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National point prevalence study on carriage of multidrug-resistant microorganisms in Dutch long-term care facilities in 2018
- Source :
- Journal of Antimicrobial Chemotherapy, 76(6), 1604-1613. Oxford University Press, Journal of Antimicrobial Chemotherapy, 76, 1604-1613, Journal of Antimicrobial Chemotherapy, 76, 6, pp. 1604-1613
- Publication Year :
- 2021
- Publisher :
- Oxford University Press, 2021.
-
Abstract
- Objectives Long-term care facilities (LTCFs) may act as a reservoir of ESBL-producing Enterobacterales (ESBL-E) and carbapenemase-producing Enterobacterales (CPE) for hospitals and the general population. In this study, we estimated the prevalence and molecular epidemiology of rectal carriage with ESBL-E and CPE in residents of Dutch LTCFs between March 2018 and December 2018. Methods LTCFs were geographically selected across the country. For each LTCF, a random sample of residents were tested for ESBL-E and CPE in 2018. To identify risk factors for high carriage prevalence and/or individual carriage, characteristics of LTCFs and of a subset of the tested residents were collected. WGS was conducted on isolates from LTCFs with an ESBL-E prevalence of >10% and all CPE isolates to identify institutional clonal transmission. Results A total of 4420 residents of 159 LTCFs were included. The weighted mean ESBL-E prevalence was 8.3% (95% CI: 6.8–10.0) and no CPE were found. In 53 LTCFs (33%), where ESBL-E prevalence was >10%, MLST using WGS (wgMLST) was performed. This included 264 isolates, the majority being Escherichia coli (n = 224) followed by Klebsiella pneumoniae (n = 30). Genetic clusters were identified in more than half (30/53; 57%) of high ESBL-positive LTCFs. Among the E. coli isolates, blaCTX-M-15 (92/224; 41%) and blaCTX-M-27 (40/224; 18%) were the most prevalent ESBL-encoding genes. For K. pneumoniae isolates, the most common was blaCTX-M-15 (23/30; 80%). Conclusions The estimated prevalence of ESBL-E rectal carriage in Dutch LTCFs is 8.3% and resistance is observed mainly in E. coli with predominance of blaCTX-M-15 and blaCTX-M-27. ESBL-E prevalence in LTCFs seems comparable to previously reported prevalence in hospitals and the general population.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
Klebsiella pneumoniae
030106 microbiology
Population
Prevalence
beta-Lactamases/genetics
beta-Lactamases
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
0302 clinical medicine
Antibiotic resistance
Environmental health
Escherichia coli
Medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
education
Escherichia coli Infections
Pharmacology
education.field_of_study
Molecular epidemiology
biology
business.industry
biochemical phenomena, metabolism, and nutrition
biology.organism_classification
bacterial infections and mycoses
Long-Term Care
Long-term care
Escherichia coli/genetics
lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4]
Infectious Diseases
Carriage
Multilocus sequence typing
business
Multilocus Sequence Typing
Subjects
Details
- Language :
- English
- ISSN :
- 14602091 and 03057453
- Volume :
- 76
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of Antimicrobial Chemotherapy
- Accession number :
- edsair.doi.dedup.....f0296c8345241dae5b1e36277ea14e77