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We estimated the prevalence of extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE), carbapenem-resistant Enterobacterales (CRE), and methicillin-resistant Staphylococcus aureus (MRSA) in communities and hospitals in Kenya to identify human colonization with multidrug-resistant bacteria. Nasal and fecal specimen were collected from inpatients and community residents in Nairobi (urban) and Siaya (rural) counties. Swabs were plated on chromogenic agar to presumptively identify ESCrE, CRE and MRSA isolates. Confirmatory identification and antibiotic susceptibility testing were done using the VITEK®2 instrument. A total of 1999 community residents and 1023 inpatients were enrolled between January 2019 and March 2020. ESCrE colonization was higher in urban than rural communities (52 vs. 45%; P = 0.013) and in urban than rural hospitals (70 vs. 63%; P = 0.032). Overall, ESCrE colonization was ~ 18% higher in hospitals than in corresponding communities. CRE colonization was higher in hospital than community settings (rural: 7 vs. 1%; urban: 17 vs. 1%; with non-overlapping 95% confidence intervals), while MRSA was rarely detected (≤ 3% overall). Human colonization with ESCrE and CRE was common, particularly in hospitals and urban settings. MRSA colonization was uncommon. Evaluation of risk factors and genetic mechanisms of resistance can guide prevention and control efforts tailored to different environments.

Titel:	Prevalence of colonization with multidrug-resistant bacteria in communities and hospitals in Kenya.
Autor/in / Beteiligte Person:	Ita, T ; Luvsansharav, UO ; Smith, RM ; Mugoh, R ; Ayodo, C ; Oduor, B ; Jepleting, M ; Oguta, W ; Ouma, C ; Juma, J ; Bigogo, G ; Kariuki, S ; Ramay, BM ; Caudell, M ; Onyango, C ; Ndegwa, L ; Verani, JR ; Bollinger, S ; Sharma, A ; Palmer, GH ; Call, DR ; Omulo, S
Link:	Zum Volltext
Zeitschrift:	Scientific reports, Jg. 12 (2022-12-24), Heft 1, S. 22290
Veröffentlichung:	London : Nature Publishing Group, copyright 2011-, 2022
Medientyp:	academicJournal
ISSN:	2045-2322 (electronic)
DOI:	10.1038/s41598-022-26842-3
Schlagwort:	Humans Prevalence Kenya epidemiology Drug Resistance, Multiple, Bacterial genetics Hospitals Anti-Bacterial Agents pharmacology Anti-Bacterial Agents therapeutic use Methicillin-Resistant Staphylococcus aureus Staphylococcal Infections microbiology
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Research Support, N.I.H., Extramural Language: English [Sci Rep] 2022 Dec 24; Vol. 12 (1), pp. 22290. <i>Date of Electronic Publication: </i>2022 Dec 24. MeSH Terms: Methicillin-Resistant Staphylococcus aureus* ; Staphylococcal Infections* / microbiology ; Humans ; Prevalence ; Kenya / epidemiology ; Drug Resistance, Multiple, Bacterial / genetics ; Hospitals ; Anti-Bacterial Agents / pharmacology ; Anti-Bacterial Agents / therapeutic use References: Dadgostar, P. Antimicrobial resistance: Implications and costs. Infect. Drug Resist. 12, 3903–3910 (2019). (PMID: 10.2147/IDR.S234610) ; Murray, C. J. L. et al. Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet 399, 629–655 (2022). (PMID: 10.1016/S0140-6736(21)02724-0) ; Medina, M.-J., Legido-Quigley, H. & Hsu, L. Y. Antimicrobial resistance in one health. In Global Health Security 209–229 (Springer, 2020). 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(PMID: 10.1503/cmaj.080239) Grant Information: U01 GH002143 United States GH CGH CDC HHS Substance Nomenclature: 0 (Anti-Bacterial Agents) Entry Date(s): Date Created: 20221224 Date Completed: 20221227 Latest Revision: 20230121 Update Code: 20240513 PubMed Central ID: PMC9789952

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Prevalence of colonization with multidrug-resistant bacteria in communities and hospitals in Kenya.