ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Colonization With Antibiotic-Resistant Bacteria in a Hospital and Associated Communities in Guatemala: An Antibiotic Resistance in Communities and Hospitals (ARCH) Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Pooled it
- Diverse Reservoirs of Third-Generation Cephalosporin-Resistant Escherichia coli in Guatemala.EcoHealth · 2026Article
- Spread of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) in the community living spaces of patients identified as ESBL-E carriers: impact of the housing density in an African context.Tropical medicine and health · 2026Article
- Factors influencing antibiotic-resistant bacteria colonization among community and hospitalized individuals in Chennai, India: an Antibiotic Resistance in Communities and Hospitals (ARCH) study.Antimicrobial resistance and infection control · 2026Article
- Comparing cultural perceptions of drinking water safety with water quality in urban and rural Guatemalan communities.Journal of water and health · 2025Article
- Distribution and Evolutionary Trajectories of β-Lactamases in Vibrio: Genomic Insights from Carbenicillin-Hydrolyzing Class A β-Lactamases (CARB) in the Harveyi and Cholerae Clades.Genome biology and evolution · 2025Article
- Colonization with antibiotic resistant bacteria in communities and hospitals across six countries, including Bangladesh, Botswana, Chile, Guatemala, India, and Kenya.Scientific reports · 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
- Antimicrobial stewardship practices in Guatemala: communication, perceptions, and behaviors regarding antimicrobial prescribing.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Gastrointestinal carriage of carbapenemase-producing enterobacterales among inpatient and outpatient children in Kenya.Scientific reports · 2024Article
- Article
- Using Colonization to Understand the Burden of Antimicrobial Resistance Across Low- and Middle-Income Countries.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Antibiotic Resistance: A Global Problem and the Need to Do More.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Network meta-analysis of antibiotic resistance patterns in gram-negative bacterial infections: a comparative study of carbapenems, fluoroquinolones, and aminoglycosides.Frontiers in microbiology · 2023Article
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Authors and funding
18 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundWe estimated the prevalence of colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) and carbapenem-resistant Enterobacterales (CRE) from a hospital and associated communities in western Guatemala.
methodsRandomly selected infants, children, and adults (<1, 1-17, and ≥18 years, respectively) were enrolled from the hospital (n = 641) during the coronavirus disease 2019 (COVID-19) pandemic, March to September 2021. Community participants were enrolled using a 3-stage cluster design between November 2019 and March 2020 (phase 1, n = 381) and between July 2020 and May 2021 (phase 2, with COVID-19 pandemic restrictions, n = 538). Stool samples were streaked onto selective chromogenic agar, and a Vitek 2 instrument was used to verify ESCrE or CRE classification. Prevalence estimates were weighted to account for sampling design.
resultsThe prevalence of colonization with ESCrE and CRE was higher among hospital patients compared to community participants (ESCrE: 67% vs 46%, P < .01; CRE: 37% vs 1%, P < .01). Hospital ESCrE colonization was higher for adults (72%) compared with children (65%) and infants (60%) (P < .05). Colonization was higher for adults (50%) than children (40%) in the community (P < .05). There was no difference in ESCrE colonization between phase 1 and 2 (45% and 47%, respectively, P > .05), although reported use of antibiotics among households declined (23% and 7%, respectively, P < .001).
conclusionsWhile hospitals remain foci for ESCrE and CRE colonization, consistent with the need for infection control programs, community prevalence of ESCrE in this study was high, potentially adding to colonization pressure and transmission in healthcare settings. Better understanding of transmission dynamics and age-related factors is needed.
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