High prevalence of antibiotic resistance in commensal Escherichia coli among children in rural Vietnam
- Equal contributors
1 Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden
2 Health System Research, Hanoi Medical University, 1 Ton That Tung street, Hanoi, Vietnam
3 Vietnam Cuba Friendship Hospital, 37 Hai Ba Trung street, Hanoi, Vietnam
4 Department of Medical Microbiology, Hanoi Medical University, 1 Ton That Tung street, Hanoi, Vietnam
5 Department of Probability and Statistics, Institute of Mathematics, 18 Hoang Quoc Viet road, Hanoi, Vietnam
6 Oxford University Clinical Research Unit, National Hospital of Tropical Diseases, 78 Giai Phong road, Dong Da district, Hanoi, Vietnam
BMC Infectious Diseases 2012, 12:92 doi:10.1186/1471-2334-12-92Published: 18 April 2012
Commensal bacteria represent an important reservoir of antibiotic resistance genes. Few community-based studies of antibiotic resistance in commensal bacteria have been conducted in Southeast Asia. We investigated the prevalence of resistance in commensal Escherichia coli in preschool children in rural Vietnam, and factors associated with carriage of resistant bacteria.
We tested isolates of E. coli from faecal samples of 818 children aged 6-60 months living in FilaBavi, a demographic surveillance site near Hanoi. Daily antibiotic use data was collected for participating children for three weeks prior to sampling and analysed with socioeconomic and demographic characteristics extracted from FilaBavi's re-census survey 2007. Descriptive statistics were generated, and a logistic regression model was used to identify contributions of the examined factors.
High prevalences of resistance were found to tetracycline (74%), co-trimoxazole (68%), ampicillin (65%), chloramphenicol (40%), and nalidixic acid (27%). Two isolates were resistant to ciprofloxacin. Sixty percent of isolates were resistant to three or more antibiotics. Recent sulphonamide use was associated with co-trimoxazole resistance [OR 3.2, 95% CI 1.8-5.7], and beta-lactam use with ampicillin resistance [OR 1.8, 95% CI 1.3-2.4]. Isolates from children aged 6-23 months were more likely to be resistant to ampicillin [OR 1.8, 95% CI 1.3-2.4] and co-trimoxazole [OR 1.5, 95% CI 1.1-2.0]. Associations were identified between geographical areas and tetracycline and ampicillin resistance.
We present high prevalence of carriage of commensal E. coli resistant to commonly used antibiotics. The identified associations with recent antibiotic use, age, and geographical location might contribute to our understanding of carriage of antibiotic resistant commensal bacteria.