{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:55:08Z","timestamp":1792788908221,"version":"4.5.0"},"reference-count":33,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T00:00:00Z","timestamp":1663286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fleming Fund Country Grant for Timor-Leste","award":["FF\/17\/233"],"award-info":[{"award-number":["FF\/17\/233"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Invasive bacterial infections are a leading cause of death in children, primarily in low- and middle-income countries (LMIC). Links between carriage of antimicrobial-resistant organisms and more resistant infections have been established; however, little has been reported regarding community carriage of antibiotic-resistant organisms such as extended-spectrum \u03b2-lactamase (ESBL)-producing Enterobacterales in LMIC. The aim of this study was to determine colonic carriage of ESBL-producing fluoroquinolone- and aminoglycoside-resistant Enterobacterales in healthy children in three municipalities of Timor-Leste. In November 2020, 621 stool samples were collected from school-aged children and underwent screening for the presence of Enterobacterales species and antimicrobial resistance (AMR). Ciprofloxacin-resistant Gram-negative organisms were cultured from 16.5% (95% CI 6.2\u201326.9), and gentamicin resistance was identified in 6.8% (95% CI 2.8\u201310.7). Compared to the prevalence of ciprofloxacin resistance in Dili (36.1%), there was significantly lower prevalence in the rural municipalities of Ermera (12.9%; AOR 0.38, 95% CI 0.24\u20130.60, p &lt; 0.001) and Manufahi (4.5%; AOR 0.07, 95% CI 0.01\u20130.51, p = 0.009). The overall cluster-adjusted prevalence of ESBL-producing bacteria was 8.3%, with no significant differences between municipalities. This study demonstrates high rates of carriage of AMR among school-aged children in Timor-Leste, with higher rates observed in Dili compared to rural municipalities. Empiric antibiotic guidelines should include recommendations for treating community-acquired infections that account for the possibility of antimicrobial resistance.<\/jats:p>","DOI":"10.3390\/antibiotics11091262","type":"journal-article","created":{"date-parts":[[2022,9,18]],"date-time":"2022-09-18T22:12:43Z","timestamp":1663539163000},"page":"1262","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Gastrointestinal Carriage of Antimicrobial Resistance in School-Aged Children in Three Municipalities of Timor-Leste"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3263-879X","authenticated-orcid":false,"given":"Tessa","family":"Oakley","sequence":"first","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Le","sequence":"additional","affiliation":[{"name":"The Kirby Institute, University of New South Wales, Sydney 2052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"da Conceicao","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Marr","sequence":"additional","affiliation":[{"name":"The Canberra Hospital, Canberra 2605, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Maia","sequence":"additional","affiliation":[{"name":"National Health Laboratory, Dili, Timor-Leste"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Messias","family":"Soares","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana Correia","family":"Belo","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nevio","family":"Sarmento","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Endang","family":"da Silva","sequence":"additional","affiliation":[{"name":"National Health Laboratory, Dili, Timor-Leste"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvador","family":"Amaral","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2399-7785","authenticated-orcid":false,"given":"Susana","family":"Vaz Nery","sequence":"additional","affiliation":[{"name":"The Canberra Hospital, Canberra 2605, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Lynar","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste"},{"name":"Royal Darwin Hospital, Darwin 0810, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9302-4543","authenticated-orcid":false,"given":"Joshua R.","family":"Francis","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste"},{"name":"Royal Darwin Hospital, Darwin 0810, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Yan","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste"},{"name":"Royal Darwin Hospital, Darwin 0810, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,16]]},"reference":[{"key":"ref_1","unstructured":"(2022, May 19). 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