University of Washington, Seattle, Washington.
Facultad de Salud Publica y Adminstración, Universidad Peruana Cayetano Heredia, Lima, Peru.
Am J Trop Med Hyg. 2019 Jun;100(6):1363-1368. doi: 10.4269/ajtmh.18-0776.
Antibiotic resistance in pathogenic bacteria is a serious public health issue. The growing threat is a cause for concern and action to prevent the emergence of new resistant strains and the spread of existing ones to humans via the environment. This study aimed at identifying fecal pathogens in drinking water obtained from rural Andean households from Cajamarca, Peru, and measuring the antibiotic resistance profile of . The study was embedded within a community-randomized controlled trial among 102 communities in the northern highlands of the Cajamarca region, Peru. Of 314 samples, 55.4% (95% CI [49.7, 61.0], = 174) were identified as thermotolerant coliforms. Among the samples positive for thermotolerant coliform, was isolated in 37.3% ( = 117), spp in 8.0% ( = 25), spp in 5.1% ( = 16), and spp in 2.5% ( = 8). Of the 117 samples, 48.7% (95% CI [39.4, 58.1], = 57) showed resistance to any antibiotic. The antibiotic resistance profile showed highest resistance against tetracycline (37.6%), ampicillin (34.2%), sulfamethoxazole-trimethoprim (21.4%), and nalidixic acid (13%). Some 19.7% (95% CI [12.9, 28.0], = 23) of the isolates displayed multidrug resistance, defined as resistance to at least three classes of antibiotics. The CTX-M-3 gene, which encodes extended-spectrum resistance to beta-lactamase antibiotics, was found in one isolate. The high prevalence of fecal contamination in drinking water highlights the importance of household water treatment methods. Likewise, the high levels of antibiotic resistance found indicate a need for further research to identify the origins of potential environmental contamination, misuse, or inadequate disposal of antibiotics.
秘鲁 Cajamarca 地区农村社区的一项横断面研究
肠道病原体在食源性致病菌中具有重要的公共卫生意义。这些耐药菌的出现和传播,对人类健康构成了严重威胁。本研究旨在检测秘鲁 Cajamarca 地区北部农村家庭饮用水中的肠道病原体,并分析其耐药谱。
该研究是一项在秘鲁 Cajamarca 北部高地 102 个社区开展的社区随机对照试验的一部分。共采集了 314 份水样,结果显示 55.4%(95%CI [49.7, 61.0], = 174)为耐热大肠菌群。在耐热大肠菌群阳性的水样中, 分离率为 37.3%( = 117), spp 为 8.0%( = 25), spp 为 5.1%( = 16), spp 为 2.5%( = 8)。在 117 株 中,48.7%(95%CI [39.4, 58.1], = 57)对至少一种抗生素耐药。耐药谱分析显示, 对四环素(37.6%)、氨苄西林(34.2%)、复方磺胺甲噁唑(21.4%)和萘啶酸(13%)的耐药率最高。19.7%(95%CI [12.9, 28.0], = 23)的 分离株表现为多重耐药,即至少对三类抗生素耐药。研究还在一株 中发现了 CTX-M-3 基因,该基因编码对β-内酰胺类抗生素的扩展谱耐药性。饮用水中粪便污染的高检出率提示家庭水处理方法的重要性。此外,检测到的高耐药率表明需要进一步研究以确定潜在的环境污染来源、抗生素的不合理使用或处置不当。