{"doi":"10.1093/cid/ciad220","title":"High-level Colonization With Antibiotic-Resistant Enterobacterales Among Individuals in a Semi-Urban Setting in South India: An Antibiotic Resistance in Communities and Hospitals (ARCH) Study","abstract":"BACKGROUND: Antimicrobial resistance poses a significant threat to public health globally. We studied the prevalence of colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE), carbapenem-resistant Enterobacterales (CRE), and colistin-resistant Enterobacterales (Col-RE) in hospitals and the surrounding community in South India. METHODS: Adults from 2 hospitals and the catchment community who consented to provide stool specimens were enrolled. Stools were plated on CHROMagar selective for ESCrE, CRE, and Col-RE. Bacterial identification and antibiotic susceptibility testing were done using Vitek 2 Compact and disc diffusion testing. Colistin broth microdilution was performed for a subset of isolates. Prevalence estimates were calculated with 95% confidence intervals (CIs), and differences were compared across populations using the Pearson χ 2 or Fisher exact test. RESULTS: Between November 2020 and March 2022, 757 adults in the community and 556 hospitalized adults were enrolled. ESCrE colonization prevalence was 71.5% (95% CI, 68.1%-74.6%) in the community and 81.8% (95% CI, 78.4%-84.8%) in the hospital, whereas CRE colonization prevalence was 15.1% (95% CI, 12.7%-17.8%) in the community and 22.7% (95% CI, 19.4%-26.3%) in the hospital. Col-RE colonization prevalence was estimated to be 1.1% (95% CI, .5%-2.1%) in the community and 0.5% (95% CI, .2%-1.6%) in the hospital. ESCrE and CRE colonization in hospital participants was significantly higher compared with community participants (P < .001 for both). CONCLUSIONS: High levels of colonization with antibiotic-resistant Enterobacterales were found in both community and hospital settings. This study highlights the importance of surveillance of colonization in these settings for understanding the burden of antimicrobial resistance.","journal":"Clinical Infectious Diseases","year":2023,"id":350687,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9564,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1095076,"name":"Tarun Bhatnagar","orcid":"0000-0002-5603-1418","position":1,"is_corresponding":false},{"id":1095504,"name":"G Sathya Narayanan","orcid":null,"position":2,"is_corresponding":false},{"id":1095077,"name":"S. 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