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Correlates of multi-drug non-susceptibility in enteric bacteria isolated from Kenyan children with acute diarrhea
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نویسنده
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brander r.l. ,walson j.l. ,john-stewart g.c. ,naulikha j.m. ,ndonye j. ,kipkemoi n. ,rwigi d. ,singa b.o. ,pavlinac p.b.
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منبع
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plos neglected tropical diseases - 2017 - دوره : 11 - شماره : 10
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چکیده
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Background: reduced antimicrobial susceptibility threatens treatment efficacy in sub-saharan africa,where data on the burden and correlates of antibiotic resistance among enteric pathogens are limited. methods: fecal samples from children aged 6 mos—15 yrs presenting with acute diarrhea in western kenya were cultured for bacterial pathogens. hiv-uninfected children with identified shigella or salmonella species or pathogenic escherichia coli (epec,etec,eaec or eiec) were included in this cross-sectional sub-study. non-susceptibility to ampicillin,ceftriaxone,ciprofloxacin,cotrimoxazole,and tetracycline was determined using microscan walkaway40 plus. multivariable log-binomial regression was used to identify correlates of multi-drug non-susceptibility (mdns,non-susceptibility to ≥ 3 of these antibiotics). results: of 292 included children,median age was 22.5 mos. mdns was identified in 62.5% of 318 isolates. non-susceptibility to cotrimoxazole (92.8%),ampicillin (81.3%),and tetracycline (75.0%) was common. young age (6–24 mos vs. 24–59 mos adjusted prevalence ratio [apr] = 1.519 [95% confidence interval: 1.19,1.91]),maternal hiv (apr = 1.29 [1.01,1.66]); and acute malnutrition (apr = 1.28 [1.06,1.55]) were associated with higher prevalence of mdns,as were open defecation (apr = 2.25 [1.13,4.50]),household crowding (apr = 1.29 [1.08,1.53]) and infrequent caregiver hand-washing (apr = 1.50 [1.15,1.95]). conclusions: young age,hiv exposure,acute malnutrition and poor sanitation may increase risk of antibiotic non-susceptible enteric pathogen infections among children in kenya. © 2017 brander et al.
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آدرس
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department of epidemiology,university of washington,seattle,wa, United States, department of epidemiology,university of washington,seattle,wa,united states,department of pediatrics,university of washington,seattle,wa,united states,department of global health,university of washington,seattle,wa,united states,department of medicine (allergy and infectious disease),university of washington,seattle,wa,united states,childhood acute illness and nutrition network,university of washington,seattle,wa, United States, department of epidemiology,university of washington,seattle,wa,united states,department of pediatrics,university of washington,seattle,wa,united states,department of global health,university of washington,seattle,wa,united states,department of medicine (allergy and infectious disease),university of washington,seattle,wa, United States, department of pediatrics,university of washington,seattle,wa,united states,kenya medical research institute,department of the centre for clinical research,nairobi, Kenya, walter reed army institute of research,united states army medical research directorate-kenya,kericho, Kenya, walter reed army institute of research,united states army medical research directorate-kenya,kericho, Kenya, kenya medical research institute,department of the centre for clinical research,nairobi, Kenya, kenya medical research institute,department of the centre for clinical research,nairobi, Kenya, department of global health,university of washington,seattle,wa, United States
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Authors
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