ESBL/AmpC-producing Enterobacteriaceae in households with children of preschool age: prevalence, risk factors and co-carriage

Bunt, Gerrita van den; Liakopoulos, Apostolos; Mevius, Dik; Geurts, Yvon; Fluit, Ad C.; Bonten, Marc J. M.; Mughini‐Gras, Lapo; Pelt, Wilfrid van

doi:10.1093/jac/dkw443

Cited by 34 publications

(48 citation statements)

References 45 publications

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“…Attendance at preschools and daycare centers has been shown to increase the risk for transmission of microbes and gastrointestinal infections ( 33 , 34 ). Furthermore, a recent study in the Netherlands reported an increased risk for colonization with ESBL producers in household members if the children attend daycare centers ( 35 ). However, Birgy et al reported an inverse relationship ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Rapid Increase in Carriage Rates ofEnterobacteriaceaeProducing Extended-Spectrum β-Lactamases in Healthy Preschool Children, Sweden

Kaarme¹,

Riedel²,

Schaal³

et al. 2018

Emerg. Infect. Dis.

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By collecting and analyzing diapers, we identified a >6-fold increase in carriage of extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae for healthy preschool children in Sweden (p<0.0001). For 6 of the 50 participating preschools, the carriage rate was >40%. We analyzed samples from 334 children and found 56 containing >1 ESBL producer. The prevalence in the study population increased from 2.6% in 2010 to 16.8% in 2016 (p<0.0001), and for 6 of the 50 participating preschools, the carriage rate was >40%. Furthermore, 58% of the ESBL producers were multidrug resistant, and transmission of ESBL-producing and non–ESBL-producing strains was observed at several of the preschools. Toddlers appear to be major carriers of ESBL producers in Sweden.

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Section: Discussionmentioning

confidence: 99%

Rapid Increase in Carriage Rates ofEnterobacteriaceaeProducing Extended-Spectrum β-Lactamases in Healthy Preschool Children, Sweden

Kaarme¹,

Riedel²,

Schaal³

et al. 2018

Emerg. Infect. Dis.

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“…Several studies in the Netherlands have reported the predominance of bla CTX−M genes in ESC R Enterobacteriaceae , mostly Escherichia coli , among hospital and primary care patients (van der Bij et al, 2011 ; Voets et al, 2012 ; Reuland et al, 2013 ), nursing home residents (Willemsen et al, 2015 ) and humans in the community (van Hoek et al, 2015 ; van den Bunt et al, 2016 ). Among them, E. coli belonging to sequence types (ST)10, ST38, ST69 and ST131 recovered from Dutch individuals have been recently associated with ESC R phenotype (Leverstein-van Hall et al, 2011 ; Overdevest et al, 2011 , 2015 ; van der Bij et al, 2011 ; Voets et al, 2012 ; Reuland et al, 2013 , 2016 ; Huijbers et al, 2014 ; Dohmen et al, 2015 ; van Hoek et al, 2015 ; Willemsen et al, 2015 ; Souverein et al, 2016 ; Voor in 't holt et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

High Prevalence of Intra-Familial Co-colonization by Extended-Spectrum Cephalosporin Resistant Enterobacteriaceae in Preschool Children and Their Parents in Dutch Households

et al. 2018

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Extended-spectrum cephalosporin-resistant (ESCR) Enterobacteriaceae pose a serious infection control challenge for public health. The emergence of the ESCR phenotype is mostly facilitated by plasmid-mediated horizontal extended-spectrum β-lactamases (ESBLs) and AmpC gene transfer within Enterobacteriaceae. Current data regarding the plasmid contribution to this emergence within the Dutch human population is limited. Hence, the aim of this study was to gain insight into the role of plasmids in the dissemination of ESBL/AmpC genes inside Dutch households with preschool children and precisely delineate co-colonization. In 87 ESCR Enterobacteriaceae from fecal samples of parents and preschool children within 66 Dutch households, genomic localization, plasmid type and insertion sequences linked to ESBL/AmpC genes were determined. Chromosomal location of ESBL/AmpC genes was confirmed when needed. An epidemiologically relevant subset of the isolates based on household co-carriage was assessed by Multilocus Sequence Typing and Pulsed-Field Gel Electrophoresis for genetic relatedness. The narrow-host range I1α and F plasmids were the major facilitators of ESBL/AmpC-gene dissemination. Interestingly, we documented a relatively high occurrence of chromosomal integration of typically plasmid-encoded ESBL/AmpC-genes. A high diversity of non-epidemic Escherichia coli sequence types (STs) was revealed; the predominant STs belonged to the pandemic lineages of extraintestinal pathogenic E. coli ST131 and ST69. Intra-familiar co-carriage by identical ESCR Enterobacteriaceae was documented in 7 households compared to 14 based on sole gene typing, as previously reported. Co-carriage was more frequent than expected based on pure chance, suggesting clonal transmission between children and parents within the household.

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“…Although we did not have information on mothers' antibiotic use or their carriage of ceftriaxone-resistant organisms, HIV-positive mothers may have been on daily trimethoprim-sulfamethoxazole prevention and may have harbored and passed multidrug-resistant PLOS ONE bacteria to their children. Household transmission and intrafamilial co-carriage of resistant Enterobacteriaceae have been documented in previous studies [20][21][22].…”

Section: Discussionmentioning

confidence: 66%

Exploration of risk factors for ceftriaxone resistance in invasive non-typhoidal Salmonella infections in western Kenya

et al. 2020

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Multidrug-resistant non-typhoidal Salmonella (NTS) infection has emerged as a prominent cause of invasive infections in Africa. We investigated the prevalence of ceftriaxone-resistant invasive NTS infections, conducted exploratory analysis of risk factors for resistance, and described antimicrobial use in western Kenya. We conducted a secondary analysis of existing laboratory, epidemiology, and clinical data from three independent projects, a malaria vaccine trial, a central nervous system (CNS) study, and the International Emerging Infections Program morbidity surveillance (surveillance program) during 2009-2014. We calculated odds ratios (OR) with 95% confidence intervals (CI) for ceftriaxone-resistant NTS infections compared with ceftriaxone-susceptible infections. We surveyed hospitals, pharmacies, and animal drug retailers about the availability and use of antimicrobials. In total, 286 invasive NTS infections were identified in the three projects; 43 NTS isolates were ceftriaxone-resistant. The absolute prevalence of ceftriaxone resistance varied among these methodologically diverse projects, with 18% (16/90) of isolates resistant to ceftriaxone in the vaccine trial, 89% (16/18) in the CNS study, and 6% (11/178) in the surveillance program. Invasive ceftriaxone-resistant infections increased over time. Most ceftriaxone-resistant isolates were co-resistant to multiple other antimicrobials. Having an HIV-positive mother (OR = 3.7; CI = 1.2-11.4) and taking trimethoprim-sulfamethoxazole for the current illness (OR = 9.6, CI = 1.2-78.9) were significantly associated with acquiring ceftriaxone-resistant invasive NTS infection. Ceftriaxone and other antibiotics were widely prescribed; multiple issues related to prescription practices and misuse were identified. In summary, ceftriaxone-resistant invasive NTS infection is increasing and limiting treatment options for serious infections.

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ESBL/AmpC-producing Enterobacteriaceae in households with children of preschool age: prevalence, risk factors and co-carriage

Cited by 34 publications

References 45 publications

Rapid Increase in Carriage Rates ofEnterobacteriaceaeProducing Extended-Spectrum β-Lactamases in Healthy Preschool Children, Sweden

Rapid Increase in Carriage Rates ofEnterobacteriaceaeProducing Extended-Spectrum β-Lactamases in Healthy Preschool Children, Sweden

High Prevalence of Intra-Familial Co-colonization by Extended-Spectrum Cephalosporin Resistant Enterobacteriaceae in Preschool Children and Their Parents in Dutch Households

Exploration of risk factors for ceftriaxone resistance in invasive non-typhoidal Salmonella infections in western Kenya

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