Risk factors associated with community colonization of extended-spectrum cephalosporin-resistant Enterobacterales from an antibiotic resistance in communities and hospitals (ARCH) study, Guatemala
Abstract Colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) in communities may contribute to proliferation of resistance genes and drug-resistant community and hospital infections. Previous work in the Western Highlands of Guatemala found that approximately 46% of t...
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Nature Portfolio
2025-05-01
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| Online Access: | https://doi.org/10.1038/s41598-025-03379-9 |
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| author | Brooke M. Ramay Mark A. Caudell Carmen Castillo Laura Grajeda Lucas F. Santos Juan Carlos Romero Maria Renee Lopez Sylvia Omulo Mariangeli Freitas Ning Guy H. Palmer Rachel M. Smith Carolyn T. A. Herzig Ashley Styczynski Celia Cordon-Rosales Douglas R. Call |
| author_facet | Brooke M. Ramay Mark A. Caudell Carmen Castillo Laura Grajeda Lucas F. Santos Juan Carlos Romero Maria Renee Lopez Sylvia Omulo Mariangeli Freitas Ning Guy H. Palmer Rachel M. Smith Carolyn T. A. Herzig Ashley Styczynski Celia Cordon-Rosales Douglas R. Call |
| author_sort | Brooke M. Ramay |
| collection | DOAJ |
| description | Abstract Colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) in communities may contribute to proliferation of resistance genes and drug-resistant community and hospital infections. Previous work in the Western Highlands of Guatemala found that approximately 46% of the population is colonized with these bacteria, setting the stage to identify factors that are associated with increased odds of ESCrE colonization. Stool samples and questionnaire data were collected from randomly selected participants in the catchment area of the third largest tertiary hospital in Guatemala. Logistic regression path analysis was used for this cross-sectional study to identify potential direct and indirect risk factors for colonization with ESCrE. Participants (N = 951) had a higher odds of ESCrE colonization if they had exposure to a healthcare facility within 30 days of enrollment (OR: 2.12, 95% CI = 1.19–3.77), if they resided in urban areas (OR: 1.93, 95% CI 1.09–3.42), if they did not have a service to remove household trash (OR: 1.99, 95% CI 1.11–3.58), and if the household reported drinking water from non-bottled sources (OR:1.53, 95% CI 1.0–2.33). Antibiotic self-medication was not significantly associated with the risk of colonization (OR: 1.16, 95% CI 0.65–2.06). Multiple transmission-related factors were associated with increased likelihood of ESCrE colonization, but the cross-sectional nature of this study does not distinguish factors that are correlated with an individual’s risk for colonization whence exposed. Assessing risk factors associated with colonization with antibiotic resistant bacteria may be useful for identifying mitigation strategies and evaluating the effectiveness of interventions against antibiotic resistance in community settings. |
| format | Article |
| id | doaj-art-c4fb1dfc34c440d59acd04e2d406ed2a |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-c4fb1dfc34c440d59acd04e2d406ed2a2025-08-20T03:22:08ZengNature PortfolioScientific Reports2045-23222025-05-011511910.1038/s41598-025-03379-9Risk factors associated with community colonization of extended-spectrum cephalosporin-resistant Enterobacterales from an antibiotic resistance in communities and hospitals (ARCH) study, GuatemalaBrooke M. Ramay0Mark A. Caudell1Carmen Castillo2Laura Grajeda3Lucas F. Santos4Juan Carlos Romero5Maria Renee Lopez6Sylvia Omulo7Mariangeli Freitas Ning8Guy H. Palmer9Rachel M. Smith10Carolyn T. A. Herzig11Ashley Styczynski12Celia Cordon-Rosales13Douglas R. Call14Paul G. Allen School for Global Health, Washington State UniversityPaul G. Allen School for Global Health, Washington State UniversityPaul G. Allen School for Global Health, Washington State UniversityCenter for Health Studies, Universidad del Valle de GuatemalaCenter for Health Studies, Universidad del Valle de GuatemalaCenter for Health Studies, Universidad del Valle de GuatemalaCenter for Health Studies, Universidad del Valle de GuatemalaPaul G. Allen School for Global Health, Washington State UniversityCentral America Regional Office, U.S. Centers for Disease Control and PreventionPaul G. Allen School for Global Health, Washington State UniversityDivision of Healthcare Quality Promotion, U.S. Centers for Disease Control and PreventionDivision of Healthcare Quality Promotion, U.S. Centers for Disease Control and PreventionDivision of Healthcare Quality Promotion, U.S. Centers for Disease Control and PreventionPaul G. Allen School for Global Health, Washington State UniversityPaul G. Allen School for Global Health, Washington State UniversityAbstract Colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) in communities may contribute to proliferation of resistance genes and drug-resistant community and hospital infections. Previous work in the Western Highlands of Guatemala found that approximately 46% of the population is colonized with these bacteria, setting the stage to identify factors that are associated with increased odds of ESCrE colonization. Stool samples and questionnaire data were collected from randomly selected participants in the catchment area of the third largest tertiary hospital in Guatemala. Logistic regression path analysis was used for this cross-sectional study to identify potential direct and indirect risk factors for colonization with ESCrE. Participants (N = 951) had a higher odds of ESCrE colonization if they had exposure to a healthcare facility within 30 days of enrollment (OR: 2.12, 95% CI = 1.19–3.77), if they resided in urban areas (OR: 1.93, 95% CI 1.09–3.42), if they did not have a service to remove household trash (OR: 1.99, 95% CI 1.11–3.58), and if the household reported drinking water from non-bottled sources (OR:1.53, 95% CI 1.0–2.33). Antibiotic self-medication was not significantly associated with the risk of colonization (OR: 1.16, 95% CI 0.65–2.06). Multiple transmission-related factors were associated with increased likelihood of ESCrE colonization, but the cross-sectional nature of this study does not distinguish factors that are correlated with an individual’s risk for colonization whence exposed. Assessing risk factors associated with colonization with antibiotic resistant bacteria may be useful for identifying mitigation strategies and evaluating the effectiveness of interventions against antibiotic resistance in community settings.https://doi.org/10.1038/s41598-025-03379-9Extended-spectrum cephalosporin-resistant EnterobacteralesColonizationCommunitiesGuatemala |
| spellingShingle | Brooke M. Ramay Mark A. Caudell Carmen Castillo Laura Grajeda Lucas F. Santos Juan Carlos Romero Maria Renee Lopez Sylvia Omulo Mariangeli Freitas Ning Guy H. Palmer Rachel M. Smith Carolyn T. A. Herzig Ashley Styczynski Celia Cordon-Rosales Douglas R. Call Risk factors associated with community colonization of extended-spectrum cephalosporin-resistant Enterobacterales from an antibiotic resistance in communities and hospitals (ARCH) study, Guatemala Scientific Reports Extended-spectrum cephalosporin-resistant Enterobacterales Colonization Communities Guatemala |
| title | Risk factors associated with community colonization of extended-spectrum cephalosporin-resistant Enterobacterales from an antibiotic resistance in communities and hospitals (ARCH) study, Guatemala |
| title_full | Risk factors associated with community colonization of extended-spectrum cephalosporin-resistant Enterobacterales from an antibiotic resistance in communities and hospitals (ARCH) study, Guatemala |
| title_fullStr | Risk factors associated with community colonization of extended-spectrum cephalosporin-resistant Enterobacterales from an antibiotic resistance in communities and hospitals (ARCH) study, Guatemala |
| title_full_unstemmed | Risk factors associated with community colonization of extended-spectrum cephalosporin-resistant Enterobacterales from an antibiotic resistance in communities and hospitals (ARCH) study, Guatemala |
| title_short | Risk factors associated with community colonization of extended-spectrum cephalosporin-resistant Enterobacterales from an antibiotic resistance in communities and hospitals (ARCH) study, Guatemala |
| title_sort | risk factors associated with community colonization of extended spectrum cephalosporin resistant enterobacterales from an antibiotic resistance in communities and hospitals arch study guatemala |
| topic | Extended-spectrum cephalosporin-resistant Enterobacterales Colonization Communities Guatemala |
| url | https://doi.org/10.1038/s41598-025-03379-9 |
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