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dc.contributor.authorKnudsen, Per Kristian
dc.contributor.authorBrandtzæg, Petter
dc.contributor.authorHøiby, Ernst Arne
dc.contributor.authorBohlin, Jon
dc.contributor.authorSamuelsen, Ørjan
dc.contributor.authorSteinbakk, Martin
dc.contributor.authorAbrahamsen, Tore G
dc.contributor.authorMüller, Fredrik
dc.contributor.authorGammelsrud, Karianne Wiger
dc.date.accessioned2018-01-04T09:53:57Z
dc.date.available2018-01-04T09:53:57Z
dc.date.issued2017-11-07
dc.description.abstractWe prospectively studied the consequences of extensive antibiotic treatment on faecal carriage of antibiotic-resistant enterobacteria in a cohort of children with cystic fibrosis (CF) and a cohort of children with cancer compared to healthy children with no or low antibiotic exposure. The study was conducted in Norway in a low resistance prevalence setting. Sixty longitudinally collected faecal samples from children with CF (n = 32), 88 samples from children with cancer (n = 45) and 127 samples from healthy children (n = 70) were examined. A direct MIC-gradient strip method was used to detect resistant Enterobacteriaceae by applying Etest strips directly onto agar-plates swabbed with faecal samples. Whole genome sequencing (WGS) data were analysed to identify resistance mechanisms in 28 multidrug-resistant Escherichia coli isolates. The prevalence of resistance to third-generation cephalosporins, gentamicin and ciprofloxacin was low in all the study groups. At inclusion the prevalence of ampicillin-resistant E. coli and trimethoprim-sulfamethoxazole-resistant E. coli in the CF group compared to healthy controls was 58.6% vs. 28.4% (p = 0.005) and 48.3% vs. 14.9% (p = 0.001), respectively, with a similar prevalence at the end of the study. The prevalence of resistant enterobacteria was not significantly different in the children with cancer compared to the healthy children, not even at the end of the study when the children with cancer had been treated with repeated courses of broad-spectrum antibiotics. Children with cancer were mainly treated with intravenous antibiotics, while the CF group mainly received peroral treatment. Our observations indicate that the mode of administration of antibiotics and the general level of antimicrobial resistance in the community may have an impact on emergence of resistance in intestinal enterobacteria during antibiotic treatment. The WGS analyses detected acquired resistance genes and/or chromosomal mutations that explained the observed phenotypic resistance in all 28 multidrug-resistant E. coli isolates examined.en_US
dc.descriptionSource at <a href=https://doi.org/10.1371/journal.pone.0187618> https://doi.org/10.1371/journal.pone.0187618 </a>en_US
dc.identifier.citationKnudsen PK, Brandtzæg P, Høiby EA, Bohlin J, Samuelsen Ø, Steinbakk M, Abrahamsen TG, Müller F, Gammelsrud K. Impact of extensive antibiotic treatment on faecal carriage of antibiotic-resistant enterobacteria in children in a low resistance prevalence setting. PLoS ONE. 2017;12(11)en_US
dc.identifier.cristinIDFRIDAID 1522326
dc.identifier.doi10.1371/journal.pone.0187618
dc.identifier.issn1932-6203
dc.identifier.urihttps://hdl.handle.net/10037/11904
dc.language.isoengen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.journalPLoS ONE
dc.relation.urihttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675440/pdf/pone.0187618.pdf
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710::Medisinsk mikrobiologi: 715en_US
dc.subjectVDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710::Medical microbiology: 715en_US
dc.titleImpact of extensive antibiotic treatment on faecal carriage of antibiotic-resistant enterobacteria in children in a low resistance prevalence settingen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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