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Project ID: ICA4-CT-2001-10014
Financiado con arreglo a: FP5-INCO 2
País: Italy

Antimicrobial resistance screening

Antimicrobial resistance was analysed in the commensal microbiota of the gut (Escherichia coli) in healthy children aged 6-72 months by a rapid resistance screening method used on stool specimens and confirmed by a standard antimicrobial susceptibility test. A total of 3174 children in the target age cohort were enrolled from four urban communities in Bolivia and Peru. Moreover, antimicrobial use and bacterial microbial resistance were investigated in 93 inhabitants of Angaiza, a remote community of the Peruvian Amazonas characterised by very low human use of antimicrobials. The adopted screening method was refined and confirmed to be particularly suitable to monitor resistance-control programs cost-effectively in low resource countries.

Results showed a high prevalence (70%-95%) of healthy carriers of E. coli resistant to a number of older antimicrobial agent (ampicillin, tetracycline, trimethoprim-sulphamethoxazole, chloramphenicol). A relatively high prevalence (18%-30%) of carriers of E. coli resistant to other agents (kanamycin, gentamicin, nalidixic acid and ciprofloxacin) was also observed, while the carriage of E. coli resistant to expanded-spectrum cephalosporins and amikacin was uncommon (<0.5%).

Milestones consisted in the collection of 18.042 E. coli isolates from which 2000 representatives were selected and scored to undergo further phenotypic and genotypic analysis. In the isolated community in Peru, where antimicrobial use was very limited, unexpectedly high resistance rates were detected suggesting that, in some cases, the spread and maintenance of resistant strains could be not directly related to antimicrobial consumption.

The antimicrobial resistance screening was repeated in the same study area in 3193 healthy children aged 6-72 months. The investigation was carried out after the implementation of an Information-Education-Communication Intervention campaign performed to control the rational use of antimicronbials in the community. As the time period passed between the intervention and the microbiological study was too small, the antimicrobial resistance screening, did not represent a valuable indicator to evaluate the impact of the Information-Education-Communication campaign.

Results, besides confirming the high resistance rates, showed an alarming significant increase in the resistance rates to quinolones (57% vs. 35% for nalidixic acid and 33% vs. 18% for ciprofloxacin) and ceftriaxone (1.7% vs. 0.1 %). The trend was similar overall in each of the 4 studied areas.

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Contacto

Alessandro BARTOLONI, (Associate professor)
Tel.: +39-055-7949482
Fax: +39-055-7949480
Correo electrónico
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