{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T20:58:02Z","timestamp":1788814682072,"version":"build-2803163510"},"reference-count":70,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43 TW010540"],"award-info":[{"award-number":["D43 TW010540"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006521","name":"School of Medicine, Stanford University","doi-asserted-by":"publisher","award":["MCHRI"],"award-info":[{"award-number":["MCHRI"]}],"id":[{"id":"10.13039\/100006521","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32AI052073"],"award-info":[{"award-number":["T32AI052073"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Neonatal infections are increasingly caused by antibiotic-resistant bacteria. It is unknown to what extent home-based births, which account for nearly a third of deliveries in Bangladesh, may also result in exposure to antibiotic-resistant bacteria.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We enrolled mothers who delivered at home and their newborns from a rural community in Bangladesh during April-June, 2022. Within 2\u20137 days after delivery, we collected vaginal and rectal swabs from mothers and rectal swabs from the newborns. Swabs were cultured on chromogenic culture media selective for extended-spectrum \u03b2-lactamase-producing bacteria (ESBL-PB) and carbapenem-resistant bacteria (CRB). Demographic and risk factor data were collected via surveys. Birth attendants who facilitated the deliveries were interviewed regarding infection prevention practices. We performed descriptive analyses and Firth\u2019s penalized logistic regression to identify potential risk factors associated with colonization.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of the 50 mothers enrolled, the median age was 23 years (range 18\u201326). Thirty-eight (76%) mothers had at least one antenatal care visit. Only one mother reported hospitalization during pregnancy, and 4 reported antibiotic use during pregnancy. Following delivery, 47 (94%) mothers were colonized with ESBL-PB, and 37 (74%) were colonized with CRB. Of the newborns, 36 (72%) were colonized with ESBL-PB, and 27 (54%) were colonized with CRB. No associations were found with any perinatal exposures, though all households reported incomes below the international poverty level. Of the 9 birth attendants who were able to be interviewed, 7 (78%) reported performing hand hygiene before delivery, and 8 (89%) reported glove use during delivery. Attendants reported cleaning equipment shared across deliveries with soap and water and using boiled water for delivery (89%, n\u2009=\u20098).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Women and newborns in this rural population were frequently colonized with both ESBL-PB and CRB following home deliveries. This demonstrates the importance of community-based antibiotic-resistant bacterial transmission and need for further understanding community exposures driving antibiotic resistance.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0325404","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T21:25:24Z","timestamp":1758317124000},"page":"e0325404","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Perinatal colonization with extended-spectrum beta-lactamase-producing and carbapenem-resistant gram-negative bacteria among home births in Bangladesh"],"prefix":"10.1371","volume":"20","author":[{"given":"Gregory S.","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafsa","family":"Hossain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Badrul","family":"Amin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahana","family":"Parveen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Aminul","family":"Islam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajrin Sultana","family":"Sraboni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abu Faisal Md.","family":"Pervez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilruba","family":"Zeba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily S.","family":"Gurley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Luby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4682-8087","authenticated-orcid":true,"given":"Ashley","family":"Styczynski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"issue":"10325","key":"pone.0325404.ref001","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","article-title":"Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis","volume":"399","author":"Antimicrobial Resistance Collaborators","year":"2022","journal-title":"Lancet"},{"issue":"10442","key":"pone.0325404.ref002","doi-asserted-by":"crossref","first-page":"2426","DOI":"10.1016\/S0140-6736(24)00876-6","article-title":"The scope of the antimicrobial resistance challenge","volume":"403","author":"IN Okeke","year":"2024","journal-title":"Lancet"},{"issue":"5","key":"pone.0325404.ref003","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(22)00043-2","article-title":"Neonatal sepsis and mortality in low-income and middle-income countries from a facility-based birth cohort: an international multisite prospective observational study","volume":"10","author":"R Milton","year":"2022","journal-title":"Lancet Glob Health"},{"issue":"1","key":"pone.0325404.ref004","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJM200101043440102","article-title":"Nasal carriage as a source of Staphylococcus aureus bacteremia. Study Group","volume":"344","author":"C von Eiff","year":"2001","journal-title":"N Engl J Med"},{"issue":"8","key":"pone.0325404.ref005","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1007\/s00134-018-5268-8","article-title":"Pathogen colonization of the gastrointestinal microbiome at intensive care unit admission and risk for subsequent death or infection","volume":"44","author":"DE Freedberg","year":"2018","journal-title":"Intensive Care Med"},{"issue":"4","key":"pone.0325404.ref006","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1093\/cid\/ciy539","article-title":"Temporal Dynamics and Risk Factors for Bloodstream Infection With Extended-spectrum \u03b2-Lactamase-producing Bacteria in Previously-colonized Individuals: National Population-based Cohort Study","volume":"68","author":"J Isendahl","year":"2019","journal-title":"Clin Infect Dis"},{"issue":"6","key":"pone.0325404.ref007","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/S1473-3099(22)00811-8","article-title":"Incidence of infection with multidrug-resistant Gram-negative bacteria and vancomycin-resistant enterococci in carriers: a systematic review and meta-regression analysis","volume":"23","author":"RPJ Willems","year":"2023","journal-title":"Lancet Infect Dis"},{"issue":"8","key":"pone.0325404.ref008","article-title":"Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis","volume":"10","author":"GJ Chan","year":"2013","journal-title":"PLoS Med"},{"key":"pone.0325404.ref009","article-title":"Adherence to three different strategies to prevent early onset GBS infection in newborns","volume":"33","author":"DGE Kolkman","year":"2020","journal-title":"Women Birth"},{"key":"pone.0325404.ref010","unstructured":"Prevention of Group B Streptococcal Early-Onset Disease in Newborns. [cited 5 Jan 2025]. Available: https:\/\/www.acog.org\/clinical\/clinical-guidance\/committee-opinion\/articles\/2020\/02\/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns#:~:text=The%20American%20College%20of%20Obstetricians%20and%20Gynecologists%20now%20recommends%20performing,Guidelines%20From%20CDC%2C%202010.%E2%80%9D"},{"issue":"2","key":"pone.0325404.ref011","first-page":"213","article-title":"Adherence to universal screening for group B Streptococcus in pregnancy and prevalence of colonised pregnancies in Caserta province, Italy","volume":"32","author":"S Porzio","year":"2024","journal-title":"Infez Med"},{"issue":"4","key":"pone.0325404.ref012","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1038\/s41564-021-00870-7","article-title":"Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries","volume":"6","author":"K Sands","year":"2021","journal-title":"Nat 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study (NeoOBS)","volume":"20","author":"NJ Russell","year":"2023","journal-title":"PLoS Med"},{"issue":"6","key":"pone.0325404.ref016","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-2013","article-title":"Epidemiology of Invasive Early-Onset Neonatal Sepsis, 2005 to 2014","volume":"138","author":"SJ Schrag","year":"2016","journal-title":"Pediatrics"},{"issue":"6","key":"pone.0325404.ref017","doi-asserted-by":"crossref","DOI":"10.1136\/archdischild-2017-313203","article-title":"Epidemiology of UK neonatal infections: the neonIN infection surveillance network","volume":"103","author":"B Cailes","year":"2018","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"pone.0325404.ref018","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1038\/s41372-020-00860-3","article-title":"Early-onset sepsis in term infants admitted to neonatal intensive care units (2011-2016)","volume":"41","author":"LB Polcwiartek","year":"2021","journal-title":"J Perinatol"},{"issue":"9","key":"pone.0325404.ref019","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1038\/s41564-022-01184-y","article-title":"Antibiotic resistance genes in the gut microbiota of mothers and linked neonates with or without sepsis from low- and middle-income countries","volume":"7","author":"MJ Carvalho","year":"2022","journal-title":"Nat Microbiol"},{"issue":"5","key":"pone.0325404.ref020","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1016\/j.chom.2015.04.004","article-title":"Dynamics and Stabilization of the Human Gut Microbiome during the First Year of Life","volume":"17","author":"F B\u00e4ckhed","year":"2015","journal-title":"Cell Host Microbe"},{"issue":"26","key":"pone.0325404.ref021","doi-asserted-by":"crossref","first-page":"11971","DOI":"10.1073\/pnas.1002601107","article-title":"Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns","volume":"107","author":"MG Dominguez-Bello","year":"2010","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"7946","key":"pone.0325404.ref022","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1038\/s41586-022-05620-1","article-title":"The person-to-person transmission landscape of the gut and oral microbiomes","volume":"614","author":"M Valles-Colomer","year":"2023","journal-title":"Nature"},{"issue":"1","key":"pone.0325404.ref023","doi-asserted-by":"crossref","first-page":"10635","DOI":"10.1038\/s41598-019-46964-5","article-title":"Impact of intrapartum and postnatal antibiotics on the gut microbiome and emergence of antimicrobial resistance in infants","volume":"9","author":"T Tapiainen","year":"2019","journal-title":"Sci Rep"},{"issue":"5","key":"pone.0325404.ref024","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1093\/cid\/ciy976","article-title":"Carriage and Acquisition of Extended-spectrum \u03b2-Lactamase-producing Enterobacterales Among Neonates Admitted to Hospital in Kilifi, Kenya","volume":"69","author":"N Kagia","year":"2019","journal-title":"Clin Infect Dis"},{"key":"pone.0325404.ref025","doi-asserted-by":"crossref","first-page":"100156","DOI":"10.1016\/j.xcrm.2020.100156","article-title":"Delivery Mode Affects Stability of Early Infant Gut Microbiota","volume":"1","author":"CM Mitchell","year":"2020","journal-title":"Cell Rep Med"},{"key":"pone.0325404.ref026","author":"Organization World Health","year":"2005"},{"key":"pone.0325404.ref027","article-title":"Levels and trends in child mortality","volume-title":"UNICEF DATA","author":"A Arora","year":"2024"},{"key":"pone.0325404.ref028","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1007\/978-3-642-28036-8_12","article-title":"Millennium Development Goals (MDGs)","volume-title":"Encyclopedia of Corporate Social Responsibility","author":"A Liimatainen","year":"2013"},{"key":"pone.0325404.ref029","unstructured":"World Health Organization. Ending preventable maternal mortality (EPMM): A renewed focus for improving maternal and newborn health and well-being. 2021. Available: https:\/\/www.who.int\/publications\/i\/item\/9789240040519"},{"issue":"1","key":"pone.0325404.ref030","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s13756-024-01366-9","article-title":"Perinatal colonization with extended-spectrum beta-lactamase-producing and carbapenem-resistant Gram-negative bacteria: a hospital-based cohort study","volume":"13","author":"A Styczynski","year":"2024","journal-title":"Antimicrob Resist Infect Control"},{"key":"pone.0325404.ref031","unstructured":"National Institute of Population Research and Training (NIPORT) and ICF. Bangladesh Demographic and Health Survey 2022: Key Indicators Report. 2023. Available: https:\/\/dhsprogram.com\/pubs\/pdf\/PR148\/PR148.pdf"},{"key":"pone.0325404.ref032","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/S0140-6736(05)17907-0","article-title":"Outpatient antibiotic use in Europe and association with resistance: a cross-national database study","volume":"365","author":"H Goossens","year":"2005","journal-title":"Lancet"},{"issue":"4","key":"pone.0325404.ref033","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1503\/cmaj.080239","article-title":"Antimicrobial resistance in hospitals: how concerned should we be?","volume":"180","author":"MR Mulvey","year":"2009","journal-title":"CMAJ"},{"key":"pone.0325404.ref034","doi-asserted-by":"crossref","first-page":"640","DOI":"10.3389\/fmicb.2019.00640","article-title":"Fecal colonization with multidrug-resistant E. coli among healthy infants in rural Bangladesh","volume":"10","author":"MA Islam","year":"2019","journal-title":"Frontiers in Microbiology"},{"key":"pone.0325404.ref035","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/ciad254","article-title":"Prevalence of colonization with antibiotic-resistant organisms in hospitalized and community individuals in Bangladesh, a phenotypic analysis: Findings from the antibiotic resistance in communities and hospitals (ARCH) study","volume":"77","author":"F Chowdhury","year":"2023","journal-title":"Clin Infect Dis"},{"issue":"3","key":"pone.0325404.ref036","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1093\/cid\/ciw283","article-title":"Fecal Colonization With Extended-spectrum Beta-lactamase-Producing Enterobacteriaceae and Risk Factors Among Healthy Individuals: A Systematic Review and Metaanalysis","volume":"63","author":"S Karanika","year":"2016","journal-title":"Clin Infect Dis"},{"issue":"2","key":"pone.0325404.ref037","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.ijantimicag.2017.03.012","article-title":"Carbapenem-resistant Enterobacteriaceae in the community: a scoping review","volume":"50","author":"AM Kelly","year":"2017","journal-title":"Int J Antimicrob Agents"},{"key":"pone.0325404.ref038","article-title":"High-level Colonization With Antibiotic-Resistant Enterobacterales Among Individuals in a Semi-Urban Setting in South India: An Antibiotic Resistance in Communities and Hospitals (ARCH) Study","volume":"77","author":"CPG Kumar","year":"2023","journal-title":"Clin Infect Dis"},{"issue":"7","key":"pone.0325404.ref039","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0270707","article-title":"Dissemination of carbapenemase-producing Enterobacterales in the community of Rawalpindi, Pakistan","volume":"17","author":"A Habib","year":"2022","journal-title":"PLoS One"},{"key":"pone.0325404.ref040","doi-asserted-by":"crossref","unstructured":"Garcia CR, Norfolk WA, Howard AK, Glatter AL, Beaudry MS, Mallis NA, et al. Long-term gut colonization with ESBL-producing Escherichia coli in participants without known risk factors from the southeastern United States. medRxiv. 2024. https:\/\/doi.org\/10.1101\/2024.02.03.24302254","DOI":"10.1101\/2024.02.03.24302254"},{"issue":"4","key":"pone.0325404.ref041","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.tim.2006.02.006","article-title":"Co-selection of antibiotic and metal resistance","volume":"14","author":"C Baker-Austin","year":"2006","journal-title":"Trends Microbiol"},{"issue":"8","key":"pone.0325404.ref042","doi-asserted-by":"crossref","DOI":"10.1016\/S2666-5247(23)00137-4","article-title":"Evaluating the relationship between community water and sanitation access and the global burden of antibiotic resistance: an ecological study","volume":"4","author":"ER Fuhrmeister","year":"2023","journal-title":"Lancet Microbe"},{"key":"pone.0325404.ref043","first-page":"100993","article-title":"Socioeconomic status and the risk for colonisation or infection with priority bacterial pathogens: a global evidence map","author":"S Blackmon","year":"2024","journal-title":"Lancet Microbe"},{"issue":"8","key":"pone.0325404.ref044","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.3201\/eid2408.171030","article-title":"Poverty and Community-Acquired Antimicrobial Resistance with Extended-Spectrum \u03b2-Lactamase-Producing Organisms, Hyderabad, India","volume":"24","author":"M Alsan","year":"2018","journal-title":"Emerg Infect Dis"},{"key":"pone.0325404.ref045","article-title":"Anthropological and socioeconomic factors contributing to global antimicrobial resistance: a univariate and multivariable analysis","volume":"2","author":"P Collignon","year":"2018","journal-title":"Lancet Planet Health"},{"issue":"1","key":"pone.0325404.ref046","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1038\/s41467-019-08853-3","article-title":"Global monitoring of antimicrobial resistance based on metagenomics analyses of urban sewage","volume":"10","author":"RS Hendriksen","year":"2019","journal-title":"Nat Commun"},{"key":"pone.0325404.ref047","unstructured":"Resistance, review on antimicrobial. Infection prevention, control and surveillance: limiting the development and spread of drug resistance. 2015."},{"key":"pone.0325404.ref048","unstructured":"Improved sanitation facilities and drinking-water sources. [cited 18 Oct 2024]. Available: https:\/\/www.who.int\/data\/nutrition\/nlis\/info\/improved-sanitation-facilities-and-drinking-water-sources#:~:text=Improved%20drinking%2Dwater%20sources%20are,protected%20springs%20and%20rainwater%20collection"},{"key":"pone.0325404.ref049","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3389\/fmicb.2013.00087","article-title":"The human microbiome as a reservoir of antimicrobial resistance","volume":"4","author":"J Penders","year":"2013","journal-title":"Front Microbiol"},{"issue":"4","key":"pone.0325404.ref050","doi-asserted-by":"crossref","first-page":"565","DOI":"10.2166\/wh.2012.102","article-title":"Unsealed tubewells lead to increased fecal contamination of drinking water","volume":"10","author":"PSK Knappett","year":"2012","journal-title":"J Water Health"},{"key":"pone.0325404.ref051","doi-asserted-by":"crossref","first-page":"121401","DOI":"10.1016\/j.envpol.2023.121401","article-title":"Deep tubewell use is associated with increased household microbial contamination in rural Bangladesh: Results from a prospective cohort study among households in rural Bangladesh","volume":"324","author":"V Goel","year":"2023","journal-title":"Environ Pollut"},{"issue":"12","key":"pone.0325404.ref052","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1289\/ehp.1409002","article-title":"Association of Supply Type with Fecal Contamination of Source Water and Household Stored Drinking Water in Developing Countries: A Bivariate Meta-analysis","volume":"123","author":"KF Shields","year":"2015","journal-title":"Environ Health Perspect"},{"key":"pone.0325404.ref053","doi-asserted-by":"crossref","first-page":"117350","DOI":"10.1016\/j.watres.2021.117350","article-title":"Faecal contamination of groundwater self-supply in low- and middle income countries: Systematic review and meta-analysis","volume":"201","author":"F Genter","year":"2021","journal-title":"Water Res"},{"issue":"3","key":"pone.0325404.ref054","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.ijheh.2016.12.007","article-title":"Microbial contamination of drinking water from risky tubewells situated in different hydrological regions of Bangladesh","volume":"220","author":"NC Dey","year":"2017","journal-title":"Int J Hyg Environ Health"},{"key":"pone.0325404.ref055","unstructured":"Gay D, Gallagher K. The need to extend the WTO TRIPS pharmaceuticals transition period for LDCs in the COVID-19 era: Evidence from Bangladesh. [cited 1 Aug 2025]. Available: https:\/\/www.un.org\/development\/desa\/dpad\/wp-content\/uploads\/sites\/45\/publication\/CDP-review-2020-1.pdf"},{"issue":"4","key":"pone.0325404.ref056","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1007\/s15010-017-1007-2","article-title":"Environmental pollution with antimicrobial agents from bulk drug manufacturing industries in Hyderabad, South India, is associated with dissemination of extended-spectrum beta-lactamase and carbapenemase-producing pathogens","volume":"45","author":"C L\u00fcbbert","year":"2017","journal-title":"Infection"},{"key":"pone.0325404.ref057","doi-asserted-by":"crossref","DOI":"10.1073\/pnas.2113947119","article-title":"Pharmaceutical pollution of the world\u2019s rivers","volume":"119","author":"JL Wilkinson","year":"2022","journal-title":"Proc Natl Acad Sci U S A"},{"key":"pone.0325404.ref058","article-title":"Identifying the priority infection prevention and control gaps contributing to neonatal healthcare-associated infections in low-and middle-income countries: results from a modified Delphi process","volume":"5","author":"D Yee","year":"2021","journal-title":"J Glob Health Rep"},{"issue":"12","key":"pone.0325404.ref059","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0002631","article-title":"Improved household flooring is associated with lower odds of enteric and parasitic infections in low- and middle-income countries: A systematic review and meta-analysis","volume":"3","author":"H Legge","year":"2023","journal-title":"PLOS Glob Public Health"},{"issue":"24","key":"pone.0325404.ref060","doi-asserted-by":"crossref","DOI":"10.1128\/AEM.01978-18","article-title":"Risk Factors for Detection, Survival, and Growth of Antibiotic-Resistant and Pathogenic Escherichia coli in Household Soils in Rural Bangladesh","volume":"84","author":"MC Montealegre","year":"2018","journal-title":"Appl Environ 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from rectal swabs in Botswana","volume":"72","author":"N Mannathoko","year":"2023","journal-title":"J Med Microbiol"},{"issue":"4","key":"pone.0325404.ref064","doi-asserted-by":"crossref","first-page":"775","DOI":"10.3390\/microorganisms13040775","article-title":"Experience in Implementing Colonization Screening in a Multidisciplinary County Clinical Hospital in Romania","volume":"13","author":"V Birlutiu","year":"2025","journal-title":"Microorganisms"},{"key":"pone.0325404.ref065","doi-asserted-by":"crossref","first-page":"427","DOI":"10.3389\/fped.2020.00427","article-title":"Colonization Screening Targeting Multidrug-Resistant Gram-Negative Pathogens Does Not Increase the Use of Carbapenems in Very Low Birth Weight Infants","volume":"8","author":"D Sch\u00f6ndorf","year":"2020","journal-title":"Front Pediatr"},{"issue":"2","key":"pone.0325404.ref066","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1086\/338234","article-title":"High rate of false-negative results of the 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