CoChat
Sign Up
Cited by 20

The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.

Multidrug-resistant enteric pathogens in older children and adults with diarrhea in Bangladesh: epidemiology and risk factors

Garbern, Stephanie C., Chu, Tzu-Chun, Gainey, Monique, Kanekar, Samika S., Nasrin, Sabiha, Qu, Kexin, Barry, Meagan A., Nelson, Eric J., Leung, Daniel T., Schmid, Christopher H., Alam, Nur H., Levine, Adam C.·2021·Tropical Medicine and Health
DOI 10.1186/s41182-021-00327-xPMC PMC8108363
Open this paper in CoChat — free account

Abstract

Background: Antimicrobial resistance (AMR) is a global public health threat and is increasingly prevalent among enteric pathogens in low- and middle-income countries (LMICs). However, the burden of multidrug-resistant organisms (MDROs) in older children, adults, and elderly patients with acute diarrhea in LMICs is poorly understood. This study’s aim was to characterize the prevalence of MDR enteric pathogens isolated from patients with acute diarrhea in Dhaka, Bangladesh, and assess a wide range of risk factors associated with MDR. Methods: This study was a secondary analysis of data collected from children over 5 years, adults, and elderly patients with acute diarrhea at the International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka Hospital between March 2019 and March 2020. Clinical, historical, socio-environmental information, and a stool sample for culture and antimicrobial susceptibility testing were collected from each patient. Univariate statistics and multiple logistic regression were used to assess the prevalence of MDR among enteric pathogens and the association between independent variables and presence of MRDOs among culture-positive patients. Results: A total of 1198 patients had pathogens isolated by stool culture with antimicrobial susceptibility results. Among culture-positive patients, the prevalence of MDR was 54.3%. The prevalence of MDR was highest in Aeromonas spp. (81.5%), followed by Campylobacter spp. (72.1%), Vibrio cholerae (28.1%), Shigella spp. (26.2%), and Salmonella spp. (5.2%). Factors associated with having MDRO in multiple logistic regression included longer transport time to hospital (>90 min), greater stool frequency, prior antibiotic use prior to hospital presentation, and non-flush toilet use. However, pseudo-R2 was low 0.086, indicating that other unmeasured variables need to be considered to build a more robust predictive model of MDR. Conclusions: MDR enteric pathogens were common in this study population with clinical, historical, and socio-environmental risk factors associated with MDROs. These findings may help guide clinical decision-making regarding antibiotic use and selection in patients at greatest risk of complications due to MDROs. Further prospective research is urgently needed to determine what additional factors place patients at greatest risk of MDRO, and the best strategies to mitigate the spread of MDR in enteric pathogens.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/s41182-021-00327-x

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Multidrug-resistant bacteria have previously been associated with severe human illnesses like cholera, diarrhea, and other water-borne diseases in the Bangladeshi population.

    “Multidrug-resistant bacteria have previously been associated with severe human illnesses like cholera, diarrhea, and other water-borne diseases in the Bangladeshi population18,71–74.”

    From Impact of untreated tannery wastewater in the evolution of multidrug-resistant bacteria in Bangladesh (2024) · cites this paper as [71]

    The Results report multidrug resistance in enteric pathogens isolated from patients with diarrhea in Dhaka, including Vibrio cholerae. The Discussion links multidrug-resistant infections to greater stool frequency, a marker of more severe illness, and reports prior Bangladeshi findings for shigellosis and V. cholerae. The paper does not establish the broader claim about other water-borne diseases. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Flagged first, then by citations

Research works printed but not linked: 41

  1. Troeger C, Blacker BF, Khalil IA, Rao PC, Cao S, Zimsen SR, et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis. 2018;18(11):1211–28. https://doi.org/10.1016/S1473-3099(18)30362-1. · DOI
  2. James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789–858. https://doi.org/10.1016/S0140-6736(18)32279-7 Available from: http://www.sciencedirect.com/science/article/pii/S0140673618322797. · DOI · Paper page
  3. World Health Organization. The treatment of diarrhoea: a manual for physicians and other senior health workers. 2005.
  4. Hatchette TF, Farina D. Infectious diarrhea: when to test and when to treat. CMAJ. 2011;183(3):339–44. https://doi.org/10.1503/cmaj.091495. · DOI
  5. Pavlinac PB, Denno DM, John-Stewart GC, Onchiri FM, Naulikha JM, Odundo EA, et al. Failure of syndrome-based diarrhea management guidelines to detect shigella infections in Kenyan children. J Pediatric Infect Dis Soc. 2016;5(4):366–74. https://doi.org/10.1093/jpids/piv037. · DOI
  6. Vila J, Pal T. Update on antibacterial resistance in low-income countries: factors favoring the emergence of resistance. Open Infect Dis J. 2010;4:38-54. · DOI
  7. Okeke IN, Laxminarayan R, Bhutta ZA, Duse AG, Jenkins P, O’Brien TF, et al. Antimicrobial resistance in developing countries. Part I: recent trends and current status. Lancet Infect Dis. 2005;5(8):481–93. https://doi.org/10.1016/S1473-3099(05)70189-4. · DOI · Paper page
  8. Rijal N, Acharya J, Adhikari S, Upadhaya BP, Shakya G, Kansakar P, et al. Changing epidemiology and antimicrobial resistance in Vibrio cholerae: AMR surveillance findings (2006-2016) from Nepal. BMC Infect Dis. 2019;19(1):1–8. · DOI
  9. Das SK, Klontz EH, Azmi IJ, Ud-Din AIMS, Chisti MJ, Afrad MH, et al. Characteristics of multidrug resistant Shigella and Vibrio cholerae O1 infections in patients treated at an urban and a rural hospital in Bangladesh. ISRN Microbiol. 2013;2013:213915. · DOI
  10. Kotloff KL, Nataro JP, Blackwelder WC, Nasrin D, Farag TH, Panchalingam S, et al. Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study. Lancet. 2013;382(9888):209–222. Available from: https://www.sciencedirect.com/science/article/pii/S0140673613608442 [cited 2019 Aug 24] · DOI · Paper page
  11. Collaborators G 2016 DD. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis. 2018;18(11):1211–28. · DOI
  12. Levine AC, Barry MA, Gainey M, Nasrin S, Qu K, Schmid CH, et al. Derivation of the first clinical diagnostic models for dehydration severity in patients over five years with acute diarrhea. PLoS Negl Trop Dis. 2021;15(3):e0009266. · DOI
  13. Levine A, Glavis-Bloom J, Modi P, Al E. Empirically derived dehydration scoring and decision tree models for children with diarrhea: assessment and internal validation in a prospective cohort study in Dhaka, Bangladesh. Glob Heal Sci Pr. 2015;3(405):18.
  14. Hooper L, Abdelhamid A, Attreed NJ, Campbell WW, Channell AM, Chassagne P, et al. Clinical symptoms, signs and tests for identification of impending and current water-loss dehydration in older people. Cochrane Database Syst Rev. 2015;(4):CD009647. https://doi.org/10.1002/14651858.CD009647.pub2. · DOI · Paper page
  15. Shirreffs S. Markers of hydration status. Eur J Clin Nutr. 2003;57(2):9.
  16. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, Morgan DR. Manual of clinical microbiology (6th edn). Trends Microbiol. 1995;3(11):449. · DOI
  17. Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49(12):1373–9. https://doi.org/10.1016/S0895-4356(96)00236-3. · DOI · Paper page
  18. Nagelkerke NJD. A note on a general definition of the coefficient of determination. Biometrika. 1991;78(3):691–2. https://doi.org/10.1093/biomet/78.3.691. · DOI · Paper page
  19. Klontz EH, Faruque ASG, Das SK, Malek MA, Islam Z, Luby SP, et al. Clinical and epidemiologic features of diarrheal disease due to Aeromonas hydrophila and Plesiomonas shigelloides infections compared with those due to Vibrio cholerae Non-O1 and Vibrio parahaemolyticus in Bangladesh. ISRN Microbiol. 2012;2012:1–6. https://doi.org/10.5402/2012/654819. · DOI
  20. Stang AS, Trudeau M, Vanderkooi OG, Lee BE, Chui L, Pang XL, et al. Diagnostic interpretation guidance for pediatric enteric pathogens: a modified delphi consensus process. Can J Infect Dis Med Microbiol. 2018;2018:1–11. https://doi.org/10.1155/2018/2589826. · DOI
  21. Moharana SS, Panda RK, Dash M, Chayani N, Bokade P, Pati S, et al. Etiology of childhood diarrhoea among under five children and molecular analysis of antibiotic resistance in isolated enteric bacterial pathogens from a tertiary care hospital, Eastern Odisha, India. BMC Infect Dis. 2019;19(1):1–9. · DOI
  22. O’Ryan G, Ashkenazi-Hoffnung L, O’Ryan-Soriano M, Ashkenazi S. Management of acute infectious diarrhea for children living in resource-limited settings. Expert Rev Anti-Infect Ther. 2014;12(5):621–32. https://doi.org/10.1586/14787210.2014.901168. · DOI
  23. Parvin I, Shahunja KM, Khan SH, Alam T, Shahrin L, Ackhter MM, et al. Changing susceptibility pattern of Vibrio cholerae O1 isolates to commonly used antibiotics in the largest diarrheal disease hospital in Bangladesh during 2000–2018. Am J Trop Med Hyg. 2020;103(2):652-8. · DOI
  24. García-Fernández A, Dionisi AM, Arena S, Iglesias-Torrens Y, Carattoli A, Luzzi I. Human campylobacteriosis in Italy: emergence of multi-drug resistance to ciprofloxacin, tetracycline, and erythromycin. Front Microbiol. 2018;9:1–8. · DOI
  25. Brown JD, Willcox SJ, Franklin N, Hazelton B, Howard P, Reinten T, et al. Shigella species epidemiology and antimicrobial susceptibility: the implications of emerging azithromycin resistance for guiding treatment, guidelines and breakpoints. J Antimicrob Chemother. 2017;72(11):3181–6. https://doi.org/10.1093/jac/dkx268. · DOI
  26. Okeke IN, Aboderin OA, Byarugaba DK, Ojo KK, Opintan JA. Growing problem of multidrug-resistant enteric pathogens in Africa. Emerg Infect Dis. 2007;13:1640–6 Centers for Disease Control and Prevention (CDC). · DOI
  27. Mahbubur R, Shoma S, Rashid H, El Arifeen S, Baqui AH, Siddique AK, et al. Increasing spectrum in antimicrobial resistance of Shigella isolates in Bangladesh: resistance to azithromycin and ceftriaxone and decreased susceptibility to ciprofloxacin. J Health Popul Nutr. 2007;25(2):158.
  28. Brander RL, Walson JL, John-Stewart GC, Naulikha JM, Ndonye J, Kipkemoi N, et al. Correlates of multi-drug non-susceptibility in enteric bacteria isolated from Kenyan children with acute diarrhea. PLoS Negl Trop Dis. 2017;11(10):1–18. · DOI
  29. Torres NF, Chibi B, Middleton LE, Solomon VP, Mashamba-Thompson TP. Evidence of factors influencing self-medication with antibiotics in low and middle-income countries: a systematic scoping review. Public Health. 2019;168:92–101 Elsevier B.V. · DOI
  30. Gruninger RJ, Johnson RA, Das SK, Nelson EJ, Spivak ES, Contreras JR, et al. Socioeconomic determinants of ciprofloxacin-resistant Shigella infections in Bangladeshi children. Pathog Immun. 2017;2(1):89 Available from: /pmc/articles/PMC5461975/?report=abstract [cited 2021 Jan 1]. · DOI
  31. Matin MA, Khan WA, Karim MM, Ahmed S, John-Langba J, Sankoh OA, Gyapong M, Kinsman J, Wertheim H What influences antibiotic sales in rural Bangladesh? A drug dispensers’ perspective. 13;1:20. doi: https://doi.org/10.1186/s40545-020-00212-8 [cited 2021 Mar 15] · DOI
  32. Nahar P, Unicomb L, Lucas PJ, Uddin MR, Islam MA, Nizame FA, et al. What contributes to inappropriate antibiotic dispensing among qualified and unqualified healthcare providers in Bangladesh? A qualitative study. BMC Health Serv Res. 2020;20(1):656 Available from: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05512-y [cited 2021 Apr 23]. · DOI
  33. Moïsi J, Nokes D, Gatakaa H, Williams T, Bauni E, Levine O, et al. Sensitivity of hospital-based surveillance for severe disease: a geographic information system analysis of access to care in Kilifi district, Kenya. Bull World Health Organ. 2011;89(2):102–11. https://doi.org/10.2471/BLT.10.080796. · DOI
  34. Schoeps A, Gabrysch S, Niamba L, Sié A, Becher H. The effect of distance to health-care facilities on childhood mortality in rural Burkina Faso. Am J Epidemiol. 2011;173(5):492–8 Available from: https://academic.oup.com/aje/article-lookup/doi/10.1093/aje/kwq386 [cited 2021 Apr 22]. · DOI
  35. Okwaraji YB, Cousens S, Berhane Y, Mulholland K, Edmond K. Effect of geographical access to health facilities on child mortality in rural Ethiopia: a community based cross sectional study. PLoS One. 2012;7(3):e33564 Available from: https://dx.plos.org/10.1371/journal.pone.0033564 [cited 2021 Apr 22], Noor AM, editor. · DOI
  36. Basu J, Mobley LR. Illness severity and propensity to travel along the urban-rural continuum. Health Place. 2007;13:381–99 Available from: http://www.ers. [cited 2021 Apr 22]. · DOI
  37. Fink G, D’Acremont V, Leslie HH, Cohen J. Antibiotic exposure among children younger than 5 years in low-income and middle-income countries: a cross-sectional study of nationally representative facility-based and household-based surveys. Lancet Infect Dis. 2020;20(2):179–87. https://doi.org/10.1016/S1473-3099(19)30572-9. · DOI
  38. Omulo S, Thumbi SM, Njenga MK, Call DR. A review of 40 years of enteric antimicrobial resistance research in Eastern Africa: what can be done better? Antimicrob Resist Infect Control. 2015;4(1):1–13 Available from: https://link.springer.com/articles/10.1186/s13756-014-0041-4 [cited 2020 Oct 4]. · DOI
  39. Gomila A, Shaw E, Carratalà J, Leibovici L, Tebé C, Wiegand I, et al. Predictive factors for multidrug-resistant gram-negative bacteria among hospitalised patients with complicated urinary tract infections 11 Medical and Health Sciences 1108 Medical Microbiology. Antimicrob Resist Infect Control. 2018;7(1):111 Available from: https://aricjournal.biomedcentral.com/articles/10.1186/s13756-018-0401-6 [cited 2020 Nov 25]. · DOI
  40. Lindsay B, Ochieng JB, Ikumapayi UN, Toure A, Ahmed D, Li S, et al. Quantitative PCR for detection of Shigella improves ascertainment of Shigella burden in children with moderate-to-severe diarrhea in low-income countries. J Clin Microbiol. 2013;51(6):1740–6. https://doi.org/10.1128/JCM.02713-12. · DOI
  41. Liu J, Platts-Mills JA, Juma J, Kabir F, Nkeze J, Okoi C, et al. Use of quantitative molecular diagnostic methods to identify causes of diarrhoea in children: a reanalysis of the GEMS case-control study. Lancet. 2016;388(10051):1291–301. https://doi.org/10.1016/S0140-6736(16)31529-X. · DOI

Cited by

Sorted by citations

Metadata

Authors
Garbern, S. C., Chu, T.-C., Gainey, M., Kanekar, S. S., Nasrin, S., Qu, K., Barry, M. A., Nelson, E. J., Leung, D. T., Schmid, C. H., Alam, N. H., & Levine, A. C.
Venue
Tropical Medicine and Health
Publisher
Springer Science and Business Media LLC
Published
2021-05-10
Volume
49
Issue
1
ISSN
1349-4147
DOI
10.1186/s41182-021-00327-x
PMC
PMC8108363
Cited by
20
References
1
Language
en
Licence
Funders
  • National Institute of Diabetes and Digestive and Kidney Diseases (DK116163)
  • National Institute of General Medical Sciences (U54GM115677)

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review