Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in Amsterdam

OBJECTIVES: The objectives of this study were to determine the prevalence of carriage of ESBL-producing Enterobacteriaceae (ESBL-E) in a representative sample of the general adult Dutch community, to identify risk factors and to gain understanding of the epidemiology of these resistant strains. METHODS: Adults enrolled in five general practices in Amsterdam were approached by postal mail and asked to fill in a questionnaire and to collect a faecal sample. Samples were analysed for the presence of ESBL-E. ESBL genes were characterized by PCR and sequencing. Strains were typed using MLST and amp... Mehr ...

Verfasser: Reuland, E A
Al Naiemi, N
Kaiser, A M
Heck, M
Kluytmans, J A J W
Savelkoul, P H M
Elders, P J M
Vandenbroucke-Grauls, C M J E
Dokumenttyp: Artikel
Erscheinungsdatum: 2016
Schlagwörter: Adolescent / Adult / Aged / 80 and over / Amplified Fragment Length Polymorphism Analysis / Carrier State / Case-Control Studies / Cross-Sectional Studies / Enterobacteriaceae / Enterobacteriaceae Infections / Female / Humans / Male / Microbial Sensitivity Tests / Middle Aged / Multilocus Sequence Typing / Netherlands / Population Surveillance / Prevalence / Risk Factors / Young Adult / beta-Lactam Resistance / beta-Lactamases / Journal Article / Research Support / Non-U.S. Gov't
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29201709
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://dspace.library.uu.nl/handle/1874/343465

OBJECTIVES: The objectives of this study were to determine the prevalence of carriage of ESBL-producing Enterobacteriaceae (ESBL-E) in a representative sample of the general adult Dutch community, to identify risk factors and to gain understanding of the epidemiology of these resistant strains. METHODS: Adults enrolled in five general practices in Amsterdam were approached by postal mail and asked to fill in a questionnaire and to collect a faecal sample. Samples were analysed for the presence of ESBL-E. ESBL genes were characterized by PCR and sequencing. Strains were typed using MLST and amplified fragment length polymorphism (AFLP) and plasmids were identified by PCR-based replicon typing. Risk factors for carriage were investigated by multivariate analysis. RESULTS: ESBL-E were found in 145/1695 (8.6%) samples; 91% were Escherichia coli. Most ESBL genes were of the CTX-M group (blaCTX-M-1 and blaCTX-M-15). MLST ST131 was predominant and mainly associated with CTX-M-15-producing E. coli. One isolate with reduced susceptibility to ertapenem produced OXA-48. In multivariate analyses, use of antimicrobial agents, use of antacids and travel to Africa, Asia and Northern America were associated with carriage of ESBL-E, in particular strains with blaCTX-M-14/15. CONCLUSIONS: This study showed a high prevalence of ESBL-E carriage in the general Dutch community. Also, outside hospitals, the use of antibiotics was a risk factor; interestingly, use of antacids increased the risk of carriage. A major risk factor in the general population was travel to countries outside Europe, in particular to Asia, Africa and Northern America.