{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:38:15Z","timestamp":1790775495891,"version":"4.1.0"},"reference-count":40,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T00:00:00Z","timestamp":1647820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["R25 TW011227"],"award-info":[{"award-number":["R25 TW011227"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Colonization of multidrug resistant (MDR) bacteria is associated with subsequent invasive infections in children with comorbidities. This study aimed to determine the resistance profile and factors associated with MDR pathogen colonization among HIV\u2212and HIV+ children below five years of age in Mwanza, Tanzania. A total of 399 (HIV\u2212 255 and HIV+ 144) children were enrolled and investigated for the presence of MDR bacteria. The median [IQR] age of children was 19 (10\u201336) months. Out of 27 Staphylococcus aureus colonizing the nasal cavity, 16 (59.5%) were methicillin resistant while 132\/278 (47.2%) of Enterobacteriaceae from rectal swabs were resistant to third generation cephalosporins, with 69.7% (92\/132) exhibiting extended spectrum beta lactamase (ESBL) phenotypes. The proportion of resistance to gentamicin, amoxicillin\/clavulanic acid and meropenem were significantly higher among HIV+ than HIV\u2212 children. A history of antibiotic use in the last month OR 2.62 [1.1, 6.9] (p = 0.04) and history of a relative admitted from the same household in the past three months OR 3.73 [1.1, 13.2] (p = 0.03) independently predicted ESBL rectal colonization. HIV+ children had significantly more fecal carriage of isolates resistant to uncommonly used antibiotics. There is a need to strengthen antimicrobial stewardship and Infection Prevention and Control (IPC) programs to prevent the emergence and spread of MDR pathogens in children.<\/jats:p>","DOI":"10.3390\/pathogens11030379","type":"journal-article","created":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T21:48:42Z","timestamp":1647899322000},"page":"379","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["High Fecal Carriage of Multidrug Resistant Bacteria in the Community among Children in Northwestern Tanzania"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3472-9620","authenticated-orcid":false,"given":"Delfina R.","family":"Msanga","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4178-3254","authenticated-orcid":false,"given":"Vitus","family":"Silago","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tulla","family":"Massoza","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benson R.","family":"Kidenya","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, Mwanza P.O. Box 1464, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3707-9985","authenticated-orcid":false,"given":"Emmanuel","family":"Balandya","sequence":"additional","affiliation":[{"name":"Department of Physiology, School of Medicine, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2313-3079","authenticated-orcid":false,"given":"Mariam M.","family":"Mirambo","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3625-0725","authenticated-orcid":false,"given":"Bruno","family":"Sunguya","sequence":"additional","affiliation":[{"name":"Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5550-1916","authenticated-orcid":false,"given":"Blandina Theophil","family":"Mmbaga","sequence":"additional","affiliation":[{"name":"Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical University College, Moshi P.O. Box 2236, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eligius","family":"Lyamuya","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Bartlet","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University Medical Center Durham, P.O. Box 3238, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7526-6271","authenticated-orcid":false,"given":"Stephen E.","family":"Mshana","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,21]]},"reference":[{"key":"ref_1","unstructured":"CDC (2019). Antibiotic Resistance Threats in the United States, 2019, Department of Health and Human Services, CDC."},{"key":"ref_2","unstructured":"O\u2019Neill, J. (2016). Tackling Drug-Resistant Infections Globallyss: Final Report and Recommendations, AMR Review."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6506a1","article-title":"Core Elements of Outpatient Antibiotic Stewardship","volume":"65","author":"Sanchez","year":"2016","journal-title":"MMWR Recomm. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e002104","DOI":"10.1136\/bmjgh-2019-002104","article-title":"Tackling antimicrobial resistance in low-income and middle-income countries","volume":"4","author":"Pokharel","year":"2019","journal-title":"BMJ Glob. 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