Predicting carriage with extended-spectrum beta-lactamase-producing bacteria at hospital admission: a cross-sectional study

Platteel, Tamara N; Hall, Maurine A. Leverstein–van; Stuart, J.W. Cohen; Thijsen, Steven; Mascini, Ellen M.; Hees, B.C. van; Scharringa, Jelle; Fluit, Ad C.; Bonten, Marc J. M.

doi:10.1016/j.cmi.2014.09.014

Cited by 41 publications

(45 citation statements)

References 23 publications

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“…Our prevalence of intestinal carriers at admission is virtually the same as that found by a Dutch study published recently, which was 7.9% in patients coming from their homes and 8.6% in patients coming from long-term care facilities, a distinction not made in our research 21. Studies in three different areas in Spain (Madrid, Barcelona and Zaragoza) show that the prevalence of carriers has increased in the last few years, reaching rates ranging from 5.5% and 8.1% in 2002 and 2004 respectively, as in our study findings 11 13 16.…”

Section: Discussionsupporting

confidence: 88%

Local prevalence of extended-spectrum beta-lactamase (ESBL) producingEnterobacteriaceaeintestinal carriers at admission and co-expression of ESBL and OXA-48 carbapenemase inKlebsiella pneumoniae: a prevalence survey in a Spanish University Hospital

et al. 2019

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ObjectiveTo assess the prevalence of extended-spectrum beta-lactamase (ESBL)-producingEnterobacteriaceae(ESBL-E) faecal carriers at admission in a University Hospital in Spain.DesignPrevalence survey.SettingPneumology, gastroenterology, urology and neurosurgery units at a university tertiary hospital in Madrid (Spain).ParticipantsA total of 10 643 patients aged 18 and older admitted from March 2014 to April 2016 with a rectal swab taken at admission or as soon as possible within the first 48 hours.Primary and secondary outcome measuresPrevalence of ESBL-E faecal carriers and prevalence of ESBL-E infections at admission.ResultsThe prevalance of ESBL-E carriers at admission was 7.69% (CI 95% 7.18 to 8.19). Most of the isolates wereEscherichia coli(77.51%), followed byKlebsiella pneumoniae(20.71%). Eighty-eight (10.41%) of ESBL-E were simultaneous ESBL and carbapenemase (CP) producers, 1.83% in the case ofE. coliand 42.86% amongK. pneumoniaeisolates. Of the ESBL typed, 52.15% belonged to the cefotaximases (CTX-M-15) type and 91.38% of the CP were oxacillinase (OXA-48) type. Only 0.43% patients presented an active infection by ESBL-E at admission.ConclusionsThe prevalence found in our study is very similar to that found in literature. However, we found a high percentage of simultaneous ESBL and CP producers, particularly inK. pneumoniae. Despite the high prevalence of colonised patients, the ESBL-infection rate at admission was very low.

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Section: Discussionsupporting

confidence: 88%

Local prevalence of extended-spectrum beta-lactamase (ESBL) producingEnterobacteriaceaeintestinal carriers at admission and co-expression of ESBL and OXA-48 carbapenemase inKlebsiella pneumoniae: a prevalence survey in a Spanish University Hospital

et al. 2019

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“…The prevalence of ESBL among E. coli and K. pneumoniae in our study (3.6%) was comparable with the national data. Other studies reported prevalences ranging from 4.5 to 19.1% [18][19][20][21][22][23][24][25]. It should be noted, however, that these other studies have included populations that are not comparable with our patient population.…”

Section: Discussionmentioning

confidence: 74%

“…In these studies, faecal samples were examined. Paltansing et al [24] included travellers and rectal swabs, whereof one isolate was Citrobacter freundii, and Platteel et al [25] analysed perianal and faeces swabs from patients admitted to the hospital. The study population of Star-SHL is most comparable with the population of NethMap, i.e.…”

Section: Discussionmentioning

confidence: 99%

Low antimicrobial resistance in general practice patients in Rotterdam, the city with the largest proportion of immigrants in the Netherlands

Honsbeek

Tjon-A-Tsien

Stobberingh

et al. 2020

Eur J Clin Microbiol Infect Dis

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Antimicrobial resistance (AMR) is an increasing problem. The prevalence of antimicrobial resistance in general practice patients is expected to be relatively high in Rotterdam, the Dutch city with the largest proportion non-Western immigrants. The aim of this study was to assess the prevalence of antibiotic-resistant uropathogens (Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis) in general practices in Rotterdam, and to find a possible association between the prevalence of antibiotic-resistant E. coli and age, gender, and socioeconomic status (SES). A retrospective analysis was performed of urine samples from general practice patients in 2016. The prevalence of AMR in uropathogens was compared with national resistance data, as was the prevalence of highly and multidrug resistant and extended spectrum β-lactamase (ESBL) producing E. coli and K. pneumoniae. Univariate logistic regression was used to study associations between antibiotic-resistant E. coli and age, gender, and SES area score. No clinically relevant differences were observed in the prevalence of antibiotic-resistant uropathogens in Rotterdam compared with the national prevalence. For E. coli and K. pneumoniae, the prevalence was 3.6% for ESBL production (both pathogens together), while the prevalence ranged between 4.2%-5.0% for high resistance and between 1.2%-3.3% for multidrug resistance. Ciprofloxacin-resistant E. coli was significantly associated with higher age. Although Rotterdam has a high percentage of non-western immigrants and a low SES, AMR is low among general practice patients. This indicates that adherence to national guidelines in general practice enables maintenance of low AMR, even in high-risk populations.

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“…In a study of UK surfers, Leonard et al 5 found that 1.5 per cent of a non-surfing, control population were colonised by E coli -bearing bla CTX-M compared with 6.3 per cent of UK surfers. Intestinal colonisation with ESBL-producing bacteria before hospital admission is associated with increased risk of nosocomial infection 6. Patients with infections caused by ESBL-producing bacteria and carriers of these organisms represent a source of resistance and can be responsible for nosocomial and community transmission 7.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of faecal carriage of extended‐spectrum β‐lactamase (ESBL)‐producing Escherichia coli in veterinary hospital staff and students

Royden

Ormandy

Pinchbeck

et al. 2019

Veterinary Record Open

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Extended-spectrum β-lactamase (ESBL)-producing bacteria causing clinical infections are often also multidrug-resistant (MDR; resistance to ≥3 antimicrobial drug classes), therefore treatment options may be limited. High carriage rates of these potentially zoonotic bacteria have been found in livestock and companion animals. Therefore, people working in veterinary hospitals may be a high-risk population for carriage. This is the first study to determine the prevalence and longitudinal carriage of antimicrobial-resistant (AMR) and ESBL-producing faecal Escherichia coli in veterinary hospital staff and students. Prevalence of faecal AMR and ESBL-producing E coli was determined in 84 staff members and students in three UK veterinary hospitals. Twenty-seven participants were followed for six weeks to investigate longitudinal carriage. Antimicrobial susceptibility and phenotypic ESBL production were determined and selected isolates were whole genome sequenced. ESBL-producing E coli were isolated from five participants (5.95 per cent; 95 per cent CI 0.89 to 11.0 per cent); two participants carried ESBL-producing E coli resistant to all antimicrobials tested. Carriage of MDR E coli was common (32.1 per cent; 95per cent CI 22.2 to 42.1 per cent) and there was a high prevalence of ciprofloxacin resistance (11.9 per cent; 95 per cent CI 4.98 to 18.8 per cent). ESBL-producing E coli were isolated from seven longitudinal participants (25.9 per cent; 95 per cent CI 9.40 to 42.5 per cent); two participants carried ESBL-producing E coli for the entire study period. Twenty-six participants (96.3 per cent; 95 per cent CI 89.2 to 100) carried ≥1 MDR E coli isolate during the six-week period, with seven participants (25.9 per cent) carrying ≥1 MDR isolate for at least five out of six weeks. The prevalence of faecal ESBL-producing E coli in cross-sectional participants is similar to asymptomatic general populations. However, much higher levels of carriage were observed longitudinally in participants. It is vital that veterinary hospitals implement gold-standard biosecurity to prevent transmission of MDR and ESBL-producing bacteria between patients and staff. Healthcare providers should be made aware that people working in veterinary hospitals are a high-risk population for carriage of MDR and ESBL-producing bacteria, and that this poses a risk to the carrier and for transmission of resistance throughout the wider community.

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Predicting carriage with extended-spectrum beta-lactamase-producing bacteria at hospital admission: a cross-sectional study

Cited by 41 publications

References 23 publications

Local prevalence of extended-spectrum beta-lactamase (ESBL) producingEnterobacteriaceaeintestinal carriers at admission and co-expression of ESBL and OXA-48 carbapenemase inKlebsiella pneumoniae: a prevalence survey in a Spanish University Hospital

Local prevalence of extended-spectrum beta-lactamase (ESBL) producingEnterobacteriaceaeintestinal carriers at admission and co-expression of ESBL and OXA-48 carbapenemase inKlebsiella pneumoniae: a prevalence survey in a Spanish University Hospital

Low antimicrobial resistance in general practice patients in Rotterdam, the city with the largest proportion of immigrants in the Netherlands

Prevalence of faecal carriage of extended‐spectrum β‐lactamase (ESBL)‐producing Escherichia coli in veterinary hospital staff and students

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