Increased risk of acquisition and transmission of ESBL-producing Enterobacteriaceae in malnourished children exposed to amoxicillin - Université Paris-Est-Créteil-Val-de-Marne Access content directly
Journal Articles Journal of Antimicrobial Chemotherapy Year : 2020

Increased risk of acquisition and transmission of ESBL-producing Enterobacteriaceae in malnourished children exposed to amoxicillin

Naouale Maataoui
  • Function : Author
Céline Langendorf
  • Function : Author
Fatou Berthe
  • Function : Author
Jumamurat Bayjanov
  • Function : Author
Willem van Schaik
  • Function : Author
Sheila Isanaka
  • Function : Author
Rebecca Grais
  • Function : Author
Olivier Clermont
  • Function : Author
Antoine Andremont
  • Function : Author
Laurence Armand-Lefèvre
  • Function : Author
  • PersonId : 948287
  • IdRef : 137056591

Abstract

Abstract Objectives Routine amoxicillin for children with uncomplicated severe acute malnutrition raises concerns of increasing antibiotic resistance. We performed an ancillary study nested within a double-blind, placebo-controlled trial in Niger testing the role of routine 7 day amoxicillin therapy in nutritional recovery of children 6 to 59 months of age with uncomplicated severe acute malnutrition. Methods We screened 472 children for rectal carriage of ESBL-producing Enterobacteriaceae (ESBL-E) as well as their household siblings under 5 years old, at baseline and Week 1 (W1) and Week 4 (W4) after start of therapy, and characterized strains by WGS. ClinicalTrials.gov: NCT01613547. Results Carriage in index children at baseline was similar in the amoxicillin and the placebo groups (33.8% versus 27.9%, P = 0.17). However, acquisition of ESBL-E in index children at W1 was higher in the amoxicillin group than in the placebo group (53.7% versus 32.2%, adjusted risk ratio = 2.29, P = 0.001). Among 209 index and sibling households possibly exposed to ESBL-E transmission, 16 (7.7%) had paired strains differing by ≤10 SNPs, suggesting a high probability of transmission. This was more frequent in households from the amoxicillin group than from the placebo group [11.5% (12/104) versus 3.8% (4/105), P = 0.04]. Conclusions Among children exposed to amoxicillin, ESBL-E colonization was more frequent and the risk of transmission to siblings higher. Routine amoxicillin should be carefully balanced with the risks associated with ESBL-E colonization.
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Dates and versions

hal-04298579 , version 1 (21-11-2023)

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Naouale Maataoui, Céline Langendorf, Fatou Berthe, Jumamurat Bayjanov, Willem van Schaik, et al.. Increased risk of acquisition and transmission of ESBL-producing Enterobacteriaceae in malnourished children exposed to amoxicillin. Journal of Antimicrobial Chemotherapy, 2020, 75 (3), pp.709-717. ⟨10.1093/jac/dkz487⟩. ⟨hal-04298579⟩
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