ArticleTropical medicine and health2021
Multidrug-resistant enteric pathogens in older children and adults with diarrhea in Bangladesh: epidemiology and risk factors.
Article in Tropical medicine and health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Childhood diarrhoea attributed to enteropathogenic bacteria in low- and middle-income countries: a systematic review and meta-analysis.Journal of global health · 2025Pooled it
- A Phase 2a randomized, single-center, double-blind, placebo-controlled study to evaluate the safety and preliminary efficacy of oral iOWH032 against cholera diarrhea in a controlled human infection model.PLoS neglected tropical diseases · 2021Trial
- Gender and equity within antimicrobial resistance: a scoping review of evidence and policy in Bangladesh and Sri Lanka.BMC public health · 2026Article
- Sociodemographic and clinical factors influencing typhoid fever prevalence and multidrug resistance in Niger State, Nigeria.PloS one · 2025Article
- Impact of untreated tannery wastewater in the evolution of multidrug-resistant bacteria in Bangladesh.Scientific reports · 2024Article
- Understanding variations in diarrhea management across healthcare facilities in Bangladesh: a formative qualitative study.Journal of infection in developing countries · 2023Article
- Prevalence of Antibiotic-ResistantAntibiotics (Basel, Switzerland) · 2023Review
- Vibrio cholerae in rural and urban Bangladesh, findings from hospital-based surveillance, 2000-2021.Scientific reports · 2023Article
- Global epidemiology of campylobacteriosis and the impact of COVID-19.Frontiers in cellular and infection microbiology · 2022Review
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Authors and funding
12 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundAntimicrobial 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.
methodsThis 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.
resultsA 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.
conclusionsMDR 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.
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