ArticleNature microbiology2018
Dynamics of antimicrobial resistance in intestinal Escherichia coli from children in community settings in South Asia and sub-Saharan Africa.
Article in Nature microbiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
62 citing papers in PubMed, 2 syntheses or guidelines pooled it, 119 citations in OpenAlex.
- Molecular Epidemiology and AMR Perspective of Diarrhoeagenic Escherichia coli in Africa: A Systematic Review and Meta-analysis.Journal of epidemiology and global health · 2024Pooled it
- High prevalence of antibiotic resistance in commensal Escherichia coli from healthy human sources in community settings.Scientific reports · 2021Pooled it
- Age- and diet-driven assembly of the gut antibiotic resistome in humans and food-producing animals.Gut microbes · 2026Review
- Genomic Insights and Antimicrobial Resistance Profiling of DiarrheagenicMicroorganisms · 2026Article
- Imported Retail Beef and Chicken Meat Products Serve as Reservoirs for Emerging Antibiotic-Resistant Pathotypes of Escherichia coli in Pristine Areas Free From Agricultural Activity.MicrobiologyOpen · 2026Article
- Global distribution and genomic characteristics of linezolid resistance gene-positiveFrontiers in microbiology · 2026Article
- Integrating computational approaches to uncover β-lactamase-associated resistance in diarrheagenic Escherichia coli from pediatric patients.Scientific reports · 2025Article
- Genomic features of three major diarrhoeagenicMicrobial genomics · 2025Article
- Risk of multidrug resistance in Escherichia coli associated with routine antimicrobial prophylaxis on pig farms.npj antimicrobials and resistance · 2025Article
- Characteristics of ESBL-positive Klebsiella pneumoniae isolated from paired children with and without diarrhea.Gut pathogens · 2025Article
- Pathways through which water, sanitation, hygiene, and nutrition interventions reduce antibiotic use in young children: a mediation analysis of a cohort nested within a cluster-randomized trial.EClinicalMedicine · 2025Article
- Restoring Multidrug-ResistantAntibiotics (Basel, Switzerland) · 2024Article
- Pathways through which water, sanitation, hygiene, and nutrition interventions reduce antibiotic use in young children: a mediation analysis of a cluster-randomized trial.medRxiv : the preprint server for health sciences · 2024Article
- Carriage of third-generation cephalosporin-resistant and carbapenem-resistant Enterobacterales among children in sub-Saharan Africa: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Generalizability of machine learning in predicting antimicrobial resistance in E. coli: a multi-country case study in Africa.BMC genomics · 2024Article
- Application of a Novel Proteomic Microarray Reveals High Exposure to DiarrhoeagenicMicroorganisms · 2024Article
- One species, many faces: The underappreciated importance of strain diversity.PLoS pathogens · 2024Article
- Advancing pathogen genomics in resource-limited settings.Cell genomics · 2023Review
- Prevalence of DiarrhoeagenicMicroorganisms · 2023Article
- Evaluating the relationship between community water and sanitation access and the global burden of antibiotic resistance: an ecological study.The Lancet. Microbe · 2023Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
Abstract
The dynamics of antimicrobial resistance (AMR) in developing countries are poorly understood, especially in community settings, due to a sparsity of data on AMR prevalence and genetics. We used a combination of phenotyping, genomics and antimicrobial usage data to investigate patterns of AMR amongst atypical enteropathogenic Escherichia coli (aEPEC) strains isolated from children younger than five years old in seven developing countries (four in sub-Saharan Africa and three in South Asia) over a three-year period. We detected high rates of AMR, with 65% of isolates displaying resistance to three or more drug classes. Whole-genome sequencing revealed a diversity of known genetic mechanisms for AMR that accounted for >95% of phenotypic resistance, with comparable rates amongst aEPEC strains associated with diarrhoea or asymptomatic carriage. Genetic determinants of AMR were associated with the geographic location of isolates, not E. coli lineage, and AMR genes were frequently co-located, potentially enabling the acquisition of multi-drug resistance in a single step. Comparison of AMR with antimicrobial usage data showed that the prevalence of resistance to fluoroquinolones and third-generation cephalosporins was correlated with usage, which was higher in South Asia than in Africa. This study provides much-needed insights into the frequency and mechanisms of AMR in intestinal E. coli in children living in community settings in developing countries.
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