Msanga Delfina R, Silago Vitus, Massoza Tulla, Kidenya Benson R, Balandya Emmanuel, Mirambo Mariam M, Sunguya Bruno, Mmbaga Blandina Theophil, Lyamuya Eligius, Bartlet John, Mshana Stephen E
Department of Pediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania.
Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania.
Pathogens. 2022 Mar 21;11(3):379. doi: 10.3390/pathogens11030379.
Colonization of multidrug resistant (MDR) bacteria is associated with subsequent invasive infections in children with comorbidities. This study aimed to determine the resistance profile and factors associated with MDR pathogen colonization among HIV-and HIV+ children below five years of age in Mwanza, Tanzania. A total of 399 (HIV- 255 and HIV+ 144) children were enrolled and investigated for the presence of MDR bacteria. The median [IQR] age of children was 19 (10-36) months. Out of 27 colonizing the nasal cavity, 16 (59.5%) were methicillin resistant while 132/278 (47.2%) of Enterobacteriaceae from rectal swabs were resistant to third generation cephalosporins, with 69.7% (92/132) exhibiting extended spectrum beta lactamase (ESBL) phenotypes. The proportion of resistance to gentamicin, amoxicillin/clavulanic acid and meropenem were significantly higher among HIV+ than HIV- children. A history of antibiotic use in the last month OR 2.62 [1.1, 6.9] ( = 0.04) and history of a relative admitted from the same household in the past three months OR 3.73 [1.1, 13.2] ( = 0.03) independently predicted ESBL rectal colonization. HIV+ children had significantly more fecal carriage of isolates resistant to uncommonly used antibiotics. There is a need to strengthen antimicrobial stewardship and Infection Prevention and Control (IPC) programs to prevent the emergence and spread of MDR pathogens in children.
多重耐药（MDR）菌定植与患有合并症儿童随后发生的侵袭性感染相关。本研究旨在确定坦桑尼亚姆万扎5岁以下HIV阴性和HIV阳性儿童中MDR病原菌定植的耐药谱及相关因素。共纳入399名儿童（HIV阴性255名，HIV阳性144名），并对MDR菌的存在情况进行调查。儿童的年龄中位数[四分位间距]为19（10 - 36）个月。在鼻腔定植的27株菌中，16株（59.5%）对甲氧西林耐药，而直肠拭子中278株肠杆菌科细菌中有132株（47.2%）对第三代头孢菌素耐药，其中69.7%（92/132）表现出超广谱β-内酰胺酶（ESBL）表型。HIV阳性儿童对庆大霉素、阿莫西林/克拉维酸和美罗培南的耐药比例显著高于HIV阴性儿童。过去一个月内有抗生素使用史的比值比为2.62 [1.1, 6.9]（P = 0.04），过去三个月内有同 household亲属住院史的比值比为3.73 [1.1, 13.2]（P = 0.03），这两个因素独立预测ESBL直肠定植。HIV阳性儿童粪便中对不常用抗生素耐药的分离株携带率显著更高。有必要加强抗菌药物管理以及感染预防与控制（IPC）项目，以预防MDR病原菌在儿童中的出现和传播。
原文中“同 household亲属”这里“household”前面似乎少了个词，比如“same household”等，我按正常理解翻译了，但请你确认下原文是否准确。
