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 3 Multivariable regression analysis for antimicrobial resistance load (Log₁₀ CFU) at the household level

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

Predictor	Ampicillin	Streptomycin	Sulfamethoxazole	Tetracycline	Trimethoprim
Predictor	β [95% CI]	β [95% CI]	β [95% CI]	β [95% CI]	β [95% CI]
Night toilet type
Ventilator improved pit	0.46 [− 0.34, 1.26]	0.32 [− 0.59, 1.23]	0.07 [− 0.59, 0.74]	− 0.27 [− 1.22, 0.67]	− 0.06 [− 0.69, 0.57]
Pit with concrete slab	0.49 [0.00, 0.99]	0.50 [− 0.06, 1.07]	0.13 [− 0.28, 0.54]	− 0.13 [− 0.71, 0.46]	− 0.04 [− 0.43, 0.35]
Traditional pit latrine^a	0.03 [− 0.58, 0.63]	0.25 [− 0.44, 0.94]	− 0.07 [− 0.57, 0.43]	− 0.79 [− 1.51, − 0.08]	− 0.07 [− 0.54, 0.40]
Bucket/plastic	0.26 [− 0.23, 0.75]	0.23 [− 0.32, 0.79]	− 0.06 [− 0.47, 0.34]	− 0.62 [− 1.19, − 0.04]	− 0.24 [− 0.62, 0.15]
No facilities/open field	0.46 [− 0.29, 1.22]	0.03 [− 0.82, 0.88]	− 0.02 [− 0.64, 0.60]	− 0.71 [− 1.59, 0.18]	− 0.64 [− 1.23, − 0.04]
Handwashing with soap	0.20 [0.01, 0.40]	0.21 [− 0.01, 0.43]	0.07 [− 0.09, 0.23]	0.19 [− 0.03, 0.42]	0.10 [− 0.06, 0.25]
Handwashing facility location
Toilet within premises	0.14 [− 0.15, 0.43]	0.13 [− 0.19, 0.46]	0.10 [− 0.13, 0.34]	0.25 [− 0.09, 0.59]	0.17 [− 0.05, 0.4]
Elsewhere on premises^b	0.47 [0.20, 0.73]	0.28 [− 0.02, 0.58]	0.35 [0.13, 0.57]	0.36 [0.05, 0.67]	0.22 [0.01, 0.43]
No designated place	− 0.28 [− 0.55, − 0.02]	− 0.13 [− 0.44, 0.17]	0.04 [− 0.18, 0.26]	0.26 [− 0.05, 0.58]	− 0.21 [− 0.42, 0.00]
Enrolled child
Time spent outside (h)	0.00 [− 0.05, 0.05]	− 0.01 [− 0.08, 0.05]	0.01 [− 0.03, 0.06]	0.03 [− 0.03, 0.09]	0.00 [− 0.04, 0.04]
Eats soil	0.51 [0.26, 0.77]	0.39 [0.10, 0.68]	0.27 [0.06, 0.48]	0.54 [0.24, 0.84]	0.28 [0.08, 0.48]
Rainfall (per mm)	− 2.56 [− 3.60, − 1.52]	− 1.23 [− 2.40, − 0.06]	− 0.57 [− 1.42, 0.28]	1.18 [− 0.03, 2.40]	− 1.19 [− 2.00, − 0.37]
Mother’s education level
Primary school	− 0.52 [− 1.17, 0.14]	− 0.72 [− 1.48, 0.05]	− 0.25 [− 0.82, 0.32]	− 0.11 [− 0.91, 0.68]	0.02 [− 0.50, 0.53]
High school	− 0.87 [− 1.58, − 0.16]	− 0.91 [− 1.73, − 0.08]	− 0.29 [− 0.90, 0.32]	− 0.26 [− 1.11, 0.60]	0.02 [− 0.53, 0.57]
College	− 0.93 [− 1.90, 0.05]	− 1.40 [− 2.53, − 0.26]	− 0.32 [− 1.16, 0.52]	− 0.70 [− 1.88, 0.47]	0.19 [− 0.57, 0.95]
Respondent age (years)	− 0.02 [− 0.03, − 0.02]	− 0.01 [− 0.02, 0.00]	0.00 [− 0.01, 0.00]	0.00 [− 0.01, 0.00]	− 0.01 [− 0.01, 0.00]

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 4 for complete table
^aSingle pit covered by a wooden, earthen or concrete slab with a drop hole
^bOther than at a toilet facility or the household kitchen

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