학술논문
Prevalence and factors associated with faecal carriage of extended-spectrum β-lactamase-producing Enterobacterales among peripartum women in the community in Cambodia
Document Type
Author
de Lauzanne, Agathe; Sreng, Navin; Foucaud, Elsa; Sok, Touch; Chon, Thida; Yem, Chhaily; Hak, Veasna; Heng, Sothada; Soda, Meng; Gouali, Malika; Nadimpalli, Maya; Inghammar, Malin; Rabenandrasana, Mamitina Alain Noah; Collard, Jean Marc; Vray, Muriel; Hello, Simon Le; Kerleguer, Alexandra; Piola, Patrice; Delarocque-Astagneau, Elisabeth; Guillemot, Didier; Huynh, Bich Tram; Borand, Laurence
Source
The Journal of antimicrobial chemotherapy EpiHealth: Epidemiology for Health. 77(10):2658-2666
Subject
Language
English
ISSN
1460-2091
Abstract
BACKGROUND: In Southeast-Asia, where many conditions associated with dissemination of ESBL-producing Enterobacterales (ESBL-E) in the community are met, data from the community are scarce but show high ESBL-E carriage prevalence. Maternal ESBL-E colonization is considered a risk factor for neonatal colonization, which is the first step towards developing neonatal sepsis. Despite this, ESBL-E carriage prevalence and its risk factors during pregnancy or postpartum remain undefined in Southeast-Asia. OBJECTIVES: To estimate the prevalence of ESBL-E faecal colonization among peripartum women in the community of an urban and a rural area in Cambodia, to investigate ESBL-E genomic characteristics and to identify associated risk factors. METHODS: Epidemiological data and faecal samples from 423 peripartum women were collected in an urban and rural areas in Cambodia (2015-16). Bacterial cultures, antibiotic susceptibility tests and ESBL gene sequencing were performed. Risk factor analysis was conducted using logistic regression. RESULTS: The prevalence of ESBL-E faecal carriage was 79.2% (95% CI 75.0%-82.8%) among which Escherichia coli (n = 315/335, 94.0%) were most frequent. All isolates were multidrug resistant. Among 318 ESBL-E, the genes most frequently detected were blaCTX-M-15 (41.5%), blaCTX-M-55 (24.8%), and blaCTX-M-27 (15.1%). Low income, undernutrition, multiparity, regular consumption of pork, dried meat, and raw vegetables, were associated with ESBL-E faecal carriage. CONCLUSIONS: The high prevalence of ESBL-E carriage observed among peripartum women in Southeast-Asia and the identified associated factors underline the urgent need for public health measures to address antimicrobial resistance, including a 'One Health' approach.