding should be interpreted with extreme caution due to multiple testing, low statistical power (n = 40), and potential sources of bias including altered gut microbiota, reduced health care exposure among severely malnourished children, or chance. These observations only describe colonization patterns and cannot be used to infer causality.

Conclusions

We found a high prevalence of fecal carriage of AMR genes in stool samples from pediatric inpatients in this hospital in rural Ethiopia, underscoring the need for enhanced surveillance, stewardship, and infection control measures in resource-limited settings.

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埃塞俄比亚农村医院抗菌素耐药性机制高流行率

前言：测定埃塞俄比亚某农村医院2024年5 - 6月收治的40例儿科住院患者粪便携带抗微生物药物耐药性（AMR）基因的流行情况。患者和方法我们对埃塞俄比亚奥罗米亚Gambo农村总医院的40名儿科住院患者进行了一项前瞻性研究（2024年5月至6月）。收集粪便样本以评估肠道运输情况，并使用Allplex™Entero-DR多重PCR法筛选产碳青霉烯酶肠杆菌（CPE）、产广谱β -内酰胺酶肠杆菌（ESBL）和耐万古霉素肠球菌（VRE）相关基因。我们收集了人口统计学和临床特征以及抗生素暴露的数据。统计分析包括Mann-Whitney U和Fisher的精确检验。结果82.5%的患者粪便中检出AMR基因。耐药机制以CTX-M为主（80.0%），其次为NDM（37.5%）、vanA（32.5%）和VIM（10.0%）。检测未检测到KPC、OXA-48、IMP或vanB基因。65%的患者存在营养不良。携带和不携带AMR基因的患者的临床结局（住院时间、严重程度）无统计学差异（所有比较P >； 0.05；受限于n = 40的样本量）。碳青霉烯酶携带者的严重慢性营养不良发生率较低（12.5% vs 62.5%; P = 0.033）。这一探索性发现应该非常谨慎地解释，因为多次测试，低统计能力（n = 40），以及潜在的偏倚来源，包括肠道微生物群的改变，严重营养不良儿童的医疗保健暴露减少，或偶然。这些观察结果只描述了殖民模式，不能用来推断因果关系。结论：我们发现来自埃塞俄比亚农村该医院儿科住院患者的粪便样本中AMR基因的粪便携带率很高，这强调了在资源有限的情况下加强监测、管理和感染控制措施的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anales de pediatria 医学-小儿科

CiteScore

2.10

自引率

4.80%

发文量

155

审稿时长

44 days

期刊介绍： La Asociación Española de Pediatría tiene como uno de sus objetivos principales la difusión de información científica rigurosa y actualizada sobre las distintas áreas de la pediatría. Anales de Pediatría es el Órgano de Expresión Científica de la Asociación y constituye el vehículo a través del cual se comunican los asociados. Publica trabajos originales sobre investigación clínica en pediatría procedentes de España y países latinoamericanos, así como artículos de revisión elaborados por los mejores profesionales de cada especialidad, las comunicaciones del congreso anual y los libros de actas de la Asociación, y guías de actuación elaboradas por las diferentes Sociedades/Secciones Especializadas integradas en la Asociación Española de Pediatría.