{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T10:40:44Z","timestamp":1778236844992,"version":"3.51.4"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Increasing antimicrobial resistance (AMR) is a global public health emergency. Although chemoprevention has improved malaria-related pregnancy outcomes, the downstream effects on AMR have not been characterized. We compared the abundance of 10 AMR genes in stool samples from pregnant women receiving sulfadoxine-pyrimethamine (SP) as intermittent preventive treatment against malaria in pregnancy (IPTp) to that in samples from women receiving dihydroartemisinin-piperaquine (DP) for IPTp. All participants had at least one AMR gene at baseline. Mean quantities of the antifolate gene <jats:italic>dfrA17<\/jats:italic> were increased after two or more doses of SP (mean difference = 1.6, 95% CI: 0.4\u20132.7, <jats:italic>P<\/jats:italic> = 0.008). Antimicrobial resistance gene abundance tended to increase from baseline in SP recipients compared with a downward trend in the DP group. Overall, IPTp-SP had minimal effects on the abundance of antifolate resistance genes (except for <jats:italic>dfrA17<\/jats:italic>), potentially owing to a high starting prevalence. However, the trend toward increasing AMR in SP recipients warrants further studies.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0824","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T18:09:58Z","timestamp":1716919798000},"page":"43-47","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Sulfadoxine-Pyrimethamine and Dihydroartemisinin-Piperaquine as Intermittent Preventive Treatment in Pregnancy on Stool Antimicrobial Resistance Gene Abundance"],"prefix":"10.4269","volume":"111","author":[{"given":"Kofi B.","family":"Opoku","sequence":"first","affiliation":[{"name":"Applied Epidemiology Program, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Tompkins","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Pittsburgh, Pittsburgh, Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreea","family":"Waltmann","sequence":"additional","affiliation":[{"name":"Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina;"},{"name":"Division of Infectious Diseases, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily J.","family":"Ciccone","sequence":"additional","affiliation":[{"name":"Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina;"},{"name":"Division of Infectious Diseases, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luther","family":"Bartlelt","sequence":"additional","affiliation":[{"name":"Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina;"},{"name":"Division of Infectious Diseases, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tessa","family":"Andermann","sequence":"additional","affiliation":[{"name":"Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina;"},{"name":"Division of Infectious Diseases, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jobiba","family":"Chinkhumba","sequence":"additional","affiliation":[{"name":"Malaria Alert Center, Malawi College of Medicine, Blantyre, Malawi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Don P.","family":"Mathanga","sequence":"additional","affiliation":[{"name":"Malaria Alert Center, Malawi College of Medicine, Blantyre, Malawi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie R.","family":"Gutman","sequence":"additional","affiliation":[{"name":"Division of Parasitic Diseases and Malaria, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan J.","family":"Juliano","sequence":"additional","affiliation":[{"name":"Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina;"},{"name":"Division of Infectious Diseases, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina;"},{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina;"},{"name":"Curriculum in Genetics and Molecular Biology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet","first-page":"629","article-title":"Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis","volume":"399","year":"2022"},{"key":"b2","series-title":"Crit Rev Food Sci Nutr","first-page":"2857","article-title":"Antimicrobial resistance: A global emerging threat to public health systems","volume":"57","author":"Ferri","year":"2017"},{"key":"b3","year":"2023"},{"key":"b4","year":"2015"},{"key":"b5","series-title":"Malar J","first-page":"39","article-title":"Combination of probenecid-sulphadoxine-pyrimethamine for intermittent preventive treatment in pregnancy","volume":"11","author":"Gutman","year":"2012"},{"key":"b6","year":"2013"},{"key":"b7","series-title":"Lancet Infect Dis","first-page":"546","article-title":"Effect of Plasmodium falciparum sulfadoxine-pyrimethamine resistance on the effectiveness of intermittent preventive 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