Journal article

Dynamics of antimicrobial resistance in intestinal Escherichia coli from children in community settings in South Asia and sub-Saharan Africa

Danielle J Ingle, Myron M Levine, Karen L Kotloff, Kathryn E Holt, Roy M Robins-Browne



The dynamics of antimicrobial resistance (AMR) in developing countries are poorly understood, especially in community settings, due to a sparsity of data on AMR prevalence and genetics. We used a combination of phenotyping, genomics and antimicrobial usage data to investigate patterns of AMR amongst atypical enteropathogenic Escherichia coli (aEPEC) strains isolated from children younger than five years old in seven developing countries (four in sub-Saharan Africa and three in South Asia) over a three-year period. We detected high rates of AMR, with 65% of isolates displaying resistance to three or more drug classes. Whole-genome sequencing revealed a diversity of known genetic mechanisms fo..

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Awarded by NHMRC of Australia

Awarded by Bill & Melinda Gates Foundation

Awarded by National Health and Medical Research Council of Australia

Funding Acknowledgements

This work was supported by the NHMRC of Australia (Project Grants 1043830 to K.E.H., and 1009296 and 1067428 to R.M.R-B.; Fellowship 1061409 to K.E.H.) and the Bill & Melinda Gates Foundation (Grant 38874 to M.M.L.). We thank G. Dougan and the sequencing teams at the Wellcome Trust Sanger Institute for sequencing the aEPEC isolate collection.