Large variation in ESBL-producing Escherichia coli carriers in six European countries including Russia

Abstract

We investigated the faecal carriage prevalence of extended-spectrum β-lactamase production in Escherichia coli (EP-EC) and/or Klebsiella pneumoniae (EP-KP) and risk factors associated with carriage among adult study subjects in Finland, Germany, Latvia, Poland, Russia and Sweden (partner countries). The aim was to get indicative data on the prevalence of ESBL-carriage in specific populations in the region. Faecal samples were collected from four study populations and screened on ChromID-ESBL and ChromID-OXA-48 plates. Positive isolates were further characterised phenotypically. Our results show a large variation in carrier prevalence ranging from 1.6% in Latvia to 23.2% in Russia for EP-EC. For the other partner countries, the prevalence of EP-EC were in increasing numbers, 2.3% for Germany, 4.7% for Finland, 6.6% for Sweden, 8.0% for Poland and 8.1% for all partner countries in total. Carriers of EP-KP were identified only in Finland, Russia and Sweden, and the prevalence was < 2% in each of these countries. No carriers of carbapenemase-producing isolates were identified. This is the first study reporting prevalence of carriers (excluding traveller studies) for Finland, Latvia, Poland and Russia. It contributes with important information regarding the prevalence of EP-EC and EP-KP carriage in regions where studies on carriers are limited.

Characteristics of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae and Contact to Animals in Estonia

“…The latter contributes to the formation and transmission of resistance reservoirs between environments [6]. Our finding of 6.8% of fecal carriage of ESBL-Enterobacteriaceae in total is in concordance with reports from other Northern European countries with rates between 4.7 and 6.6% [3,33,34]. This result was fairly predictable considering Estonia's good sanitation level and prudent antibiotic consumption strategies in human medicine [35].…”

“…The reported prevalence of ESBL-Enterobacteriaceae, varies significantly across the world, ranging between 1.6% in Latvia to 70% in some provinces of China and Thailand [3,7,31,32]. Geographic variances might have developed mainly due to different antibiotic policies and hygiene standards in both human medicine and animal husbandry, but also of the level of access to basic sanitation and clean water.…”

“…Therefore, monitoring mucosal colonization provides an indication of antimicrobial resistance (AMR) rates in a country. A large variability in ESBL-Enterobacteriaceae colonization in Estonia s neighboring countries, namely Latvia and Russia (1.6% vs. 23.3%, respectively) were found in a recent study by Ny et al [3]. Thus, the importance of local knowledge is crucial when planning measures to tackle antibiotic resistance.…”

“…The prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-Enterobacteriaceae) has continuously increased in both hospitals and communities all over the world [1,2]. Its frequency varies widely (2-70%) and depends on geographical location [3][4][5]. These trends have been mainly associated with the spread of the highly pathogenic multi-resistant Escherichia coli ST131 carrying bla CTX-M-15 in healthcare institutions [6,7].…”

Antimicrobial resistance of pathogens causing community-acquired urinary tract infections in Russia: results of the multicenter study “DARMIS-2018”

“…Это также чрезвычайно важно в контексте утвержденного плана по реализации Стратегии предупреждения распространения антимик робной резистентности, обновления существующих клинических рекомендаций и повышения эффек-тивности проводимого лечения. В настоящее время одной из наиболее значимых проблем химиотерапии внебольничных ИМП является глобальный рост продукции бета-лактамаз расширенного спектра (БЛРС) во внебольничной среде [7] и устойчивости к фторхинолонам [8].…”