ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Risk Factors for Colonization With Multidrug-Resistant Bacteria in Urban and Rural Communities in Kenya: An Antimicrobial 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 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- 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
- Role of the gut microbiome in frequent gut colonization with extended-spectrum β lactamase-producing Enterobacterales among Peruvian children.Gut microbes · 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
- Understanding and addressing β-lactam resistance mechanisms in gram-negative bacteria in Lebanon: A scoping review.Heliyon · 2025Review
- Molecular characterization of antibiotic resistance in bacteria from daycare centres in Ile-Ife, Nigeria.JAC-antimicrobial resistance · 2025Article
- Admission screening for extended-spectrum cephalosporin-resistant and carbapenem-resistant Enterobacterales colonization at a referral hospital in Botswana: A one-year period-prevalence survey, 2022-2023.PLOS global public health · 2025Article
- Long-term antibiotic exposure landscapes and resistant Escherichia coli colonization in a densely populated setting.PloS one · 2024Article
- 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
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Authors and funding
11 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundColonization with antimicrobial-resistant bacteria increases the risk of drug-resistant infections. We identified risk factors potentially associated with human colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) in low-income urban and rural communities in Kenya.
methodsFecal specimens, demographic and socioeconomic data were collected cross-sectionally from clustered random samples of respondents in urban (Kibera, Nairobi County) and rural (Asembo, Siaya County) communities between January 2019 and March 2020. Presumptive ESCrE isolates were confirmed and tested for antibiotic susceptibility using the VITEK2 instrument. We used a path analytic model to identify potential risk factors for colonization with ESCrE. Only 1 participant was included per household to minimize household cluster effects.
resultsStool samples from 1148 adults (aged ≥18 years) and 268 children (aged <5 years) were analyzed. The likelihood of colonization increased by 12% with increasing visits to hospitals and clinics. Furthermore, individuals who kept poultry were 57% more likely to be colonized with ESCrE than those who did not. Respondents' sex, age, use of improved toilet facilities, and residence in a rural or urban community were associated with healthcare contact patterns and/or poultry keeping and may indirectly affect ESCrE colonization. Prior antibiotic use was not significantly associated with ESCrE colonization in our analysis.
conclusionsThe risk factors associated with ESCrE colonization in communities include healthcare- and community-related factors, indicating that efforts to control antimicrobial resistance in community settings must include community- and hospital-level interventions.
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