title: Risk factors for antibiotic-resistant Escherichia coli carriage in young children in Peru: community-based cross-sectional prevalence study.
abstract: Few studies have examined the influence of individual-, household-, and community-scale risk factors on carriage of resistant commensal bacteria. We determined children's medical, agricultural, and environmental exposures by household, pharmacy, and health facility surveys and Escherichia coli cultures of children, mothers' hands, household animals, and market chickens in Peru. Among 522 children with a positive stool culture, by log-binomial regression, using "any antibiotic" and 1-14 (versus 0) sulfa doses in the past 3 months increased children's risk, respectively, for ampicillin- and sulfamethoxazole-resistant E. coli carriage (P = 0.01-0.02). Each household member taking "any antibiotic" increased children's risk for sulfamethoxazole- and multidrug-resistant E. coli carriage (P < 0.0001). Residence in a zone where a larger proportion of households served home-raised chicken (as contrasted with intensively antibiotic-raised market chicken) protected against carrying E. coli resistant to all drugs (P = 0.0004-0.04). Environmental contamination with drug-resistant bacteria appeared to significantly contribute to children's carriage of antibiotic-resistant E. coli.
authors.affiliation: Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, Rm E-8132, Baltimore, MD 21205, USA. hkalter@jhsph.edu
authors.forename: Henry D
authors.initials: HD
authors.lastname: Kalter
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Moulton
authors.forename: Anna R
authors.initials: AR
authors.lastname: Cullotta
authors.forename: Lilia
authors.initials: L
authors.lastname: Cabrera
authors.forename: Billie
authors.initials: B
authors.lastname: Velapatiño
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology*; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D002645:Chickens; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial / Q000502:physiology*; D004926:Escherichia coli / Q000187:drug effects*; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005502:Food; D006801:Humans; D007223:Infant; D008297:Male; D008460:Meat; D010063:Ovum; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents