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Urinary lead level and colonization by antibiotic resistant bacteria: Evidence from a population-based study

Eggers, Shoshannah ; Safdar, Nasia ; Kates, Ashley ; Sethi, Ajay K ; Peppard, Paul E ; Kanarek, Marty S ; Malecki, Kristen M C

Environmental epidemiology, 2021-12, Vol.5 (6), p.e175 [Periódico revisado por pares]

United States: Lippincott Williams & Wilkins

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  • Título:
    Urinary lead level and colonization by antibiotic resistant bacteria: Evidence from a population-based study
  • Autor: Eggers, Shoshannah ; Safdar, Nasia ; Kates, Ashley ; Sethi, Ajay K ; Peppard, Paul E ; Kanarek, Marty S ; Malecki, Kristen M C
  • Assuntos: Original
  • É parte de: Environmental epidemiology, 2021-12, Vol.5 (6), p.e175
  • Descrição: Infection by antibiotic resistant bacteria (ARB) is a global health crisis and asymptomatic colonization increases risk of infection. Nonhuman studies have linked heavy metal exposure to the selection of ARB; however, few epidemiologic studies have examined this relationship. This study analyzes the association between urinary lead level and colonization by ARB in a nonclinical human population. Data came from the Survey of the Health of Wisconsin 2016-2017, and its ancillary Wisconsin Microbiome Study. Urinary lead levels, adjusted for creatinine, were used to assess exposure. ARB included methicillin resistant (MRSA), vancomycin-resistant enterococci (VRE), fluoroquinolone resistant Gram-negative bacilli (RGNB), and ( ), from skin, nose, and mouth swabs, and saliva and stool samples. Logistic regression, adjusted for covariates, was used to evaluate associations between Pb and ARB. Secondary analysis investigated Pb resistance from ARB isolates. Among 695 participants, 239 (34%) tested positive for ARB. Geometric mean urinary Pb (unadjusted) was 0.286 µg/L (95% confidence intervals [CI] = 0.263, 0.312) for ARB negative participants and 0.323 µg/L (95% CI = 0.287, 0.363) for ARB positive participants. Models adjusted for demographics, diet, and antibiotic use showed elevated odds of positive colonization for those in the 95th percentile (vs. below) of Pb exposure (odds ratio [OR] = 2.05, 95% CI = 0.95, 4.44), and associations were highest in urban residents (OR = 2.85, 95% CI = 1.07, 7.59). RGNB isolates were most resistant to Pb. These novel results suggest that Pb exposure is associated with increased colonization by ARB, and that RGNB are particularly resistant to Pb.
  • Editor: United States: Lippincott Williams & Wilkins
  • Idioma: Inglês
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