Laboratory of Microbiology, Department of Biochemistry and Microbiology, Ghent University, Ghent, Belgium.
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
PLoS Negl Trop Dis. 2024 Jun 4;18(6):e0012241. doi: 10.1371/journal.pntd.0012241. eCollection 2024 Jun.
Campylobacteriosis disproportionately affects children under five in low-income countries. However, epidemiological and antimicrobial resistance (AMR) information at the children-animal interface is lacking. We hypothesized that Campylobacter is a major cause of enteritis in children in Ethiopia, and contact with animals is a potential source of transmission. The objective of the study was to determine Campylobacter occurrence and its AMR in children under five with diarrhea, backyard farm animals, and companion pets. Stool from 303 children and feces from 711 animals were sampled. Campylobacter was isolated through membrane filtration on modified charcoal cefoperazone deoxycholate agar plates under microaerobic incubation, and the technique showed to be feasible for use in regions lacking organized laboratories. Typical isolates were characterized with MALDI-TOF MS and multiplex PCR. Of 303 children, 20% (n = 59) were infected, with a higher proportion in the 6 to 11-month age group. Campylobacter occurred in 64% (n = 14) of dogs and 44% (n = 112) of poultry. Campylobacter jejuni was present in both a child and animal species in 15% (n = 23) of 149 households positive for Campylobacter. MICs using the gradient strip diffusion test of 128 isolates displayed resistance rates of 20% to ciprofloxacin and 11% to doxycycline. MICs of ciprofloxacin and doxycycline varied between C. coli and C. jejuni, with higher resistance in C. coli and poultry isolates. Campylobacter infection in children and its prevalent excretion from backyard poultry and dogs is a understudied concern. The co-occurrence of C. jejuni in animals and children suggest household-level transmission As resistance to ciprofloxacin and doxycycline was observed, therapy of severe campylobacteriosis should consider susceptibility testing. Findings from this study can support evidence-based diagnosis, antimicrobial treatment, and further investigations on the spread of AMR mechanisms for informed One Health intervention.
空肠弯曲菌病在低收入国家 disproportionately 影响五岁以下儿童。然而，儿童-动物界面的流行病学和抗生素耐药性 (AMR) 信息却缺乏。我们假设空肠弯曲菌是埃塞俄比亚儿童肠炎的主要原因，而与动物接触是传播的潜在来源。本研究的目的是确定五岁以下腹泻儿童、后院农场动物和伴侣宠物中空肠弯曲菌的发生情况及其 AMR。采集了 303 名儿童的粪便和 711 只动物的粪便。通过在微需氧孵育下用改良的头孢哌酮去氧胆酸钠琼脂膜过滤法分离空肠弯曲菌，该技术在缺乏组织化实验室的地区显示出可行性。典型分离株用 MALDI-TOF MS 和多重 PCR 进行表征。在 303 名儿童中，20%（n=59）感染，6 至 11 个月龄组比例较高。狗中 64%（n=14）和家禽中 44%（n=112）出现空肠弯曲菌。在 149 个空肠弯曲菌阳性家庭中，有 15%（n=23）的儿童和动物物种同时存在空肠弯曲菌。对 128 株分离株进行梯度条带扩散试验 MICs 显示，环丙沙星耐药率为 20%，强力霉素耐药率为 11%。C. coli 和 C. jejuni 的环丙沙星和强力霉素 MIC 不同，C. coli 和家禽分离株的耐药性更高。儿童中空肠弯曲菌感染及其从后院家禽和狗中普遍排泄是一个研究不足的问题。动物和儿童中 C. jejuni 的共存提示家庭层面的传播。由于观察到对环丙沙星和强力霉素的耐药性，严重空肠弯曲菌病的治疗应考虑药敏试验。本研究结果可为基于证据的诊断、抗菌治疗以及进一步研究 AMR 机制的传播提供支持，以进行明智的 One Health 干预。
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