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Abstract

Background

The gene is a transferable resistance determinant against colistin, a last-resort antimicrobial for infections caused by multi-resistant Gram-negatives.

Aim

To study carriage of antibiotic-resistant bacteria in healthy school children as part of a helminth control and antimicrobial resistance survey in the Bolivian Chaco region.

Methods

From September to October 2016 we collected faecal samples from healthy children in eight rural villages. Samples were screened for - and genes. Antimicrobial susceptibility testing was performed, and a subset of 18 isolates representative of individuals from different villages was analysed by whole genome sequencing (WGS).

Results

We included 337 children (mean age: 9.2 years, range: 7–11; 53% females). The proportion of carriers was high (38.3%) and present in all villages; only four children had previous antibiotic exposure. One or more -positive isolates were recovered from 129 positive samples, yielding a total of 173 isolates (171 , 1 , 1 ). No was detected. Co-resistance to other antimicrobials varied in -positive . All 171 isolates were susceptible to carbapenems and tigecycline; 41 (24.0%) were extended-spectrum β-lactamase producers and most of them (37/41) carried -type genes. WGS revealed heterogeneity of clonal lineages and -genetic supports.

Conclusion

This high prevalence of -like carriage, in absence of professional exposure, is unexpected. Its extent at the national level should be investigated with priority. Possible causes should be studied; they may include unrestricted use of colistin in veterinary medicine and animal breeding, and importation of -positive bacteria via food and animals.

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/content/10.2807/1560-7917.ES.2018.23.45.1800115
2018-11-08
2018-11-15
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.45.1800115
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