Prevalence of Colonization With Antibiotic-Resistant Organisms in Hospitalized and Community Individuals in Bangladesh, a Phenotypic Analysis: Findings From the Antibiotic Resistance in Communities and Hospitals (ARCH) Study

作者：Fahmida Khatun Chowdhury, Syeda Mah‐E‐Muneer, Susan Bollinger, Aditya Sharma, Dilruba Ahmed, Kamal Hossain, Md Zakiul Hassan, Muhammad Aziz Rahman, Daniel S. VanderEnde, Debashis Sen, Palash Mozumder, Amin Ahmed Khan, Moushumi Sarker, Rachel M. Smith, Ashley Styczynski, Ulzii-Orshikh Luvsansharav · 发表于：Clinical Infectious Diseases · 年份：2023 · DOI：10.1093/cid/ciad254 · 被引用次数：26 · 研究领域：Antibiotic Resistance in Bacteria、Antibiotic Use and Resistance、Antimicrobial Resistance in Staphylococcus

BACKGROUND: Low- and middle-income countries bear a disproportionate burden of antimicrobial resistance (AMR) but often lack adequate surveillance to inform mitigation efforts. Colonization can be a useful metric to understand AMR burden. We assessed the colonization prevalence of Enterobacterales with resistance to extended-spectrum cephalosporins, carbapenems, colistin, and methicillin-resistant Staphylococcus aureus among hospital and community dwellers. METHODS: Between April and October 2019, we conducted a period prevalence study in Dhaka, Bangladesh. We collected stool and nasal specimens from adults in 3 hospitals and from community dwellers within the hospitals' catchment area. Specimens were plated on selective agar plates. Isolates underwent identification and antibiotic susceptibility testing using Vitek 2. We performed descriptive analysis and determined population prevalence estimates accounting for clustering at the community level. RESULTS: The majority of both community and hospital participants were colonized with Enterobacterales with resistance to extended-spectrum cephalosporins (78%; 95% confidence interval [95% CI], 73-83; and 82%; 95% CI, 79-85, respectively). Thirty-seven percent (95% CI, 34-41) of hospitalized patients were colonized with carbapenems compared with 9% (95% CI, 6-13) of community individuals. Colistin colonization prevalence was 11% (95% CI, 8-14) in the community versus 7% (95% CI, 6-10) in the hospital. Methicillin-resistant Staphylo...