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Doan T, Liu Z, Sié A, Dah C, Bountogo M, Ouattara M, Coulibaly B, Kiemde D, Zonou G, Nebie E, Brogdon J, Lebas E, Hinterwirth A, Zhong L, Chen C, Zhou Z, Porco T, Arnold BF, Oldenburg CE, Lietman TM. Gut Microbiome Diversity and Antimicrobial Resistance After a Single Dose of Oral Azithromycin in Children: A Randomized Placebo-Controlled Trial. Am J Trop Med Hyg 2024; 110:291-294. [PMID: 38227963 PMCID: PMC10859792 DOI: 10.4269/ajtmh.23-0651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 10/25/2023] [Indexed: 01/18/2024] Open
Abstract
Mass antibiotic distribution to preschool children resulted in alterations of the gut microbiome months after distribution. This individually randomized, placebo-controlled trial evaluated changes in the gut microbiome and resistome in children aged 8 days to 59 months after one dose of oral azithromycin in Burkina Faso. A total of 450 children were randomized in a 1:1 ratio to either placebo or azithromycin. Rectal samples were collected at baseline, 2 weeks, and 6 months after randomization and subjected to DNA deep sequencing. Gut microbiome diversity and normalized antimicrobial resistance determinants for different antibiotic classes were evaluated. Azithromycin decreased gut bacterial diversity (Shannon P < 0.0001; inverse Simpson P < 0.001) 2 weeks after treatment relative to placebo. Concurrently, the normalized abundance of macrolide resistance genetic determinants was 243-fold higher (95% CI: 76-fold to 776-fold, P < 0.0001). These alterations did not persist at 6 months, suggesting that disruptions were transient. Furthermore, we were unable to detect resistance changes in other antibiotic classes, indicating that co-resistance with a single course of azithromycin when treated at the individual level was unlikely.
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Affiliation(s)
- Thuy Doan
- Francis I. Proctor Foundation, University of California, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, California
| | - Zijun Liu
- Department of Ophthalmology, University of California, San Francisco, California
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Clarisse Dah
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | | | | | - Dramane Kiemde
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | - Eric Nebie
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Jessica Brogdon
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Elodie Lebas
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Armin Hinterwirth
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Lina Zhong
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Cindi Chen
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Zhaoxia Zhou
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Travis Porco
- Francis I. Proctor Foundation, University of California, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Benjamin F. Arnold
- Francis I. Proctor Foundation, University of California, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Catherine E. Oldenburg
- Francis I. Proctor Foundation, University of California, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
- Institute for Global Health Sciences, University of California, San Francisco, California
| | - Thomas M. Lietman
- Francis I. Proctor Foundation, University of California, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
- Institute for Global Health Sciences, University of California, San Francisco, California
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Coulibaly B, Kiemde D, Zonou G, Sié A, Dah C, Bountogo M, Brogdon J, Hu H, Lebas E, Porco TC, Doan T, Lietman TM, Oldenburg CE. Effect of Single-dose Azithromycin on Pneumococcal Carriage and Resistance: A Randomized Controlled Trial. Pediatr Infect Dis J 2022; 41:728-730. [PMID: 35944061 PMCID: PMC9359759 DOI: 10.1097/inf.0000000000003585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/27/2022]
Abstract
We evaluated antibiotic resistance selection in Streptococcus pneumoniae isolates from children participating in an individually randomized trial of single-dose azithromycin versus placebo. After 14 days, the prevalence of resistance to erythromycin, oxacillin, and clindamycin was elevated in the azithromycin versus placebo group. There was no difference at 6 months.
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Affiliation(s)
| | - Dramane Kiemde
- From the Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Guillaume Zonou
- From the Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Ali Sié
- From the Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Clarisse Dah
- From the Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Mamadou Bountogo
- From the Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Jessica Brogdon
- Francis I Proctor Foundation, University of California, San Francisco, CA
| | - Huiyu Hu
- Francis I Proctor Foundation, University of California, San Francisco, CA
| | - Elodie Lebas
- Francis I Proctor Foundation, University of California, San Francisco, CA
| | - Travis C. Porco
- Francis I Proctor Foundation, University of California, San Francisco, CA
| | - Thuy Doan
- Francis I Proctor Foundation, University of California, San Francisco, CA
| | - Thomas M. Lietman
- Francis I Proctor Foundation, University of California, San Francisco, CA
| | - Catherine E. Oldenburg
- Francis I Proctor Foundation, University of California, San Francisco, CA
- Department of Ophthalmology, University of California, San Francisco, CA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA
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Kiemde D, Ribeiro I, Sanou S, Coulibaly B, Sie A, Ouedraogo AS, Souares A, Eibach D. Molecular characterization of beta-lactamase genes produced by community-acquired uropathogenic Escherichia coli in Nouna. J Infect Dev Ctries 2020; 14:1274-1280. [PMID: 33296340 DOI: 10.3855/jidc.11737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 12/31/2019] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Extended-Spectrum Beta-Lactamases (ESBL) are a common mechanism of bacterial resistance in Enterobacteriaceae. The purpose of this study is to characterize the ESBL genes produced by community-acquired uropathogenic Escherichia coli strains in the Nouna District, in the West-African country, Burkina Faso. METHODOLOGY Samples were collected from non-hospitalized patients who came for consultation at the CMA (Centre Médical avec Antenne chirurgicale) in Nouna and were sent to the laboratory for a urine culture test. The detection of ESBL production by the bacteria was carried out with the double-disc synergy test and the extraction of the ESBL genes with the heat shock method. Molecular characterization of ESBL genes was performed with three sequential multiplex polymerase chain reaction (PCR) assays. RESULTS One hundred and eighty-two (182) bacteriological cultures were analyzed and 29 E. coli isolated, between 01/07/2017 and 01/07/2018. The ESBL phenotype was found in 13/29 (44.8%). Multiplex PCR yielded many beta-lactamase genes, predominantly blaCTX-M-1,3,15 (12/13; 92.3%) followed by beta-lactamase genes blaOXA-1,4,30 (8/13; 61.5%) and beta-lactamase genes blaTEM-1,2 (7/13; 53.8%). CONCLUSION This study showed that the blaCTX-M-1,3,15 genes produced by uropathogenic E. coli were predominant. Sequencing of these genes would be needed to better characterize the different types of ESBL circulating in Nouna.
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Affiliation(s)
- Dramane Kiemde
- Nouna Health Research Center/CMA (Centre Médical avec Antenne Chirurgicale) Biological Analysis Laboratory, Burkina Faso.
| | - Inês Ribeiro
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Germany.
| | - Soufiane Sanou
- Department of Medical Bacteriology and Virology, National Reference Laboratory for Antimicrobial Resistance, University Hospital Centre Sanou Sourou, Bobo Dioulasso, Burkina Faso.
| | - Boubacar Coulibaly
- Nouna Health Research Center/CMA (Centre Médical avec Antenne Chirurgicale) Biological Analysis Laboratory, Burkina Faso.
| | - Ali Sie
- Nouna Health Research Center/CMA (Centre Médical avec Antenne Chirurgicale) Biological Analysis Laboratory, Burkina Faso.
| | - Abdoul-Salam Ouedraogo
- Department of Medical Bacteriology and Virology, National Reference Laboratory for Antimicrobial Resistance, University Hospital Centre Sanou Sourou, Bobo Dioulasso, Burkina Faso.
| | - Aurélia Souares
- German Center for Infection Research (DZIF), Heidelberg, Hamburg-Lübeck-Borstel-Riems, Heidelberg, Germany.
| | - Daniel Eibach
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany.
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Coulibaly B, Sié A, Kiemde D, Dembélé N, Compaore A, Dabo O, Dah C, Ouermi L, Cevallos V, Lebas E, Brogdon JM, Keenan JD, Oldenburg CE. Pneumococcal Carriage and Antibiotic Resistance in Children Younger than 5 Years in Nouna District, Burkina Faso. Am J Trop Med Hyg 2020; 103:684-688. [PMID: 32458778 DOI: 10.4269/ajtmh.20-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Increasing antibiotic consumption has been shown to lead to increased antibiotic resistance selection. We evaluated the prevalence of antibiotic resistance in Streptococcus pneumoniae to commonly used antibiotic classes as well as correlations between resistance and antibiotic consumption at the individual and community levels in children aged 0-59 months in Nouna district, Burkina Faso. A population-based sample of 300 children aged 0-59 months was randomly selected from the most recent census in 18 communities in the Nouna Health and Demographic Surveillance Site. Caregivers were interviewed about children's recent antibiotic use, and a nasopharyngeal swab was collected from each child. Nasopharyngeal swabs were processed using standard microbiological methods to determine pneumococcal carriage and resistance. Community-level antibiotic consumption was determined by record review from primary healthcare facilities, which routinely collect prescription data for children aged 0-59 months. Streptococcus pneumoniae was isolated from 101 (35.7%) nasopharyngeal samples. Among positive isolates, co-trimoxazole (75.6%) and tetracycline (69.3%) resistance was the most common, followed by oxacillin (26.7%) and azithromycin (9.9%). Recent antibiotic use was associated with decreased pneumococcal carriage (odds ratio 0.56, 95% CI: 0.33-0.93) at the individual level. There was no statistically significant relationship between antibiotic use and antibiotic resistance at the individual or community levels, although CIs were generally wide. The prevalence of antibiotic resistance to commonly used antibiotics was high in the study area. Expanding antimicrobial resistance surveillance in areas with little population-based data will be important for informing policy related to antibiotic use.
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Affiliation(s)
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Dramane Kiemde
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Nestor Dembélé
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Adama Compaore
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Ousmane Dabo
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Clarisse Dah
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | - Vicky Cevallos
- Francis I Proctor Foundation, University of California, San Francisco, San Francisco, California
| | - Elodie Lebas
- Francis I Proctor Foundation, University of California, San Francisco, San Francisco, California
| | - Jessica M Brogdon
- Francis I Proctor Foundation, University of California, San Francisco, San Francisco, California
| | - Jeremy D Keenan
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California.,Francis I Proctor Foundation, University of California, San Francisco, San Francisco, California
| | - Catherine E Oldenburg
- Francis I Proctor Foundation, University of California, San Francisco, San Francisco, California.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.,Department of Ophthalmology, University of California, San Francisco, San Francisco, California
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