| Pauline Getanda, Isatou Jagne, Joel D Bognini, Bully Camara, Bakary Sanyang, Saffiatou Darboe, Ellen Sambou, Momodou Barry, Kady Kassibo, Aminata Cham, Harriet Mendy, Bintou K J Singateh, Ebrahim Ndure, Toussaint Rouamba, Abdoulie Bojang, Christian Bottomley, Benjamin P Howden, Umberto D’Alessandro, Halidou Tinto, Anna Roca, Fatoumata Sillah, Nathalie Beloum, Usman N Nakakana, Madikoi Danso, Joquina C Jones, Shashu Graves, Edrissa Sabally, Siaka Badjie, Sulayman Bah, Omar B Jarra, Abdoulie Suso Impact of Intrapartum Azithromycin on the Carriage and Antibiotic Resistance of Escherichia coli and Klebsiella pneumoniae in Mothers and their Newborns: a sub-study of a Randomized Double-Blind Trial Conducted in The Gambia and Burkina Faso Journal Article In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024, ISSN: 1537-6591. @article{Getanda2024,
title = {Impact of Intrapartum Azithromycin on the Carriage and Antibiotic Resistance of Escherichia coli and Klebsiella pneumoniae in Mothers and their Newborns: a sub-study of a Randomized Double-Blind Trial Conducted in The Gambia and Burkina Faso},
author = {Pauline Getanda and Isatou Jagne and Joel D Bognini and Bully Camara and Bakary Sanyang and Saffiatou Darboe and Ellen Sambou and Momodou Barry and Kady Kassibo and Aminata Cham and Harriet Mendy and Bintou K J Singateh and Ebrahim Ndure and Toussaint Rouamba and Abdoulie Bojang and Christian Bottomley and Benjamin P Howden and Umberto D’Alessandro and Halidou Tinto and Anna Roca and Fatoumata Sillah and Nathalie Beloum and Usman N Nakakana and Madikoi Danso and Joquina C Jones and Shashu Graves and Edrissa Sabally and Siaka Badjie and Sulayman Bah and Omar B Jarra and Abdoulie Suso},
url = {https://pubmed.ncbi.nlm.nih.gov/38752311/},
doi = {10.1093/CID/CIAE280},
issn = {1537-6591},
year = {2024},
date = {2024-01-01},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
publisher = {Clin Infect Dis},
abstract = {BACKGROUND: Limited data exists on effects of intrapartum azithromycin on prevalence of carriage and antibiotic resistance of Enterobacterales. METHODS: We conducted a randomized trial in Gambia and Burkina Faso where women received intrapartum azithromycin (2g) or placebo. We determined impact of treatment on prevalence of carriage and antibiotic resistance of Escherichia coli and Klebsiella pneumoniae by analysing rectal swabs (RS), nasopharyngeal swabs (NPS), breast milk and recto-vaginal swabs (RVS). Bacteria were isolated microbiologically; antibiotic susceptibility was confirmed with an E-test. Prevalence ratios (PR) with 95% confidence intervals (CI's) were used for comparison between arms. RESULTS: In infants, E. coli carriage in RS was lower in the intervention than placebo arm at days 6 (63.0% vs. 75.2%, PR, 0.84; CI, 0.75-0.95) and 28 (52.7% vs. 70.4%, 0.75; 0.64-0.87) post-intervention. Prevalence of azithromycin-resistant E. coli was higher in the azithromycin arm at days 6 (13.4% vs. 3.6%, 3.75; 1.83-7.69) and 28 (16.4% vs. 9.6%, 1.71; 1.05-2.79). For K. pneumoniae, carriage in RS was higher in the intervention than placebo arm at days 6 (49.6% vs. 37.2%, 1.33; 1.08-1.64) and 28 (53.6% vs. 32.9%, 1.63; 1.31-2.03). Prevalence of azithromycin-resistant K. pneumoniae was higher in the azithromycin arm at day 28 (7.3% vs. 2.1%, 3.49; 1.30-9.37). No differences were observed for other sample types. CONCLUSION: Intrapartum azithromycin decreased E. coli carriage but increased both K. pneumoniae carriage and azithromycin resistance in both bacteria. These data need to be considered together with efficacy results to balance the potential short- and long-term impact of the intervention. CLINICAL TRIALS REGISTRATION: www.clinicaltrials.gov: NCT03199547.},
keywords = {Isatou Jagne, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Pauline Getanda, PubMed Abstract},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Limited data exists on effects of intrapartum azithromycin on prevalence of carriage and antibiotic resistance of Enterobacterales. METHODS: We conducted a randomized trial in Gambia and Burkina Faso where women received intrapartum azithromycin (2g) or placebo. We determined impact of treatment on prevalence of carriage and antibiotic resistance of Escherichia coli and Klebsiella pneumoniae by analysing rectal swabs (RS), nasopharyngeal swabs (NPS), breast milk and recto-vaginal swabs (RVS). Bacteria were isolated microbiologically; antibiotic susceptibility was confirmed with an E-test. Prevalence ratios (PR) with 95% confidence intervals (CI's) were used for comparison between arms. RESULTS: In infants, E. coli carriage in RS was lower in the intervention than placebo arm at days 6 (63.0% vs. 75.2%, PR, 0.84; CI, 0.75-0.95) and 28 (52.7% vs. 70.4%, 0.75; 0.64-0.87) post-intervention. Prevalence of azithromycin-resistant E. coli was higher in the azithromycin arm at days 6 (13.4% vs. 3.6%, 3.75; 1.83-7.69) and 28 (16.4% vs. 9.6%, 1.71; 1.05-2.79). For K. pneumoniae, carriage in RS was higher in the intervention than placebo arm at days 6 (49.6% vs. 37.2%, 1.33; 1.08-1.64) and 28 (53.6% vs. 32.9%, 1.63; 1.31-2.03). Prevalence of azithromycin-resistant K. pneumoniae was higher in the azithromycin arm at day 28 (7.3% vs. 2.1%, 3.49; 1.30-9.37). No differences were observed for other sample types. CONCLUSION: Intrapartum azithromycin decreased E. coli carriage but increased both K. pneumoniae carriage and azithromycin resistance in both bacteria. These data need to be considered together with efficacy results to balance the potential short- and long-term impact of the intervention. CLINICAL TRIALS REGISTRATION: www.clinicaltrials.gov: NCT03199547. |
