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Abstract

Background

The epidemiology of carriage of extended-spectrum beta-lactamase-producing (ESBL-E) and carbapenemase-producing Enterobacteriaceae (CPE) in the general population is unknown.

Aim

In this observational study, the prevalence and risk factors for intestinal ESBL-E and CPE carriage in the Dutch general population were determined. ESBL-E were characterised.

Methods

From 2014 to 2016, ca 2,000 residents were invited monthly to complete a questionnaire and provide a faecal sample, which was tested for ESBL-E. The first 1,758 samples were also tested for CPE. Risk factors for ESBL-E carriage were identified by multivariable logistic regression analysis. ESBL-E isolates underwent whole genome sequencing.

Results

Of 47,957 individuals invited, 4,177 (8.7%) completed the questionnaire and provided a faecal sample. ESBL-E were detected in 186 (4.5%) individuals, resulting in an adjusted prevalence of 5.0% (95% confidence interval (CI):3.4–6.6%). Risk factors were: born outside the Netherlands (odds ratio (OR): 1.99; 95% CI: 1.16−4.54), eating in restaurants > 20 times/year (OR: 1.70; 95% CI: 1.04−2.76), antibiotic use < 6 months ago (OR: 2.05; 95% CI: 1.05−4.03), swimming in sea/ocean < 12 months ago (OR: 1.63; 95% CI: 1.11−2.39), travelling to Africa (OR: 3.03; 95% CI: 1.23−7.46) or Asia (OR: 2.00; 95% CI: 1.02−3.90) < 12 months ago, and not changing kitchen towels daily (OR: 2.19; 95% CI: 1.24−3.87). The last had the largest population attributable risk (PAR) (47.5%). Eighty-four of 189 (44.4%) ESBL-E isolates carried . isolates belonged to 70 different sequence types (ST)s, of which ST131 (42/178 isolates; 23.6%) was most prevalent. Associations were observed between IncFIA plasmids and ST131 and , and between IncI1 and ST88 and . No CPE were detected.

Conclusions

The prevalence of ESBL-E carriage in the Netherlands’ community-dwelling population is 5.0%. Identified risk factors were mostly travelling (particularly to Asia and Africa) and kitchen hygiene. CPE were not detected.

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2019-10-10
2024-12-18
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Prevalence, risk factors and genetic characterisation of extended-spectrum beta-lactamase and carbapenemase-producing Enterobacteriaceae (ESBL-E and CPE): a community-based cross-sectional study, the Netherlands, 2014 to 2016
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Gerrita+van+den+Bunt&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van den Bunt Gerrita</a>, <a href="/search?value1=Wilfrid+van+Pelt&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van Pelt Wilfrid</a>, <a href="/search?value1=Laura+Hidalgo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hidalgo Laura</a>, <a href="/search?value1=Jelle+Scharringa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Scharringa Jelle</a>, <a href="/search?value1=Sabine+C.+de+Greeff&option1=author&noRedirect=true" class="nonDisambigAuthorLink">de Greeff Sabine C.</a>, <a href="/search?value1=Anita+C.+Sch%C3%BCrch&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schürch Anita C.</a>, <a href="/search?value1=Lapo+Mughini-Gras&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mughini-Gras Lapo</a>, <a href="/search?value1=Marc+J.M.+Bonten&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bonten Marc J.M.</a>, <a href="/search?value1=Ad+C.+Fluit&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fluit Ad C.</a></span>. Prevalence, risk factors and genetic characterisation of extended-spectrum beta-lactamase and carbapenemase-producing Enterobacteriaceae (ESBL-E and CPE): a community-based cross-sectional study, the Netherlands, 2014 to 2016. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(41):pii=1800594. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.41.1800594" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.41.1800594</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 26 Oct 2018;&nbsp;&nbsp; <span class="generated">Accepted</span>: 10 Apr 2019 </span> </p>
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