Details

Autor(en) / Beteiligte

• Nadimpalli, Maya L
• Rojas Salvatierra, Luismarcelo
• Chakraborty, Subhra
• Swarthout, Jenna M
• Cabrera, Lilia Z
• Pickering, Amy J
• Calderon, Maritza
• Saito, Mayuko
• Gilman, Robert H
• Pajuelo, Monica J

Titel

Effects of breastfeeding on children's gut colonization with multidrug-resistant Enterobacterales in peri-urban Lima, Peru

Ist Teil von

• Gut microbes, 2024, Vol.16 (1), p.2309681-2309681

Ort / Verlag

United States: Taylor & Francis

Erscheinungsjahr

2024

Link zum Volltext

Quelle

Taylor & Francis Journals Auto-Holdings Collection

Beschreibungen/Notizen

• Children living in low-resource settings are frequently gut-colonized with multidrug-resistant bacteria. We explored whether breastfeeding may protect against children's incident gut colonization with extended-spectrum beta-lactamase-producing (ESBL- ) and , , or spp. (ESBL-KEC). We screened 937 monthly stool samples collected from 112 children aged 1-16 months during a 2016-19 prospective cohort study of enteric infections in peri-urban Lima. We used 52,816 daily surveys to examine how exposures to breastfeeding in the 30 days prior to a stool sample were associated with children's risks of incident gut-colonization, controlling for antibiotic use and other covariates. We sequenced 78 ESBL- from 47 children to explore their diversity. Gut-colonization with ESBL- was increasingly prevalent as children aged, approaching 75% by 16 months, while ESBL-KEC prevalence fluctuated between 18% and 36%. Through 6 months of age, exclusively providing human milk in the 30 days prior to a stool sample did not reduce children's risk of incident gut-colonization with ESBL- or ESBL-KEC. From 6 to 16 months of age, every 3 additional days of breastfeeding in the prior 30 days was associated with 6% lower risk of incident ESBL- gut-colonization (95% CI: 0.90, 0.98,  = .003). No effects were observed on incident ESBL-KEC colonization. We detected highly diverse ESBL- among children and few differences between children who were predominantly breastfed (mean age: 4.1 months) versus older children (10.8 months). Continued breastfeeding after 6 months conferred protection against children's incident gut colonization with ESBL- in this setting. Policies supporting continued breastfeeding should be considered in efforts to combat antibiotic resistance.