{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:19:32Z","timestamp":1785449972429,"version":"3.56.0"},"reference-count":22,"publisher":"Microbiology Society","issue":"5","license":[{"start":{"date-parts":[[2017,5,1]],"date-time":"2017-05-01T00:00:00Z","timestamp":1493596800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5,1]]},"abstract":"<jats:p>\n                  <jats:bold>Background.<\/jats:bold> Antimicrobial resistance is an emerging global health issue. Data on the epidemiology of multidrug-resistant organisms are scarce for Africa, especially in HIV-infected individuals who often have frequent contact with healthcare. We investigated the prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) carriage in stool among HIV-infected children attending an HIV outpatient department in Harare, Zimbabwe.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Methods.<\/jats:bold> We recruited children who were stable on antiretroviral therapy (ART) attending a HIV clinic from August 2014 to June 2015. Information was collected on antibiotic use and hospitalization. Stool was tested for ESBL-E through combination disc diffusion. API20E identification and antimicrobial susceptibility was performed on the positive samples followed by whole genome sequencing.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results.<\/jats:bold> Stool was collected from 175\/202 (86.6\u200a%) children. Median age was 11 [inter-quartile range (IQR) 9\u201312] years. Median time on ART was 4.6 years (IQR 2.4\u20136.4). ESBL-Es were found in 24\/175 samples (13.7\u200a%); 50\u200a% of all ESBL-Es were resistant to amoxicillin-clavulanate, 100\u200a% to co-trimoxazole, 45.8\u200a% to chloramphenicol, 91.6\u200a% to ceftriaxone, 20.8\u200a% to gentamicin and 62.5\u200a% to ciprofloxacin. ESBL-Es variously encoded CTX-M, OXA, TEM and SHV enzymes. The odds of ESBL-E carriage were 8.5 times (95\u200a%\u2009CI 2.2\u201332.3) higher in those on ART for less than one year (versus longer) and 8.5 times (95\u200a%\u2009CI 1.1\u201332.3) higher in those recently hospitalized for a chest infection.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusion.<\/jats:bold> We found a 13.7\u200a% prevalence of ESBL-E carriage in a population where ESBL-E carriage has not been described previously. Antimicrobial resistance (AMR) in Africa merits further study, particularly given the high HIV prevalence and limited diagnostic and therapeutic options available.<\/jats:p>","DOI":"10.1099\/jmm.0.000474","type":"journal-article","created":{"date-parts":[[2017,5,17]],"date-time":"2017-05-17T15:12:24Z","timestamp":1495033944000},"page":"609-615","source":"Crossref","is-referenced-by-count":28,"title":["Carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae in HIV-infected children in Zimbabwe"],"prefix":"10.1099","volume":"66","author":[{"given":"S. M. S","family":"Wilmore","sequence":"first","affiliation":[{"name":"Royal Free Hospital NHS Trust, London, UK"},{"name":"London School of Hygiene and Tropical Medicine, London, UK"},{"name":"UCL Centre for Clinical Microbiology, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Kranzer","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine, London, UK"},{"name":"National German Mycobacterium Reference, Borstel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Williams","sequence":"additional","affiliation":[{"name":"Royal Free Hospital NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Makamure","sequence":"additional","affiliation":[{"name":"Biomedical Research and Training Institute, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. F","family":"Nhidza","sequence":"additional","affiliation":[{"name":"Biomedical Research and Training Institute, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Mayini","sequence":"additional","affiliation":[{"name":"Biomedical Research and Training Institute, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Bandason","sequence":"additional","affiliation":[{"name":"Biomedical Research and Training Institute, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Metcalfe","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. P","family":"Nicol","sequence":"additional","affiliation":[{"name":"University of Cape Town, National Health Laboratory Service, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Royal Free Hospital NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. J","family":"Ellington","sequence":"additional","affiliation":[{"name":"Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Woodford","sequence":"additional","affiliation":[{"name":"Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Royal Free Hospital NHS Trust, London, UK"},{"name":"Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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