Department of Microbiology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
Optometry Department. Applied Medical Sciences Collage, King Saud University, P. O. Box 145111, Riyadh, Saudi Arabia.
Sci Rep. 2023 Aug 26;13(1):13975. doi: 10.1038/s41598-023-41174-6.
Antimicrobial and multidrug resistance (MDR) pathogens are becoming one of the major health threats among children. Integrated studies on the molecular epidemiology and prevalence of AMR and MDR diarrheal pathogens are lacking. A total of 404 fecal specimens were collected from children with diarrhea in Bangladesh from January 2019 to December 2021. We used conventional bacteriologic and molecular sequence analysis methods. Phenotypic and genotypic resistance were determined by disk diffusion and molecular sequencing methods. Fisher's exact tests with 95% confidence intervals (CIs) was performed. Prevalence of bacterial infection was 63% (251 of 404) among children with diarrhea. E. coli (29%) was the most prevalent. E. coli, Shigella spp., V. cholerae, and Salmonella spp., showed the highest frequency of resistance against ceftriaxone (75-85%), and erythromycin (70-75%%). About 10-20% isolates of E. coli, V. cholerae and Shigella spp. showed MDR against cephem, macrolides, and quinolones. Significant association (p value < 0.05) was found between the phenotypic and genotypic resistance. The risk of diarrhea was the highest among the patients co-infected with E. coli and rotavirus [OR 3.6 (95% CI 1.1-5.4) (p = 0.001)] followed by Shigella spp. and rotavirus [OR 3.5 (95% CI 0.5-5.3) (p = 0.001)]. This study will provide an integrated insight of molecular epidemiology and antimicrobial resistance profiling of bacterial pathogens among children with diarrhea in Bangladesh.
抗微生物药物和多药耐药（MDR）病原体正成为儿童面临的主要健康威胁之一。目前缺乏关于 AMR 和 MDR 腹泻病原体的分子流行病学和流行率的综合研究。本研究于 2019 年 1 月至 2021 年 12 月期间从孟加拉国腹泻儿童中收集了 404 份粪便标本。我们使用了常规的细菌学和分子序列分析方法。通过纸片扩散和分子测序方法确定表型和基因型耐药性。Fisher 确切检验（95%置信区间（CI））用于比较。腹泻儿童中细菌感染的患病率为 63%（251/404）。大肠杆菌（29%）是最常见的病原体。大肠杆菌、志贺氏菌属、霍乱弧菌和沙门氏菌属对头孢曲松（75-85%）和红霉素（70-75%）的耐药率最高。约 10-20%的大肠杆菌、霍乱弧菌和志贺氏菌属分离株对头孢菌素类、大环内酯类和喹诺酮类药物表现出 MDR。表型和基因型耐药之间存在显著相关性（p 值<0.05）。同时感染大肠杆菌和轮状病毒的患者腹泻风险最高[比值比（OR）3.6（95%CI 1.1-5.4）（p=0.001)]，其次是志贺氏菌属和轮状病毒[OR 3.5（95%CI 0.5-5.3）（p=0.001)]。本研究将为孟加拉国腹泻儿童中细菌病原体的分子流行病学和抗微生物药物耐药谱提供综合见解。
