ArticleScientific reports2020
Antibiotic use and hygiene interact to influence the distribution of antimicrobial-resistant bacteria in low-income communities in Guatemala.
Article in Scientific reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis.Lancet (London, England) · 2022Pooled it
- Community-Acquired Antimicrobial Resistant Enterobacteriaceae in Central America: A One Health Systematic Review.International journal of environmental research and public health · 2020Pooled it
- Azithromycin for the prevention of rehospitalisation and death among Kenyan children being discharged from hospital: a double-blind, placebo-controlled, randomised controlled trial.The Lancet. Global health · 2021Trial
- Fecal carriage of carbapenemase-producing Escherichia coli and Klebsiella spp. and associated factors among dairy farm milkers in Tigray Region, Northern Ethiopia.BMC microbiology · 2026Article
- Childhood sepsis burden: pathogens/antimicrobial-resistant bacteria, 1990-2021 and 2050 forecasts.Frontiers in cellular and infection microbiology · 2026Article
- Antibiotics and priority effects on colonizing resistant Escherichia coli strain assemblages in a community setting.PloS one · 2026Article
- Role of gut microbiome in suppression of cancers.Gut microbes · 2025Review
- Global burden of Klebsiella pneumoniae infections and antimicrobial resistance in 2019.BMC infectious diseases · 2025Article
- Antimicrobial resistance, equity and justice in low- and middle-income countries: an intersectional critical interpretive synthesis.Nature communications · 2025Article
- Exploring the association between multi-dimensional poverty and antibiotic resistance: findings from a mixed-methods study in Pakistan.The Lancet regional health. Southeast Asia · 2025Article
- High abundance of antimicrobial resistance genes in chicken flocks receiving antimicrobial treatment in Vietnamese poultry production.JAC-antimicrobial resistance · 2025Article
- Farmer field schools as interventions to reduce the need for antimicrobials in agrifood systems: a longitudinal analysis of layer farmer field school graduates and non-graduates in Kenya.Antimicrobial resistance and infection control · 2025Article
- Risk factors associated with community colonization of extended-spectrum cephalosporin-resistant Enterobacterales from an antibiotic resistance in communities and hospitals (ARCH) study, Guatemala.Scientific reports · 2025Article
- Prevalence and determinants of faecal carriage of carbapenem- and third-generation cephalosporin-resistant Enterobacterales: a cross-sectional household survey in northern Vietnam.The Lancet regional health. Western Pacific · 2025Article
- Article
- Key environmental exposure pathways to antimicrobial resistant bacteria in southern Malawi: A SaniPath approach.The Science of the total environment · 2024Article
- Article
- Long-term antibiotic exposure landscapes and resistant Escherichia coli colonization in a densely populated setting.PloS one · 2024Article
- Gut microbiota research nexus: One Health relationship between human, animal, and environmental resistomes.mLife · 2023Review
- RETRACTED: Empowering Low- and Middle-Income Countries to Combat AMR by Minimal Use of Antibiotics: A Way Forward.Antibiotics (Basel, Switzerland) · 2023Article
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Authors and funding
12 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
To examine the effects of poor sanitation and hygiene on the prevalence of antimicrobial-resistant bacteria, we surveyed households in two rural and two urban communities in Guatemala (N = 196 randomly selected households). One adult (≥ 18-years old) and, when available, one child (≤ 5 years-old) provided a stool sample. Up to 48 presumptive Escherichia coli isolates were collected from each stool sample (n = 21,256 total) and were subjected to breakpoint assays for ten antibiotics. Mixed-effects logistic models were used to identify potential factors influencing the likelihood of harboring antibiotic-resistant bacteria. For nine out of ten antibiotics, the odds of detecting resistant bacteria decreased by ~ 32% (odds ratios, OR 0.53-0.8, P < 0.001) for every unit of improvement of a hygiene scale. Hygiene differences between households had a greater impact on prevalence compared to antibiotic use differences. The likelihood of detecting resistant isolates was lower for five antibiotics among households that boiled raw milk before consumption (OR 0.31-0.69), and higher for nine antibiotics in urban households (OR > 1.89-9.6). Poor hygiene conditions likely obscure effects of individual antibiotic use, presumably due to enhanced microbial transmission. Consequently, efforts to improve antibiotic stewardship should be coupled with improving hygiene conditions.
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