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RIVM rapport:Het RIVM heeft onderzocht in welke mate bacteriën die resistent zijn tegen antibiotica, bij vegetariërs en niet-vegetariërs voorkomen. Dit onderzoek is alleen gericht op de zogeheten ESBL-producerende bacteriën, oftewel ESBL's. Hieruit blijkt dat mensen die geregeld vlees eten (minimaal drie keer per week) niet vaker een ESBL bij zich dragen dan vegetariërs. Met andere woorden: door het eten van vlees lopen mensen geen hoger risico om met een ESBL-bacterie besmet te raken. Uit deze studie bleek dat deelnemers die hadden gereisd naar Afrika, Midden-/Zuid-Amerika, Azië of naar Zuid-/Oost-Europa, vaker een ESBL bij zich droegen dan deelnemers die dit niet deden. Hetzelfde geldt voor deelnemers die zelden of nooit hun handen wasten, voordat ze voedsel gingen bereiden. ESBL staat voor Extended Spectrum Bèta-Lactamasen. Dit zijn stoffen (enzymen) die door bepaalde bacteriën kunnen worden gemaakt. Deze stoffen zorgen ervoor dat sommige soorten antibiotica (zoals penicillines) niet meer werken. Ongeveer vijf procent van de Nederlandse bevolking draagt ESBL's bij zich in de darmen. Dat leidt meestal niet tot gezondheidsproblemen. Alleen als iemand een ontsteking krijgt met zo'n resistente bacterie, is deze moeilijker te behandelen met antibiotica. Mensen kunnen op verschillende manieren met ESBL's besmet raken; via andere mensen, via de omgeving, via contact met dieren of via het eten van (dierlijke) producten. Vooral kippenvlees is vaak besmet met ESBL's. Hierdoor werd aangenomen dat het eten van vlees een belangrijke manier is om besmet te raken met een ESBL. De conclusie uit het huidige RIVM-onderzoek laat zien dat deze aanname onjuist is. Aandacht voor antibioticaresistentie en terughoudend gebruik van antibiotica bij mens en dier is essentieel om antibioticaresistentie in het algemeen terug te dringen. Voor het onderzoek zijn veganisten, vegetariërs, vegetariërs die vis eten en niet-vegetariërs onderzocht op de aanwezigheid van ESBL's in hun ontlasting. In totaal hebben, RIVM has investigated the occurrence of resistant bacteria in vegetarians and non-vegetarians. This research focused only on ESBL-producing bacteria, or ESBLs, and revealed that persons who eat meat regularly (at least three times a week) do not carry ESBLs more frequently than vegetarians. In other words, eating meat does not increase the risk of a person becoming colonized with ESBL-producing bacteria. This study showed that participants who had travelled to Africa, Central/South America, Asia or South/East Europe were more frequently carriers of an ESBL than participants who had not. The same applied to participants who rarely or never washed their hands before preparing food. ESBL stands for Extended-Spectrum Beta-Lactamases. These are substances (enzymes) which can be produced by certain bacteria. These substances inactivate certain antibiotics (such as penicillins) which consequently lose their efficacy. Approximately 5 per cent of the Dutch population is carrying ESBLs in their intestines. Usually this does not lead to disease, but infections with resistant bacteria are more difficult to treat. A person can acquire ESBLs through different routes, for example via other persons, the environment, contact with animals or by food, including animal products. Chicken meat is most often contaminated with ESBLs, and this led to the assumption that eating meat is an important risk factor for ESBL carriage. The conclusion of the current RIVM research shows that this assumption is wrong. Nevertheless, antimicrobial stewardship and restrictive use of antimicrobials in humans and animals is essential to reduce antimicrobial resistance in general. The research included vegans, vegetarians, pescatarians and people who do eat meat and investigated the presence of ESBL in their faeces. A total of 1,641 persons participated. The participants filled in a detailed questionnaire about possible risk factors for acquiring ESBL. These include contact with animals, travels abroad, the

Item does not contain fulltext, OBJECTIVES: The objective of this study was to assess carriage of antimicrobial-resistant commensal microorganisms, i.e. Escherichia coli and Staphylococcus aureus, and its predictors in long-term-care facilities (LTCFs). METHODS: Nasal swabs and/or urine or incontinence samples were collected from participating residents in 111 LTCFs and tested for the presence of S. aureus and/or E. coli, respectively. Antimicrobial resistance to eight antimicrobials was linked to antimicrobial usage in the year preceding sampling and to LTCF characteristics. Using multilevel logistic regression, predictors of carriage of ESBL-producing E. coli in LTCFs were identified. RESULTS: S. aureus was identified in 1269/4763 (26.6%) nasal swabs, including 13/4763 (0.3%) MRSA carriers in 9/107 (8%) LTCFs. Of the 5359 urine/incontinence samples, 2934 (55%) yielded E. coli, including 123 (4.2%) producing ESBL, which were found in 53/107 locations (range 1%-33%). For all but one antimicrobial (i.e. nitrofurantoin) >20% of isolated E. coli were resistant. Multilevel multivariable logistic regression identified two predictors of carriage of ESBL-producing E. coli: (i) antimicrobial usage (OR 1.8, 95% CI 1.1-3.0 for each extra 50 DDD/1000 residents/day); and (ii) presence of MRSA carriers in the LTCFs (OR 2.4, 95% CI 1.0-5.6). CONCLUSIONS: The low proportion of 4.2% ESBL-producing E. coli and the low prevalence of 0.3% MRSA carriage found in LTCF residents suggest that Dutch LTCFs are not yet an important reservoir of MDR potential pathogens. Nevertheless, the large variation between LTCFs warrants close monitoring of antimicrobial resistance in LTCFs. Integrated surveillance, i.e. linking data sources on antimicrobial usage, microbiological testing, clinical background data and epidemiological data, is needed.