Journal article
Urinary lead level and colonization by antibiotic resistant bacteria: Evidence from a population-based study
Environmental epidemiology, Vol.5(6), pp.E175-e175
12/01/2021
DOI: 10.1097/EE9.0000000000000175
PMCID: PMC8663876
PMID: 34909555
Abstract
Background: 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.
Methods: 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 Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), fluoroquinolone resistant Gram-negative bacilli (RGNB), and Clostridium difficile (C. diff), 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.
Results: Among 695 participants, 239 (34%) tested positive for ARB. Geometric mean urinary Pb (unadjusted) was 0.286 mu g/L (95% confidence intervals [CI] = 0.263, 0.312) for ARB negative participants and 0.323 mu g/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.
Discussion: These novel results suggest that Pb exposure is associated with increased colonization by ARB, and that RGNB are particularly resistant to Pb.
Details
- Title: Subtitle
- Urinary lead level and colonization by antibiotic resistant bacteria: Evidence from a population-based study
- Creators
- Shoshannah Eggers - University of Wisconsin–MadisonNasia Safdar - University of Wisconsin–MadisonAshley Kates - University of Wisconsin–MadisonAjay K. Sethi - University of Wisconsin–MadisonPaul E. Peppard - University of Wisconsin–MadisonMarty S. Kanarek - University of Wisconsin–MadisonKristen M. C. Malecki - University of Wisconsin–Madison
- Resource Type
- Journal article
- Publication Details
- Environmental epidemiology, Vol.5(6), pp.E175-e175
- DOI
- 10.1097/EE9.0000000000000175
- PMID
- 34909555
- PMCID
- PMC8663876
- NLM abbreviation
- Environ Epidemiol
- ISSN
- 2474-7882
- eISSN
- 2474-7882
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 7
- Grant note
- T15 LM007359 / National Library of Medicine training grant University of Wisconsin School of Medicine and Public Health's (UWSMPH) Wisconsin Partnership Program UWSMPH's Department of Medicine Pilot Award Program T32 HD049311 / Eunice Kennedy Shriver National Institute of Child Health and Human Development; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) P2C HD047873 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA P30 AG017266 / Center for Demography and Aging at the University of Wisconsin Madison R21 Al142481 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 12/01/2021
- Academic Unit
- Epidemiology; Injury Prevention Research Center
- Record Identifier
- 9984446522402771
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