A new study led by researchers at the INEOS Oxford Antibacterial Research Institute (IOI) found that antibiotic-resistant bacteria are rapidly spreading in malnourished children under the age of five in Niger.
Globally, it is estimated that there are approximately 45 million children under the age of five who are malnourished. These children also have an increased risk of developing life-threatening infectious diseases such as tuberculosis and sepsis due to weakened immune systems.
In collaboration with Medesin’s San Frontiers (a doctor without borders), the researchers analyzed more than 3,000 rectal swabs from 1,371 children under the age of 5 who were being treated for severe malnutrition between 2016 and 2017.
Malnutrition children show more resistance
The findings showed that:
Over three-quarters (76%) of children are carried bacteria carrying the extended spectral β-lactamase (ESBL) gene, which can degrade many commonly used antibiotics. One in four children (25%) carried bacteria with carbapenemase genes like BlandM, which brings resistance to some of the most powerful and last lineage antibiotics. It was found that more than two-thirds (69%) of children who were not carrying carbapenem-resistant bacteria at the time of hospitalization carry them upon discharge. Carbapenem is the last class of resort antibiotics used when other antibiotics fail to treat an infection. 11% of children carried E. coli ST167 strain with the BlandM gene to limit treatment options for infections caused by these bacteria.
Researchers used genomic sequencing to track the spread of these resistant bacteria. Most E. coli loaded with Blandm-5 are genetically very similar, suggesting the possibility of transmission within hospital settings. Resistance genes were carried by mobile DNA plasmids that could jump between bacteria, allowing for even more interspecies spread.
“We’ve been working hard to understand the quality of our products,” said Dr. Kirsty Sands, author of the Ineos Oxford Institute for Antimicrobial Research and The Studs.
“Our research focused on one treatment facility in Niger, but this situation could be reflected in more hospitals around the world. As AMR continues to increase worldwide, humanitarian crises such as war and climate change can exacerbate malnutrition and lead to overcrowded treatment centres.”
AMR poses a major risk of infection
Antibiotics are life-saving drugs that are ineffective due to their resistance to antibiotics. This is the process that developed the ability of bacteria, fungi, and parasites to resist the action of drugs.
If antibiotic-resistant bacteria remain in the intestine, malnourished children are at risk of developing infections such as pneumonia, sepsis, diarrhea, and urinary tract infections that do not respond to antibiotic treatment.
“Our latest findings underscore the urgent need to prioritize infection prevention and control measures in hospitals to protect the most vulnerable patients,” said Dr. Céline Langendorf, researcher of the study and co-author of MSF.
“In crowded hospitals with limited resources, these bacteria can easily spread from children to children. Without urgent action, more children could die from infections that were easy to treat.”
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