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Poverty and Community-Acquired Antimicrobial Resistance with Extended-Spectrum ß-Lactamase-Producing Organisms, Hyderabad, India.

Alsan M, Kammili N, Lakshmi J, Xing A, Khan A, Rani M, Kolli P, Relman DA, Owens DK. Poverty and Community-Acquired Antimicrobial Resistance with Extended-Spectrum ß-Lactamase-Producing Organisms, Hyderabad, India. Emerging Infectious Diseases. 2018 Aug 1; 24(8):1490-1496.

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Abstract:

The decreasing effectiveness of antimicrobial agents is a global public health threat, yet risk factors for community-acquired antimicrobial resistance (CA-AMR) in low-income settings have not been clearly elucidated. Our aim was to identify risk factors for CA-AMR with extended-spectrum ß-lactamase (ESBL)-producing organisms among urban-dwelling women in India. We collected microbiological and survey data in an observational study of primigravidae women in a public hospital in Hyderabad, India. We analyzed the data using multivariate logistic and linear regression and found that 7% of 1,836 women had bacteriuria; 48% of isolates were ESBL-producing organisms. Women in the bottom 50th percentile of income distribution were more likely to have bacteriuria (adjusted odds ratio 1.44, 95% CI 0.99-2.10) and significantly more likely to have bacteriuria with ESBL-producing organisms (adjusted odds ratio 2.04, 95% CI 1.17-3.54). Nonparametric analyses demonstrated a negative relationship between the prevalence of ESBL and income.




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