High Burden of Intestinal Colonization With Antimicrobial-Resistant Bacteria in Chile: An Antibiotic Resistance in Communities and Hospitals (ARCH) Study

Journal
Clinical Infectious Diseases
ISSN
1058-4838
1537-6591
Date Issued
2023
Author(s)
Rachel M Smith
Ashley Styczynski
Felipe Sánchez
Lea Maureira
Catalina Paredes
Maite González
Maria Spencer-Sandino
Anne Peters
Ayesha Khan
Dino Sepulveda
Loreto Rojas Wettig
María Luisa Rioseco
Pedro Usedo
Pamela Rojas Soto
Laura Andrea Huidobro
Catterina Ferreccio
Benjamin J Park
Eduardo Undurraga
Erika M C D’Agata
Alejandro Jara
Type
Resource Types::text::journal::journal article
Scopus ID
2-s2.0-85163969642
WoS ID
WOS:001026057200011
DOI
URL
URL Institutional Repository
Abstract
<jats:title>Abstract</jats:title>
<jats:sec>
<jats:title>Background</jats:title>
<jats:p>Antimicrobial resistance is a global threat, heavily impacting low- and middle-income countries. This study estimated antimicrobial-resistant gram-negative bacteria (GNB) fecal colonization prevalence in hospitalized and community-dwelling adults in Chile before the coronavirus disease 2019 pandemic.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>From December 2018 to May 2019, we enrolled hospitalized adults in 4 public hospitals and community dwellers from central Chile, who provided fecal specimens and epidemiological information. Samples were plated onto MacConkey agar with ciprofloxacin or ceftazidime added. All recovered morphotypes were identified and characterized according to the following phenotypes: fluoroquinolone-resistant (FQR), extended-spectrum cephalosporin-resistant (ESCR), carbapenem-resistant (CR), or multidrug-resistant (MDR; as per Centers for Disease Control and Prevention criteria) GNB. Categories were not mutually exclusive.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>A total of 775 hospitalized adults and 357 community dwellers were enrolled. Among hospitalized subjects, the prevalence of colonization with FQR, ESCR, CR, or MDR-GNB was 46.4% (95% confidence interval [CI], 42.9–50.0), 41.2% (95% CI, 37.7–44.6), 14.5% (95% CI, 12.0–16.9), and 26.3% (95% CI, 23.2–29.4). In the community, the prevalence of FQR, ESCR, CR, and MDR-GNB colonization was 39.5% (95% CI, 34.4–44.6), 28.9% (95% CI, 24.2–33.6), 5.6% (95% CI, 3.2–8.0), and 4.8% (95% CI, 2.6–7.0), respectively.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>A high burden of antimicrobial-resistant GNB colonization was observed in this sample of hospitalized and community-dwelling adults, suggesting that the community is a relevant source of antibiotic resistance. Efforts are needed to understand the relatedness between resistant strains circulating in the community and hospitals.</jats:p>
</jats:sec>
Cite this document
Araos, R., Smith, R. M., Styczynski, A., Sánchez, F., Acevedo, J., Maureira, L., Paredes, C., González, M., Rivas, L., Spencer-Sandino, M., Peters, A., Khan, A., Sepulveda, D., Wettig, L. R., Rioseco, M. L., Usedo, P., Soto, P. R., Huidobro, L. A., Ferreccio, C., … Munita, J. M. (2023). High burden of intestinal colonization with antimicrobial-resistant bacteria in chile: An antibiotic resistance in communities and hospitals (Arch) study. Clinical Infectious Diseases, 77(Supplement_1), S75-S81. https://doi.org/10.1093/cid/ciad283
Project(s)
Subjects
antimicrobial-resistance

; 

colonization

; 

community

; 

gram-negative

; 

latin america

; 

anti-bacterial agents

; 

anti-infective agents

; 

bacteria

; 

carbapenems

; 

cephalosporins

; 

chile

; 

covid-19

; 

drug resistance, microbial

; 

drug resistance, multiple, bacterial

; 

fluoroquinolones

; 

gram-negative bacteria

; 

gram-negative bacterial infections

; 

hospitals

; 

humans

; 

risk factors

; 

antiinfective agent

; 

carbapenem

; 

carbapenemase

; 

ceftazidime

; 

cephalosporin

; 

cephalosporin derivative

; 

ciprofloxacin

; 

antiinfective agent

; 

carbapenem derivative

; 

quinolone derivative

; 

adult

; 

antibiotic resistance

; 

antibiotic sensitivity

; 

article

; 

bacterial colonization

; 

bacterial growth

; 

bacterial strain

; 

carbapenem resistance

; 

cephalosporin resistance

; 

charlson comorbidity index

; 

chile

; 

clinical study

; 

community dwelling person

; 

controlled study

; 

coronavirus disease 2019

; 

cross-sectional study

; 

desorption

; 

disease control

; 

feces

; 

female

; 

fluoroquinolone resistance

; 

gram negative bacterium

; 

hospital patient

; 

hospital personnel

; 

hospitalization

; 

human

; 

major clinical study

; 

male

; 

middle aged

; 

middle income country

; 

morphotype

; 

multidrug resistant gram negative bacterium

; 

nonhuman

; 

pandemic

; 

phenotype

; 

point prevalence

; 

polymerase chain reaction

; 

prevalence

; 

public hospital

; 

questionnaire

; 

self concept

; 

antibiotic resistance

; 

bacterium

; 

chile

; 

coronavirus disease 2019

; 

epidemiology

; 

gram negative infection

; 

hospital

; 

multidrug resistance

; 

risk factor