Dynamics of antimicrobial resistance in intestinal Escherichia coli from children in community settings in South Asia and sub-Saharan Africa
PublisherNature Publishing Group
MetadataShow full item record
AbstractThe dynamics of antimicrobial resistance (AMR) in developing countries are poorly understood, especially in community settings, due to a sparsity of data on AMR prevalence and genetics. We used a combination of phenotyping, genomics and antimicrobial usage data to investigate patterns of AMR amongst atypical enteropathogenic Escherichia coli (aEPEC) strains isolated from children younger than five years old in seven developing countries (four in sub-Saharan Africa and three in South Asia) over a three-year period. We detected high rates of AMR, with 65% of isolates displaying resistance to three or more drug classes. Whole-genome sequencing revealed a diversity of known genetic mechanisms for AMR that accounted for >95% of phenotypic resistance, with comparable rates amongst aEPEC strains associated with diarrhoea or asymptomatic carriage. Genetic determinants of AMR were associated with the geographic location of isolates, not E. coli lineage, and AMR genes were frequently co-located, potentially enabling the acquisition of multi-drug resistance in a single step. Comparison of AMR with antimicrobial usage data showed that the prevalence of resistance to fluoroquinolones and third-generation cephalosporins was correlated with usage, which was higher in South Asia than in Africa. This study provides much-needed insights into the frequency and mechanisms of AMR in intestinal E. coli in children living in community settings in developing countries. © 2018, The Author(s).
SponsorsThis work was supported by the NHMRC of Australia (Project Grants 1043830 to K.E.H., and 1009296 and 1067428 to R.M.R-B.; Fellowship 1061409 to K.E.H.) and the Bill & Melinda Gates Foundation (Grant 38874 to M.M.L.).
enteropathogenic Escherichia coli
whole genome sequencing
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85052381939&origin=inward; http://hdl.handle.net/10713/9858
- Genomic landscape of extended-spectrum β-lactamase resistance in Escherichia coli from an urban African setting.
- Authors: Musicha P, Feasey NA, Cain AK, Kallonen T, Chaguza C, Peno C, Khonga M, Thompson S, Gray KJ, Mather AE, Heyderman RS, Everett DB, Thomson NR, Msefula CL
- Issue date: 2017 Jun 1
- Characteristics of diarrheagenic Escherichia coli among children under 5 years of age with acute diarrhea: a hospital based study.
- Authors: Zhou Y, Zhu X, Hou H, Lu Y, Yu J, Mao L, Mao L, Sun Z
- Issue date: 2018 Feb 1
- Antibiotic resistance, ESBL genes, integrons, phylogenetic groups and MLVA profiles of Escherichia coli pathotypes isolated from patients with diarrhea and farm animals in south-east of Iran.
- Authors: Taghadosi R, Shakibaie MR, Hosseini-Nave H
- Issue date: 2019 Apr
- Phenotypic and genetic features of enteropathogenic Escherichia coli isolates from diarrheal children in the Ribeirão Preto metropolitan area, São Paulo State, Brazil.
- Authors: Pitondo-Silva A, Nakazato G, Falcão JP, Irino K, Martinez R, Darini AL, Hernandes RT
- Issue date: 2015 Feb
- Reduced rates of antimicrobial resistance in Staphylococcus intermedius group and Escherichia coli isolated from diseased companion animals in an animal hospital after restriction of antimicrobial use.
- Authors: Kurita G, Tsuyuki Y, Murata Y, Takahashi T, Veterinary Infection Control Association (VICA) AMR Working Group.
- Issue date: 2019 Jul