High Burden of Intestinal Colonization With Antimicrobial-Resistant Bacteria in Chile: An Antibiotic Resistance in Communities and Hospitals (ARCH) Study

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dc.catalogadorgjm
dc.contributor.authorAraos, Rafael
dc.contributor.authorSmith, Rachel M.
dc.contributor.authorStyczynski, Ashley
dc.contributor.authorSánchez Barría, Felipe Andrés
dc.contributor.authorAcevedo, Johanna
dc.contributor.authorMaureira, Lea
dc.contributor.authorParedes, Catalina
dc.contributor.authorGonzalez, Maite
dc.contributor.authorRivas, Lina
dc.contributor.authorSpencer-Sandino, Maria
dc.contributor.authorPeters, Anne
dc.contributor.authorKhan, Ayesha
dc.contributor.authorSepulveda, Dino
dc.contributor.authorRojas Wettig, Loreto
dc.contributor.authorRioseco, Maria Luisa
dc.contributor.authorUsedo, Pedro
dc.contributor.authorRojas Soto, Pamela
dc.contributor.authorHuidobro, Laura Andrea
dc.contributor.authorFerreccio Readi, Catterina
dc.contributor.authorPark, Benjamin J.
dc.contributor.authorUndurraga Fourcade, Eduardo Andrés
dc.contributor.authorD'Agata, Erika M. C.
dc.contributor.authorJara Vallejos, Alejandro Antonio
dc.contributor.authorMunita, Jose M.
dc.date.accessioned2024-06-26T20:55:40Z
dc.date.available2024-06-26T20:55:40Z
dc.date.issued2023
dc.description.abstractWe report a high colonization burden resulting from antimicrobial-resistant Gram-negative bacteria in hospitals and a community in Chile. Strikingly, 29% (95% confidence interval, 24-34) of community-dwelling adults carried extended-spectrum cephalosporin-resistant Enterobacterales, highlighting the magnitude of the community reservoir of antimicrobial resistance., Background Antimicrobial resistance is a global threat, heavily impacting low- and middle-income countries. This study estimated antimicrobial-resistant gram-negative bacteria (GNB) fecal colonization prevalence in hospitalized and community-dwelling adults in Chile before the coronavirus disease 2019 pandemic. Methods From December 2018 to May 2019, we enrolled hospitalized adults in 4 public hospitals and community dwellers from central Chile, who provided fecal specimens and epidemiological information. Samples were plated onto MacConkey agar with ciprofloxacin or ceftazidime added. All recovered morphotypes were identified and characterized according to the following phenotypes: fluoroquinolone-resistant (FQR), extended-spectrum cephalosporin-resistant (ESCR), carbapenem-resistant (CR), or multidrug-resistant (MDR; as per Centers for Disease Control and Prevention criteria) GNB. Categories were not mutually exclusive. Results A total of 775 hospitalized adults and 357 community dwellers were enrolled. Among hospitalized subjects, the prevalence of colonization with FQR, ESCR, CR, or MDR-GNB was 46.4% (95% confidence interval [CI], 42.9-50.0), 41.2% (95% CI, 37.7-44.6), 14.5% (95% CI, 12.0-16.9), and 26.3% (95% CI, 23.2-29.4). In the community, the prevalence of FQR, ESCR, CR, and MDR-GNB colonization was 39.5% (95% CI, 34.4-44.6), 28.9% (95% CI, 24.2-33.6), 5.6% (95% CI, 3.2-8.0), and 4.8% (95% CI, 2.6-7.0), respectively. Conclusions A high burden of antimicrobial-resistant GNB colonization was observed in this sample of hospitalized and community-dwelling adults, suggesting that the community is a relevant source of antibiotic resistance. Efforts are needed to understand the relatedness between resistant strains circulating in the community and hospitals.
dc.fechaingreso.objetodigital2024-06-26
dc.fuente.origenORCID
dc.identifier.doi10.1093/cid/ciad283
dc.identifier.eissn1537-6591
dc.identifier.issn1058-4838
dc.identifier.urihttps://doi.org/10.1093/cid/ciad283
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/86876
dc.identifier.wosidWOS:001026057200011
dc.information.autorucInstituto de Sociología; Sánchez Barría, Felipe Andrés; 0000-0003-1775-5525; 208644
dc.information.autorucEscuela de Medicina; Ferreccio Readi, Catterina; 0000-0001-6331-5534; 99684
dc.information.autorucEscuela de Gobierno; Undurraga Fourcade, Eduardo Andrés; 0000-0002-4425-1253; 12868
dc.information.autorucFacultad de Matemáticas; Jara Vallejos, Alejandro Antonio; 0000-0002-2282-353X; 127927
dc.issue.numero1
dc.language.isoen
dc.nota.accesocontenido completo
dc.pagina.finalS81
dc.pagina.inicioS75
dc.revistaClinical Infectious Diseases
dc.rightsacceso abierto
dc.rights.licenseCC BY 4.0 ATTRIBUTION 4.0 INTERNATIONAL Deed
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectAntimicrobial-resistance
dc.subjectColonization
dc.subjectGram-negative
dc.subjectCommunity
dc.subjectLatin America
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleHigh Burden of Intestinal Colonization With Antimicrobial-Resistant Bacteria in Chile: An Antibiotic Resistance in Communities and Hospitals (ARCH) Study
dc.typeartículo
dc.volumen77
sipa.codpersvinculados208644
sipa.codpersvinculados99684
sipa.codpersvinculados12868
sipa.codpersvinculados127927
sipa.trazabilidadORCID;2024-06-24
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