{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:53:26Z","timestamp":1753876406555,"version":"3.41.2"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T00:00:00Z","timestamp":1611705600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Research Council Unit The Gambia (MRCG) PhD fellowship"},{"name":"UK Medical Research Council and the UK Department for International Development (DFID) under the MRC\/DFID Concordat","award":["MR\/J010391\/1"],"award-info":[{"award-number":["MR\/J010391\/1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate the impact of one oral dose of intrapartum azithromycin (2\u2009g) on the carriage and antibiotic resistance of Escherichia coli and Klebsiella pneumoniae in the nasopharynx, breast milk and vaginal swabs of mothers and K. pneumoniae in the nasopharynx of their newborns.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a post hoc analysis of a double-blind, placebo-controlled randomized-trial (ratio 1:1) conducted in The Gambia. Breast milk (BM) and vaginal swabs (VS) from mothers and nasopharyngeal swabs (NPS) from mother\u2013newborn pairs were collected at different timepoints during the 4\u2009week follow-up. Samples were processed using standard microbiological procedures. For BM and NPS post-intervention results were combined for analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the original trial 829 mothers were randomized. In this analysis, complete sample sets were available for 630 mothers for E. coli analysis (76.0%) and 564 mother\u2013newborn pairs for K. pneumoniae analysis (68.0%). For E. coli, carriage prevalence in BM and VS was similar in both arms but resistance was higher in the azithromycin arm in VS (2.6% versus 0%, P\u200a=\u200a0.004). For K. pneumoniae, carriage prevalence was higher in the azithromycin arm for BM (13.8% versus 8.7%, P\u200a=\u200a0.055) but not for VS or NPS. Prevalence of azithromycin resistant K. pneumoniae was higher in the azithromycin arm for BM (3.6% versus 1.0%, P\u200a=\u200a0.050) and VS (1.5% versus 0% P\u200a=\u200a0.057).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Oral intrapartum azithromycin did not reduce carriage of E. coli and K. pneumoniae and was associated with an increase in the prevalence of azithromycin-resistant E. coli and K. pneumoniae isolates in BM and VS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jacamr\/dlaa128","type":"journal-article","created":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T20:11:51Z","timestamp":1609272711000},"source":"Crossref","is-referenced-by-count":1,"title":["Short-term increase in the carriage of azithromycin-resistant <i>Escherichia coli<\/i> and <i>Klebsiella pneumoniae<\/i> in mothers and their newborns following intra-partum azithromycin: a post hoc analysis of a double-blind randomized trial"],"prefix":"10.1093","volume":"3","author":[{"given":"Pauline","family":"Getanda","sequence":"first","affiliation":[{"name":"Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdoulie","family":"Bojang","sequence":"additional","affiliation":[{"name":"Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bully","family":"Camara","sequence":"additional","affiliation":[{"name":"Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isatou","family":"Jagne-Cox","sequence":"additional","affiliation":[{"name":"Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Effua","family":"Usuf","sequence":"additional","affiliation":[{"name":"Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin P","family":"Howden","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, University of Melbourne, Doherty Institute for Infection and Immunity, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umberto","family":"D\u2019Alessandro","sequence":"additional","affiliation":[{"name":"Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Bottomley","sequence":"additional","affiliation":[{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Roca","sequence":"additional","affiliation":[{"name":"Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,1,27]]},"reference":[{"key":"2021052617142285100_dlaa128-B1","doi-asserted-by":"crossref","first-page":"e710","DOI":"10.1016\/S2214-109X(19)30163-9","article-title":"National, regional, and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030: a systematic analysis","volume":"7","author":"Hug","year":"2019","journal-title":"Lancet Glob Health"},{"key":"2021052617142285100_dlaa128-B2","doi-asserted-by":"crossref","first-page":"3027","DOI":"10.1016\/S0140-6736(16)31593-8","article-title":"Global, regional, and national causes of under-5 mortality in 2000\u201315: an updated systematic analysis with implications for the Sustainable Development 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