Carriage of antimicrobial-resistant bacteria in a high-density informal settlement in Kenya is associated with environmental risk-factors

Omulo, Sylvia; Lofgren, Eric T.; Lockwood, Svetlana; Thumbi, Samuel M.; Bigogo, Godfrey; Ouma, Alice; Verani, Jennifer R.; Juma, Bonventure; Njenga, M. Kariuki; Kariuki, Samuel; McElwain, Terry F.; Palmer, Guy H.; Call, Douglas R.

doi:10.1186/s13756-021-00886-y

Antimicrobial Resistance & Infection Control

Table 5 Multivariable regression analysis for antimicrobial resistance load (Log₁₀ CFU) for children aged 0–5 years

From: Carriage of antimicrobial-resistant bacteria in a high-density informal settlement in Kenya is associated with environmental risk-factors

Predictors	Ampicillin	Streptomycin	Sulfamethoxazole	Tetracycline	Trimethoprim
Predictors	β [95% CI]	β [95% CI]	β [95% CI]	β [95% CI]	β [95% CI]
Night toilet type
Ventilator improved pit	0.03 [− 0.95, 1.00]	0.46 [− 0.73, 1.64]	0.25 [− 0.65, 1.16]	− 0.59 [− 1.81, 0.64]	0.02 [− 0.81, 0.86]
Pit with concrete slab	0.24 [− 0.38, 0.86]	0.41 [− 0.35, 1.17]	0.18 [− 0.39, 0.76]	− 0.38 [− 1.17, 0.41]	0.06 [− 0.48, 0.59]
Traditional pit latrine^a	0.00 [− 0.75, 0.75]	0.25 [− 0.66, 1.16]	0.14 [− 0.56, 0.84]	− 1.39 [− 2.33, − 0.45]	0.20 [-0.44, 0.85]
Bucket/plastic	− 0.08 [− 0.69, 0.53]	0.19 [− 0.55, 0.93]	− 0.01 [− 0.57, 0.56]	− 0.99 [− 1.77, − 0.21]	-0.17 [-0.70, 0.35]
No facilities/open field	− 0.07 [− 1.05, 0.91]	− 0.43 [− 1.63, 0.76]	− 0.19 [− 1.09, 0.72]	− 1.28 [− 2.56, 0.00]	-0.78 [− 1.63, 0.06]
Handwashing after urination	0.20 [0.03, 0.38]	0.06 [− 0.16, 0.27]	0.12 [− 0.04, 0.28]	0.08 [− 0.14, 0.31]	0.19 [0.04, 0.34]
Handwashing facility location
Toilet within premises	0.12 [− 0.23, 0.47]	0.19 [− 0.24, 0.62]	0.17 [− 0.16, 0.50]	0.28 [− 0.18, 0.74]	0.28 [− 0.03, 0.58]
Elsewhere on premises^b	0.45 [0.12, 0.78]	0.39 [− 0.01, 0.79]	0.35 [0.05, 0.66]	0.26 [− 0.16, 0.68]	0.28 [0.00, 0.57]
Child eats soil	0.59 [0.27, 0.91]	0.52 [0.14, 0.91]	0.22 [− 0.08, 0.52]	0.80 [0.40, 1.21]	0.25 [− 0.03, 0.52]
Rainfall (per mm)	− 2.02 [− 3.28, − 0.76]	− 1.26 [− 2.80, 0.27]	− 0.69 [− 1.85, 0.47]	1.74 [0.07, 3.40]	− 0.82 [− 1.91, 0.27]
Altitude (10 m increments)	− 0.01 [− 0.01, 0.00]	0.00 [− 0.01, 0.01]	− 0.01 [− 0.01, 0.00]	− 0.01 [− 0.01, 0.00]	− 0.01 [− 0.01, 0.00]
Household used antibiotic	0.39 [− 0.07, 0.84]	0.22 [− 0.34, 0.77]	0.46 [0.04, 0.88]	0.10 [− 0.49, 0.69]	0.42 [0.02, 0.81]

Only variables with P < 0·2 in the univariable mixed-effects model were included in the multivariable model. Regression estimates for increasing or decreasing antimicrobial load (positive or negative β coefficients, respectively) and 95% confidence intervals with P < 0·05 are shown in bold. Only variables with significant values are shown. See Additional file 6 for complete table
^aSingle pit covered by a wooden or earthen slab with a drop hole
^bOther than at a toilet facility or the household kitchen

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