Rise of Antibiotic-Resistant Bacteria in Malnourished Children Under Five in Niger

A recent study conducted by researchers at the Ineos Oxford Institute for Antimicrobial Research has revealed a concerning surge in antibiotic-resistant bacteria among children suffering from severe malnutrition in Niger. The research, published in Nature Communications, highlights the alarming spread of antimicrobial-resistant organisms in a hospital setting that treats vulnerable young patients.

The investigation involved analyzing over 3,000 rectal swabs from 1,371 children under five years old receiving treatment for severe malnutrition between 2016 and 2017, in collaboration with Médecins Sans Frontières (Doctors Without Borders). The findings showed that an overwhelming 76% of these children carried bacteria harboring extended-spectrum β-lactamase (ESBL) genes, which enable bacteria to inactivate many commonly used antibiotics. Additionally, 25% carried bacteria with carbapenemase genes, such as bla_NDM, which confer resistance to carbapenems—some of the last effective antibiotics available.

A significant concern was that 69% of children who initially did not carry carbapenem-resistant bacteria upon admission acquired them by discharge. Strikingly, 11% carried E. coli ST167 strains with the bla_NDM gene, severely limiting treatment options for infections caused by these bacteria.

The spread of such resistant bacteria is especially troubling because it threatens the effectiveness of antibiotics critical for combating severe infections. The gut of these children often acts as a reservoir for resistant bacteria, posing future risks of infections like pneumonia, sepsis, urinary tract infections, and diarrhea that are difficult to treat.

Scientists emphasized that these patterns are not isolated to Niger. Dr. Kirsty Sands, lead author and Scientific Lead at the Ineos Oxford Institute, pointed out that the rise of antimicrobial resistance (AMR) is a global crisis worsened by humanitarian emergencies, conflicts, and climate change, which all contribute to increased malnutrition and overcrowded hospitals.

Further analysis through genome sequencing revealed that many E. coli strains with bla_NDM-5 were genetically similar, suggesting in-hospital transmission facilitated by plasmids—mobile DNA elements capable of moving between bacteria. This enhances the potential for resistant bacteria to spread across different bacterial species, complicating efforts to control the resistance.

Experts advocate for urgent implementation of infection prevention measures in hospitals worldwide, especially in resource-limited settings. Strengthening hygiene, surveillance, and antimicrobial stewardship is vital to curb the proliferation of resistant bacteria and protect vulnerable children.

This research underscores the importance of global efforts to address AMR, which poses a silent but escalating threat to public health, particularly among populations already weakened by malnutrition. Future strategies must include coordinated international action to safeguard antibiotics and improve healthcare infrastructure in affected regions.

For more detailed information, the full study is available in Nature Communications under DOI: 10.1038/s41467-025-61718-w.

Source: https://medicalxpress.com/news/2025-07-antibiotic-resistant-bacteria-malnourished-children.html