PDF(Pubmed)
Abstract：
Campylobacteriosis disproportionately affects children under five in low-income countries. However, epidemiological and antimicrobial resistance (AMR) information at the children-animal interface is lacking. We hypothesized that Campylobacter is a major cause of enteritis in children in Ethiopia, and contact with animals is a potential source of transmission. The objective of the study was to determine Campylobacter occurrence and its AMR in children under five with diarrhea, backyard farm animals, and companion pets. Stool from 303 children and feces from 711 animals were sampled. Campylobacter was isolated through membrane filtration on modified charcoal cefoperazone deoxycholate agar plates under microaerobic incubation, and the technique showed to be feasible for use in regions lacking organized laboratories. Typical isolates were characterized with MALDI-TOF MS and multiplex PCR. Of 303 children, 20% (n = 59) were infected, with a higher proportion in the 6 to 11-month age group. Campylobacter occurred in 64% (n = 14) of dogs and 44% (n = 112) of poultry. Campylobacter jejuni was present in both a child and animal species in 15% (n = 23) of 149 households positive for Campylobacter. MICs using the gradient strip diffusion test of 128 isolates displayed resistance rates of 20% to ciprofloxacin and 11% to doxycycline. MICs of ciprofloxacin and doxycycline varied between C. coli and C. jejuni, with higher resistance in C. coli and poultry isolates. Campylobacter infection in children and its prevalent excretion from backyard poultry and dogs is a understudied concern. The co-occurrence of C. jejuni in animals and children suggest household-level transmission As resistance to ciprofloxacin and doxycycline was observed, therapy of severe campylobacteriosis should consider susceptibility testing. Findings from this study can support evidence-based diagnosis, antimicrobial treatment, and further investigations on the spread of AMR mechanisms for informed One Health intervention.
摘要：
弯曲杆菌病对低收入国家五岁以下儿童的影响不成比例。然而,缺乏儿童-动物界面的流行病学和抗菌素耐药性（AMR）信息。我们假设弯曲杆菌是埃塞俄比亚儿童肠炎的主要原因，与动物接触是潜在的传播源。该研究的目的是确定5岁以下腹泻儿童中弯曲杆菌的发生及其AMR，后院农场动物，和伴侣宠物。对303名儿童的粪便和711只动物的粪便进行了采样。在微氧孵育下，通过在改良的木炭头孢哌酮脱氧胆酸琼脂平板上的膜过滤分离弯曲杆菌，并且该技术被证明在缺乏有组织的实验室的地区使用是可行的。用MALDI-TOFMS和多重PCR表征典型分离株。在303个孩子中，20％（n=59）被感染，在6至11个月年龄组中比例较高。弯曲杆菌在64％（n=14）的狗和44％（n=112）的家禽中发生。空肠弯曲杆菌在149个弯曲杆菌阳性家庭中的15％（n=23）的儿童和动物物种中均存在空肠弯曲杆菌。使用128种分离物的梯度条带扩散测试的MIC对环丙沙星的耐药率为20％，对多西环素的耐药率为11％。环丙沙星和多西环素的MIC在大肠杆菌和空肠杆菌之间不同，在大肠杆菌和家禽分离物中具有较高的耐药性。儿童弯曲杆菌感染及其从后院家禽和狗中普遍排泄是一个未被研究的问题。空肠弯曲杆菌在动物和儿童中的同时出现表明家庭水平的传播，因为观察到对环丙沙星和强力霉素的抗性，严重弯曲杆菌病的治疗应考虑药敏试验.这项研究的结果可以支持基于证据的诊断，抗菌治疗，以及对知情的OneHealth干预措施的AMR机制传播的进一步调查。
