Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, Rm E-8132, Baltimore, MD 21205, USA.
Am J Trop Med Hyg. 2010 May;82(5):879-88. doi: 10.4269/ajtmh.2010.09-0143.
Few studies have examined the influence of individual-, household-, and community-scale risk factors on carriage of resistant commensal bacteria. We determined children's medical, agricultural, and environmental exposures by household, pharmacy, and health facility surveys and Escherichia coli cultures of children, mothers' hands, household animals, and market chickens in Peru. Among 522 children with a positive stool culture, by log-binomial regression, using "any antibiotic" and 1-14 (versus 0) sulfa doses in the past 3 months increased children's risk, respectively, for ampicillin- and sulfamethoxazole-resistant E. coli carriage (P = 0.01-0.02). Each household member taking "any antibiotic" increased children's risk for sulfamethoxazole- and multidrug-resistant E. coli carriage (P < 0.0001). Residence in a zone where a larger proportion of households served home-raised chicken (as contrasted with intensively antibiotic-raised market chicken) protected against carrying E. coli resistant to all drugs (P = 0.0004-0.04). Environmental contamination with drug-resistant bacteria appeared to significantly contribute to children's carriage of antibiotic-resistant E. coli.
很少有研究探讨个体、家庭和社区层面的风险因素对携带耐药共生菌的影响。我们通过家庭、药店和医疗机构调查以及对秘鲁儿童、母亲手部、家庭动物和市场鸡肉的大肠杆菌培养来确定儿童的医疗、农业和环境暴露情况。在 522 名粪便培养阳性的儿童中，通过对数二项式回归分析，过去 3 个月中使用“任何抗生素”和 1-14 （而非 0 ）磺胺剂量分别增加了儿童携带氨苄青霉素和磺胺甲恶唑耐药大肠杆菌的风险（P 值分别为 0.01-0.02）。每个使用“任何抗生素”的家庭成员都会增加儿童携带磺胺甲恶唑和多药耐药大肠杆菌的风险（P < 0.0001）。居住在一个更大比例的家庭供应自家饲养的鸡（而非密集使用抗生素饲养的市场鸡）的区域，可预防携带所有药物耐药的大肠杆菌（P 值为 0.0004-0.04）。耐药细菌的环境污染似乎显著导致儿童携带抗生素耐药大肠杆菌。
