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Abstract：
BACKGROUND: Children with under-five year age disproportionally affected with foodborne illness. Campylobacteriosis is the most common foodborne disease next to Norovirus infection. Macrolides are commonly prescribed as the first line of treatment for Campylobacter gastroenteritis, with fluoroquinolone and tetracycline as secondary options. However, resistance to these alternatives has been reported in various regions worldwide.
OBJECTIVE: To determine the prevalence, associated risk-factors and antimicrobial resistance of Campylobacter jejuni and C. coli among under-five children with diarrhea.
METHODS: Institution-based cross-sectional study was conducted from November, 2022 to April 2023. The study sites were selected using a random sampling technique, while the study subjects were included using a convenient sampling technique. The data were collected using a structured questionnaire. Stool samples were inoculated onto modified charcoal cefoperazone deoxycholate agar and incubated for 48 hours. The suspected colonies were analyzed using matrix-assisted laser desorption ionization-time of flight mass spectrometry to confirm the species. Antimicrobial susceptibility testing was performed using a disc diffusion technique. All potential covariates (independent variables) were analyzed one by one using bivariate logistic regression model to identify candidate variables with P value < 0.25. Multivariable logistic analysis was used to identify potential associated factors using the candidate variables. A p value ≤ 0.05 at a 95% confidence interval was statistically significant.
RESULTS: Among the 428 samples, 7.0% (CI: 4.5-9.3) were confirmed Campylobacter species. The prevalence of C. jejuni and C. coli among under-five children was 5.1% (CI: 3.0-7.0) and 1.9% (CI: 0.7-3.3), respectively. C. jejuni (73.3%) was dominant over C. coli (26.7%). The resident, contact with domestic animals, and parents/guardians education level were significantly associated with campylobacteriosis among under-five children. One-third of the Campylobacter isolates (33.3%, 10/30) were resistant to ciprofloxacin and tetracycline whereas 10.0% (3/30) were resistant to erythromycin. Furthermore, 3.3% (1/30) of the Campylobacter were found to be multidrug-resistant.
CONCLUSIONS: The prevalence of Campylobacter species was 7.0%. The resistance rate of Campylobacter species of ciprofloxacin and tetracycline-resistance strains was 33.3%. Peri-urban residence, contact with domestic animals, and low parental educational statuses were significantly associated factors with increased risk of Campylobacter infection. Continuous surveillance on antimicrobial resistance and health education of personal and environmental hygiene should be implemented in the community.
OBJECTIVE: To determine the prevalence, associated risk-factors and antimicrobial resistance of Campylobacter jejuni and C. coli among under-five children with diarrhea.
METHODS: Institution-based cross-sectional study was conducted from November, 2022 to April 2023. The study sites were selected using a random sampling technique, while the study subjects were included using a convenient sampling technique. The data were collected using a structured questionnaire. Stool samples were inoculated onto modified charcoal cefoperazone deoxycholate agar and incubated for 48 hours. The suspected colonies were analyzed using matrix-assisted laser desorption ionization-time of flight mass spectrometry to confirm the species. Antimicrobial susceptibility testing was performed using a disc diffusion technique. All potential covariates (independent variables) were analyzed one by one using bivariate logistic regression model to identify candidate variables with P value < 0.25. Multivariable logistic analysis was used to identify potential associated factors using the candidate variables. A p value ≤ 0.05 at a 95% confidence interval was statistically significant.
RESULTS: Among the 428 samples, 7.0% (CI: 4.5-9.3) were confirmed Campylobacter species. The prevalence of C. jejuni and C. coli among under-five children was 5.1% (CI: 3.0-7.0) and 1.9% (CI: 0.7-3.3), respectively. C. jejuni (73.3%) was dominant over C. coli (26.7%). The resident, contact with domestic animals, and parents/guardians education level were significantly associated with campylobacteriosis among under-five children. One-third of the Campylobacter isolates (33.3%, 10/30) were resistant to ciprofloxacin and tetracycline whereas 10.0% (3/30) were resistant to erythromycin. Furthermore, 3.3% (1/30) of the Campylobacter were found to be multidrug-resistant.
CONCLUSIONS: The prevalence of Campylobacter species was 7.0%. The resistance rate of Campylobacter species of ciprofloxacin and tetracycline-resistance strains was 33.3%. Peri-urban residence, contact with domestic animals, and low parental educational statuses were significantly associated factors with increased risk of Campylobacter infection. Continuous surveillance on antimicrobial resistance and health education of personal and environmental hygiene should be implemented in the community.
摘要：
背景：五岁以下儿童患食源性疾病不成比例。弯曲杆菌病是仅次于诺如病毒感染的最常见的食源性疾病。大环内酯类药物通常被规定为弯曲杆菌胃肠炎的一线治疗，氟喹诺酮和四环素作为次要选择。然而,在世界各地的不同地区已经报道了对这些替代品的抗药性。
目的：为了确定患病率，5岁以下儿童腹泻中空肠弯曲菌和大肠杆菌的相关危险因素和耐药性。
方法：从11月开始进行基于机构的横断面研究，2022年至2023年4月。使用随机抽样技术选择研究地点，而使用方便的采样技术纳入研究对象。使用结构化问卷收集数据。将粪便样品接种到改良的木炭头孢哌酮脱氧胆酸琼脂上并孵育48小时。使用基质辅助激光解吸电离-飞行时间质谱法分析可疑菌落以确认物种。使用圆盘扩散技术进行抗菌素敏感性测试。使用双变量逻辑回归模型逐一分析所有潜在的协变量（独立变量），以识别P值<0.25的候选变量。多变量逻辑分析用于使用候选变量识别潜在的相关因素。95%置信区间的p值≤0.05具有统计学意义。
结果：在428个样本中，7.0%(CI:4.5-9.3)被确认为弯曲杆菌属。5岁以下儿童中空肠弯曲杆菌和大肠杆菌的患病率分别为5.1%(CI:3.0-7.0)和1.9%(CI:0.7-3.3),分别。空肠杆菌(73.3%)优于大肠杆菌(26.7%)。居民,与家畜接触，父母/监护人的教育水平与5岁以下儿童的弯曲杆菌病显著相关。三分之一的弯曲杆菌分离株(33.3%，10/30）对环丙沙星和四环素耐药，而10.0％（3/30）对红霉素耐药。此外，发现3.3%(1/30)的弯曲杆菌具有多重耐药性。
结论：弯曲杆菌的流行率为7.0%。弯曲菌对环丙沙星和四环素耐药菌株的耐药率为33.3%。城市周边住宅，与家畜接触，父母受教育程度低是弯曲杆菌感染风险增加的显著相关因素。应在社区实施持续的抗菌素耐药性监测以及个人和环境卫生的健康教育。
目的：为了确定患病率，5岁以下儿童腹泻中空肠弯曲菌和大肠杆菌的相关危险因素和耐药性。
方法：从11月开始进行基于机构的横断面研究，2022年至2023年4月。使用随机抽样技术选择研究地点，而使用方便的采样技术纳入研究对象。使用结构化问卷收集数据。将粪便样品接种到改良的木炭头孢哌酮脱氧胆酸琼脂上并孵育48小时。使用基质辅助激光解吸电离-飞行时间质谱法分析可疑菌落以确认物种。使用圆盘扩散技术进行抗菌素敏感性测试。使用双变量逻辑回归模型逐一分析所有潜在的协变量（独立变量），以识别P值<0.25的候选变量。多变量逻辑分析用于使用候选变量识别潜在的相关因素。95%置信区间的p值≤0.05具有统计学意义。
结果：在428个样本中，7.0%(CI:4.5-9.3)被确认为弯曲杆菌属。5岁以下儿童中空肠弯曲杆菌和大肠杆菌的患病率分别为5.1%(CI:3.0-7.0)和1.9%(CI:0.7-3.3),分别。空肠杆菌(73.3%)优于大肠杆菌(26.7%)。居民,与家畜接触，父母/监护人的教育水平与5岁以下儿童的弯曲杆菌病显著相关。三分之一的弯曲杆菌分离株(33.3%，10/30）对环丙沙星和四环素耐药，而10.0％（3/30）对红霉素耐药。此外，发现3.3%(1/30)的弯曲杆菌具有多重耐药性。
结论：弯曲杆菌的流行率为7.0%。弯曲菌对环丙沙星和四环素耐药菌株的耐药率为33.3%。城市周边住宅，与家畜接触，父母受教育程度低是弯曲杆菌感染风险增加的显著相关因素。应在社区实施持续的抗菌素耐药性监测以及个人和环境卫生的健康教育。
