Singh Shweta R, Mao Bunsoth, Evdokimov Konstantin, Tan Pisey, Leab Phana, Ong Rick, Vonthanak Saphonn, Tam Clarence C, Hsu Li Yang, Turner Paul
Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
University of Health Sciences, Phnom Penh, Cambodia.
JAC Antimicrob Resist. 2020 Dec 4;2(4):dlaa097. doi: 10.1093/jacamr/dlaa097. eCollection 2020 Dec.
The rising incidence of infections caused by MDR organisms (MDROs) poses a significant public health threat. However, little has been reported regarding community MDRO carriage in low- and middle-income countries.
We conducted a cross-sectional study in Siem Reap, Cambodia comparing hospital-associated households, in which an index child (age: 2-14 years) had been hospitalized for at least 48 h in the preceding 2-4 weeks, with matched community households on the same street, in which no other child had a recent history of hospitalization. Participants were interviewed using a survey questionnaire and tested for carriage of MRSA, ESBL-producing Enterobacterales (ESBL-E) and carbapenemase-producing Enterobacterales (CPE) by culture followed by antibiotic susceptibility testing. We used logistic regression analysis to analyse associations between collected variables and MDRO carriage.
Forty-two pairs of households including 376 participants with 376 nasal swabs and 290 stool specimens were included in final analysis. MRSA was isolated from 26 specimens (6.9%). ESBL-producing was detected in 269 specimens (92.8%) whereas ESBL-producing was isolated from 128 specimens (44.1%), of which 123 (42.4%) were co-colonized with ESBL-producing Six (2.1%) specimens tested positive for CPE (4 and 2 ). The prevalence ratios for MRSA, ESBL-producing and ESBL-producing carriage did not differ significantly in hospital-associated households and hospitalized children compared with their counterparts.
The high prevalence of ESBL-E across both household types suggests that MDRO reservoirs are common in the community. Ongoing genomic analyses will help to understand the epidemiology and course of MDRO spread.
耐多药微生物（MDROs）引起的感染发病率不断上升，对公共卫生构成重大威胁。然而，关于低收入和中等收入国家社区MDRO携带情况的报道较少。
我们在柬埔寨暹粒进行了一项横断面研究，比较医院关联家庭（在前2至4周内，索引儿童（年龄：2至14岁）住院至少48小时）与同街道匹配的社区家庭（该街道上没有其他儿童近期有住院史）。使用调查问卷对参与者进行访谈，并通过培养随后进行抗生素敏感性测试来检测耐甲氧西林金黄色葡萄球菌（MRSA）、产超广谱β-内酰胺酶肠杆菌科细菌（ESBL-E）和产碳青霉烯酶肠杆菌科细菌（CPE）的携带情况。我们使用逻辑回归分析来分析收集的变量与MDRO携带之间的关联。
最终分析纳入了42对家庭，包括376名参与者，共采集了376份鼻拭子和290份粪便标本。从26份标本（6.9%）中分离出MRSA。在269份标本（92.8%）中检测出产ESBL- ，而从128份标本（44.1%）中分离出产ESBL- ，其中123份（42.4%）与产ESBL- 共同定植。6份标本（2.1%）CPE检测呈阳性（4份 和2份 ）。与对照相比，医院关联家庭和住院儿童中MRSA、产ESBL- 和产ESBL- 携带的患病率没有显著差异。
两种家庭类型中产ESBL-E的高患病率表明MDRO储存库在社区中很常见。正在进行的基因组分析将有助于了解MDRO传播的流行病学和过程。
