Individual- and community-level risk factors for ESBL Enterobacteriaceae colonization identified by universal admission screening in London

Otter, Jonathan A.; Natale, Alex; Batra, Rahul; Auguet, Olga Tosas; Dyakova, Eleonora; Goldenberg, Simon; Edgeworth, Jonathan D

doi:10.1016/j.cmi.2019.02.026

Cited by 53 publications

(53 citation statements)

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“…Hospitalization and the use of antimicrobials, which have been described as possible risk factors in previous studies [36,37], did not show an association with ESBL-carriage in the current study. While the numbers of non-ESBL carriers hospitalized (n = 16) and treated with antimicrobials (n = 14) was comparatively high, all ESBL-carriers reported a zero usage of antimicrobials and no hospitalization within the past 12 months.…”

Section: Plos Onecontrasting

confidence: 73%

Association of intestinal colonization of ESBL-producing Enterobacteriaceae in poultry slaughterhouse workers with occupational exposure—A German pilot study

et al. 2020

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Background Bacteria that have acquired antimicrobial resistance, in particular ESBL-producing Enterobacteriaceae, are an important healthcare concern. Therefore, transmission routes and risk factors are of interest, especially for the carriage of ESBL-producing E. coli. Since there is an enhanced risk for pig slaughterhouse employees to carry ESBL-producing Enterobacteriaceae, associated with animal contact as potential risk factor, the present study investigated the occurrence of ESBL-producing Enterobacteriaceae in poultry slaughterhouse employees. Due to the higher level of resistant Enterobacteriaceae in primary poultry production than in pig production, a higher risk of intestinal colonization of poultry slaughterhouse employees was expected. Results ESBL-producing Enterobacteriaceae were detected in 5.1% (5 of 99) of the fecal samples of slaughterhouse workers. The species of these isolates was confirmed as E. coli. PCR assays revealed the presence of the genes bla CTX-M-15 (n = 2) and bla SHV-12 (n = 3) in these isolates, partly in combination with the β-lactamase gene bla TEM-135. Participants were divided into two groups according to their occupational exposure and results indicated an increased probability of colonization with ESBL-producing Enterobacteriaceae for the group of 'higher exposure' (OR 3.7, exact 95% CI 0.6-23.5; p = 0.4). For intestinal colonization with ESBL-producing Enterobacteriaceae, a prevalence of 10% (3/30) was observed in the group of 'higher exposure' versus 2.9% (2/69) in the group of 'lower exposure'. Employees

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Section: Plos Onecontrasting

confidence: 73%

Association of intestinal colonization of ESBL-producing Enterobacteriaceae in poultry slaughterhouse workers with occupational exposure—A German pilot study

et al. 2020

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“…Several factors have been linked to increased fecal carriage of 3GC-R or ESBL-producing Enterobacteriaceae, including antibiotic use, international travel, hospitalization, dietary habits, and animal contact (Meyer et al, 2012;Leistner et al, 2013;Hamprecht et al, 2016;Otter et al, 2019). In our analysis, traveling to Southeast Asia in the past year and working at a specific company were associated with colonization by 3GC-R and ESBL-producing Enterobacteriaceae.…”

Section: Discussionmentioning

confidence: 72%

Colonization With Multidrug-Resistant Organisms Among Healthy Adults in the Community Setting: Prevalence, Risk Factors, and Composition of Gut Microbiome

et al. 2020

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Background: The prevalence of colonization with multidrug-resistant organisms (MDROs) among healthy adults in the community is largely unknown. This study investigated the colonization rate of multidrug-resistant Enterobacteriaceae, methicillinresistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE) in the community in Taiwan, and compared the gut microbiota between MDRO carriers and non-carriers.

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“…Faecal material stored in three existing biobanks was chosen for study; ethical approval for the broader use of these samples was in place. Samples comprised: (i) rectal swabs from children aged 1-59 months with and without malnutrition, taken on admission to Kilifi County Hospital in Kilifi, Kenya, from 1 st April to 30 th September 2016, and stored in Amies transport media + 1ml phosphate buffered saline at −80°C (“Pharmacokinetics of Antimicrobials and Carriage of Antimicrobial Resistance amongst Hospitalised Children with Severe Acute Malnutrition (FLACSAM)’ study 10 [KEMRI/SERU/CGMR-C/023/3161; OXTREC 47-15]); (ii) faecal samples taken from newborns on admission to Angkor Hospital for Children in Siem Reap, Cambodia, from 11 th September 2013 to 10 th September 2014, and stored in tryptone soya broth + 10% glycerol at −80°C 11 (OxTREC ref 1047-13; this collection also included longitudinal samples taken from a subset of newborns during their inpatient stay for another study); and (iii), rectal swabs (Eswab, Copan diagnostics, Murrieta, CA, USA); 1ml Amies transport media) from individuals aged ≥18 years attending pre-admission clinics or on admission to Guy’s and St Thomas’ NHS Foundation Trust, London, UK, between February and May 2015, and stored at −80°C 12–14 ([REC: 14/LO/2085]). Rectal swabs and faecal samples have both been used as approaches for surveying intestinal microbiota 15,16 , and are thought to give similar results 17 .…”

Section: Methodsmentioning

confidence: 99%

Metrics for Public Health Perspective Surveillance of Bacterial Antibiotic Resistance in Low- and Middle-Income Countries

Auguet

Niehus

Gweon

et al. 2020

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29Antimicrobial resistance (AMR) is a global health threat, especially in low-/middle-income countries 30 (LMICs), where there is limited surveillance to inform empiric antibiotic treatment guidelines. 31Enterobacterales are amongst the most important causes of drug-resistant bacterial infections. We 32 developed a novel AMR surveillance approach for Enterobacterales by profiling pooled human faecal 33 metagenomes from three sites (n=563 individuals; Cambodia, Kenya, UK) to derive a taxonomy-34 adjusted AMR metric ("resistance potential") which could be used to predict the aggregate percentage 35 of resistant invasive Enterobacterales infections within each setting. Samples were sequenced 36 (Illumina); taxonomic and resistance gene profiling was performed using ResPipe. Data on organisms 37 causing bacteraemia and meningitis and antibiotic susceptibility test results from 2010-2017 were 38 collated for each site. Bayesian generalised linear models with a binomial likelihood were fitted to 39 determine the capacity of the resistance potential to predict AMR in Enterobacterales infections in 40 Antimicrobial resistance (AMR) is a global health emergency 1 , and imposes a particularly large 48 socioeconomic burden in resource-limited settings, where bacterial infections and several other 49 drivers of AMR commonly co-occur and effective antibiotics may be unavailable or unaffordable 2 . A 50 key pillar in AMR mitigation is the development of effective and standardised AMR surveillance, to 51 monitor trends, inform empiric treatment guidelines, identify emerging AMR threats, and monitor the 52 impact of interventions. There has been significant investment in surveillance capacity, such as by the 53 UK's Fleming Fund, and an attempt to promote standardised collection, analysis and sharing of global 54 AMR data with an emphasis on capturing clinical and microbiological information, encapsulated in 55 the WHO Global Antimicrobial Resistance Surveillance System (GLASS) 3 . However, limitations in 56 implementing GLASS include the time taken to develop robust infrastructural capacity to support data 57 collection in regions where AMR is most relevant or prevalent, and the difficulty in obtaining 58 systematic datasets even from enrolled countries with adequate infrastructure, especially outside 59 tertiary or University centres. Surveillance strategies which could bridge or complement the 60 implementation of approaches such as GLASS would be helpful. 61 62Colonisation with specific species and/or drug-resistant organisms, such as nasal colonisation with 63 Staphylococcus aureus 4 , or rectal colonisation with carbapenemase-producing Enterobacterales 5 , is 64 associated with risk of infection by these organisms. Metagenomic approaches are less biased than 65 targeted approaches which capture specific organism/resistance phenotypes of interest, and obviate 66 the need for culturing individual organisms. Resistance gene abundances and taxonomic distributions 67 in metagenomes are increasingly mined for a range of applicat...

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Individual- and community-level risk factors for ESBL Enterobacteriaceae colonization identified by universal admission screening in London

Cited by 53 publications

References 30 publications

Association of intestinal colonization of ESBL-producing Enterobacteriaceae in poultry slaughterhouse workers with occupational exposure—A German pilot study

Association of intestinal colonization of ESBL-producing Enterobacteriaceae in poultry slaughterhouse workers with occupational exposure—A German pilot study

Colonization With Multidrug-Resistant Organisms Among Healthy Adults in the Community Setting: Prevalence, Risk Factors, and Composition of Gut Microbiome

Metrics for Public Health Perspective Surveillance of Bacterial Antibiotic Resistance in Low- and Middle-Income Countries

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