Prevalence of MDR organism (MDRO) carriage in children and their household members in Siem Reap Province, Cambodia

Author:

Singh Shweta R1,Mao Bunsoth2,Evdokimov Konstantin1,Tan Pisey3,Leab Phana3,Ong Rick1,Vonthanak Saphonn2,Tam Clarence C1,Hsu Li Yang14ORCID,Turner Paul35

Affiliation:

1. Saw Swee Hock School of Public Health, National University of Singapore, Singapore

2. University of Health Sciences, Phnom Penh, Cambodia

3. Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia

4. Yong Loo Lin School of Medicine, National University of Singapore, Singapore

5. Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK

Abstract

Abstract Background The rising incidence of infections caused by MDR organisms (MDROs) poses a significant public health threat. However, little has been reported regarding community MDRO carriage in low- and middle-income countries. Methods We conducted a cross-sectional study in Siem Reap, Cambodia comparing hospital-associated households, in which an index child (age: 2–14 years) had been hospitalized for at least 48 h in the preceding 2–4 weeks, with matched community households on the same street, in which no other child had a recent history of hospitalization. Participants were interviewed using a survey questionnaire and tested for carriage of MRSA, ESBL-producing Enterobacterales (ESBL-E) and carbapenemase-producing Enterobacterales (CPE) by culture followed by antibiotic susceptibility testing. We used logistic regression analysis to analyse associations between collected variables and MDRO carriage. Results Forty-two pairs of households including 376 participants with 376 nasal swabs and 290 stool specimens were included in final analysis. MRSA was isolated from 26 specimens (6.9%). ESBL-producing Escherichia coli was detected in 269 specimens (92.8%) whereas ESBL-producing Klebsiella pneumoniae was isolated from 128 specimens (44.1%), of which 123 (42.4%) were co-colonized with ESBL-producing E. coli. Six (2.1%) specimens tested positive for CPE (4 E. coli and 2 K. pneumoniae). The prevalence ratios for MRSA, ESBL-producing E. coli and ESBL-producing K. pneumoniae carriage did not differ significantly in hospital-associated households and hospitalized children compared with their counterparts. Conclusions The high prevalence of ESBL-E across both household types suggests that MDRO reservoirs are common in the community. Ongoing genomic analyses will help to understand the epidemiology and course of MDRO spread.

Funder

Infectious Diseases Programme, Saw Swee Hock School of Public Health (SSHSPH), National University of Singapore

Publisher

Oxford University Press (OUP)

Subject

General Medicine

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