Okumu Noah O, Muloi Dishon M, Moodley Arshnee, Ochien'g Linnet, Watson Julie, Kiarie Alice, Ngeranwa Joseph J N, Cumming Oliver, Cook Elizabeth A J
Animal and Human Health Department, International Livestock Research Institute, Nairobi, Kenya; Department of Biochemistry, Biotechnology and Microbiology, Kenyatta University, Kenya.
Animal and Human Health Department, International Livestock Research Institute, Nairobi, Kenya; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom.
Int J Antimicrob Agents. 2025 Mar;65(3):107419. doi: 10.1016/j.ijantimicag.2024.107419. Epub 2024 Dec 24.
Peri-urban environments, characterized by dense human populations, cohabiting livestock, and complex food systems, serve as hotspots for food contamination and infectious diseases. Children aged 6-24 months are particularly vulnerable, as they often encounter contaminated food and water, increasing their risk of food-borne disease, with diarrhea being a common symptom. We investigated the prevalence of antimicrobial resistance (AMR) in pathogenic Escherichia coli from children 6-24 months of age, their food, and cohabiting livestock, in Dagoretti South subcounty in Nairobi, Kenya. Of 540 stools, 296 livestock feces, and 859 food samples collected from 585 randomly enrolled households, 16% harbored diarrheagenic E. coli (DEC) pathotypes. The predominant AMR phenotypes observed were trimethoprim-sulfamethoxazole, ampicillin, and tetracycline at 53%, 48% and 41%, respectively. Diarrheagenic E. coli from children showed significantly higher resistance to all antibiotics compared to those from livestock and food. Overall, 30% of the 274 DEC isolates from all three sources exhibited multidrug resistance. Network analysis of AMR co-occurrence revealed two clusters: (1) ampicillin, trimethoprim-sulfamethoxazole, tetracycline, amoxicillin/clavulanic acid, and chloramphenicol; and (2) nalidixic acid, ciprofloxacin, gentamicin, and ceftriaxone. The co-resistance backbone of ampicillin-trimethoprim/sulfamethoxazole-tetracycline was significantly higher among isolates from children than from other hosts (χ² = 29.858, df = 2, adjusted P < 0.05). Logistic regression analysis revealed that on-site disposal of animal manure and garbage, along with a recent history of diarrhea, were significantly associated with AMR carriage in children (P < 0.05). These findings emphasize the need for One Health interventions to curb emergence and spread of AMR in these close-contact populations.
城郊环境人口密集、牲畜与人同居且食物系统复杂，是食物污染和传染病的高发区。6至24个月大的儿童尤为脆弱，因为他们经常接触受污染的食物和水，增加了食源性疾病的风险，腹泻是常见症状。我们调查了肯尼亚内罗毕达戈雷蒂南区6至24个月大儿童、他们的食物以及同居牲畜中致病性大肠杆菌的抗菌药物耐药性（AMR）流行情况。从585个随机入选家庭收集的540份粪便、296份牲畜粪便和859份食物样本中，16%含有致泻性大肠杆菌（DEC）致病型。观察到的主要AMR表型分别为甲氧苄啶-磺胺甲恶唑、氨苄西林和四环素，比例分别为53%、48%和41%。与牲畜和食物来源的致泻性大肠杆菌相比，儿童来源的对所有抗生素的耐药性显著更高。总体而言，来自所有三个来源的274株DEC分离株中有30%表现出多重耐药性。AMR共现的网络分析显示有两个聚类：（1）氨苄西林、甲氧苄啶-磺胺甲恶唑、四环素、阿莫西林/克拉维酸和氯霉素；（2）萘啶酸、环丙沙星、庆大霉素和头孢曲松。儿童分离株中氨苄西林-甲氧苄啶/磺胺甲恶唑-四环素的共耐药主干显著高于其他宿主（χ² = 29.858，自由度 = 2，校正P < 0.05）。逻辑回归分析显示，动物粪便和垃圾的现场处理以及近期腹泻史与儿童AMR携带显著相关（P < 0.05）。这些发现强调了采取“同一健康”干预措施以遏制这些密切接触人群中AMR出现和传播的必要性。
