Evidence of Community-Wide Spread of Multi-Drug Resistant Escherichia coli in Young Children in Lusaka and Ndola Districts, Zambia

Abstract

Increased antimicrobial resistance (AMR) has been reported for pathogenic and commensal Escherichia coli (E. coli), hampering the treatment, and increasing the burden of infectious diarrhoeal diseases in children in developing countries. This study focused on exploring the occurrence, patterns, and possible drivers of AMR E. coli isolated from children under-five years in Zambia. A hospital-based cross-sectional study was conducted in the Lusaka and Ndola districts. Rectal swabs were collected from 565 and 455 diarrhoeic and healthy children, respectively, from which 1020 E. coli were cultured and subjected to antibiotic susceptibility testing. Nearly all E. coli (96.9%) were resistant to at least one antimicrobial agent tested. Further, 700 isolates were Multi-Drug Resistant, 136 were possibly Extensively-Drug Resistant and nine were Pan-Drug-Resistant. Forty percent of the isolates were imipenem-resistant, mostly from healthy children. A questionnaire survey documented a complex pattern of associations between and within the subgroups of the levels of MDR and socio-demographic characteristics, antibiotic stewardship, and guardians’ knowledge of AMR. This study has revealed the severity of AMR in children and the need for a community-specific-risk-based approach to implementing measures to curb the problem.

Determination of antimicrobial resistance patterns of Escherichia coli isolates from farm workers in broiler poultry production and assessment of antibiotic resistance awareness levels among poultry farmers in Lusaka, Zambia

“…Aworh et al also obtained similar results of resistance; 83.3, 79.2, and 77.1% to tetracycline, sulphamethoxazole/trimethoprim, and ampicillin, respectively. A recent study on AMR in young children in Lusaka and Ndola districts of Zambia showed that E. coli had highest resistance against ampicillin (78.0%), trimethoprim-sulfamethoxazole (70.4%), and tetracycline (62.8%) ( 45 ). A review by Tadesse et al on AMR in humans found that a high level of drug resistance existed to commonly prescribed antibiotics in the African continent ( 46 ).…”

Antimicrobial resistance profiles of Escherichia coli isolated from laying hens in Zambia: implications and significance on one health

“…In Zambia, antimicrobial-resistant E. coli have been isolated from humans, 61 , 62 broiler chickens, 63 , 64 dairy 65 and wildlife and livestock. 66 In broilers, E. coli , was observed to be resistant to tetracycline, ampicillin, cotrimoxazole and ciprofloxacin, whereas, in dairy, it was resistant to tetracycline, ampicillin, cotrimoxazole and ciprofloxacin.…”

Antibacterial activities of honey against Escherichia coli and Staphylococcus aureus: A potential treatment for bacterial infections and alternative to antibiotics

“…E. coli has been known to be responsible for most cases of bacteraemia in developed countries surpassing other leading bacteraemia-causing pathogens such as S. aureus 40 . Due to the high prevalence of these microorganisms and other factors, antibiotics have been frequently overused and misused for their treatment [17,[41][42][43][44] , resulting in the development of AMR among these microorganisms [45][46][47][48][49] . Consequently, infections caused by drug-resistant strains of E. coli and S. aureus are challenging to treat, thereby contributing to increased morbidity and mortality [38][39] .…”