National point prevalence study on carriage of multidrug-resistant microorganisms in Dutch long-term care facilities in 2018
© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissionsoup.com..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:76 |
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| Enthalten in: |
The Journal of antimicrobial chemotherapy - 76(2021), 6 vom: 12. Mai, Seite 1604-1613 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
van Kleef, Esther [VerfasserIn] |
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| Links: |
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| Themen: |
Beta-Lactamases |
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| Anmerkungen: |
Date Completed 09.07.2021 Date Revised 09.07.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/jac/dkab042 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM322514479 |
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| 100 | 1 | |a van Kleef, Esther |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a National point prevalence study on carriage of multidrug-resistant microorganisms in Dutch long-term care facilities in 2018 |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 09.07.2021 | ||
| 500 | |a Date Revised 09.07.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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%) | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
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| 700 | 1 | |a Wielders, Cornelia C H |e verfasserin |4 aut | |
| 700 | 1 | |a Schouls, Leo M |e verfasserin |4 aut | |
| 700 | 1 | |a Feenstra, Sabiena G |e verfasserin |4 aut | |
| 700 | 1 | |a Hertogh, Cees M P M |e verfasserin |4 aut | |
| 700 | 1 | |a Bonten, Marc J M |e verfasserin |4 aut | |
| 700 | 1 | |a van Weert, Yolanda |e verfasserin |4 aut | |
| 700 | 1 | |a Tostmann, Alma |e verfasserin |4 aut | |
| 700 | 1 | |a van der Lubben, Mariken |e verfasserin |4 aut | |
| 700 | 1 | |a de Greeff, Sabine C |e verfasserin |4 aut | |
| 700 | 0 | |a PPO study group |e verfasserin |4 aut | |
| 700 | 1 | |a Glasner, Corinna |e investigator |4 oth | |
| 700 | 1 | |a Fokkert, Karin |e investigator |4 oth | |
| 700 | 1 | |a Rademakers, Emma |e investigator |4 oth | |
| 700 | 1 | |a Terwee, Marja |e investigator |4 oth | |
| 700 | 1 | |a van Nimwegen, Dagmar |e investigator |4 oth | |
| 700 | 1 | |a Paulich, Hans |e investigator |4 oth | |
| 700 | 1 | |a de Raadt, Lisa |e investigator |4 oth | |
| 700 | 1 | |a Punt, Else |e investigator |4 oth | |
| 700 | 1 | |a den Boogert, Elke |e investigator |4 oth | |
| 700 | 1 | |a Jansen, Thera Habben |e investigator |4 oth | |
| 700 | 1 | |a Voss, Andreas |e investigator |4 oth | |
| 700 | 1 | |a Kluytmans, Jan |e investigator |4 oth | |
| 700 | 1 | |a Vos, Greet |e investigator |4 oth | |
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| 700 | 1 | |a Bootsma, Martin |e investigator |4 oth | |
| 700 | 1 | |a van 't Bosch, Gerda |e investigator |4 oth | |
| 700 | 1 | |a van Sprundel, Tineke |e investigator |4 oth | |
| 700 | 1 | |a Vos, Greet |e investigator |4 oth | |
| 700 | 1 | |a Bergervoet, Paul |e investigator |4 oth | |
| 700 | 1 | |a Schreijer, Anja |e investigator |4 oth | |
| 700 | 1 | |a Sijpkes, Gea |e investigator |4 oth | |
| 700 | 1 | |a van Haastert, Corrien |e investigator |4 oth | |
| 700 | 1 | |a Krom, André |e investigator |4 oth | |
| 700 | 1 | |a van den Brink, Patricia |e investigator |4 oth | |
| 700 | 1 | |a Vesseur, Jan |e investigator |4 oth | |
| 700 | 1 | |a Beckers, Astrid |e investigator |4 oth | |
| 700 | 1 | |a Reedijk, Nancy |e investigator |4 oth | |
| 700 | 1 | |a Rossen, John |e investigator |4 oth | |
| 700 | 1 | |a Savelkoul, Paul |e investigator |4 oth | |
| 700 | 1 | |a Laros, Jeroen |e investigator |4 oth | |
| 700 | 1 | |a van den Dool, Carline |e investigator |4 oth | |
| 700 | 1 | |a Bijkerk, Paul |e investigator |4 oth | |
| 700 | 1 | |a Beijshuizen, Berend |e investigator |4 oth | |
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| 700 | 1 | |a Alblas, Jeroen |e investigator |4 oth | |
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| 700 | 1 | |a Franz, Eelco |e investigator |4 oth | |
| 700 | 1 | |a van Duijkeren, Engeline |e investigator |4 oth | |
| 700 | 1 | |a de Haan, Angela |e investigator |4 oth | |
| 700 | 1 | |a Notermans, Daan |e investigator |4 oth | |
| 700 | 1 | |a Poorter, Elsa |e investigator |4 oth | |
| 700 | 1 | |a Landman, Fabian |e investigator |4 oth | |
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| 700 | 1 | |a Groot, James |e investigator |4 oth | |
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| 700 | 1 | |a van Luit, Martijn |e investigator |4 oth | |
| 700 | 1 | |a Witteveen, Sandra |e investigator |4 oth | |
| 700 | 1 | |a Kuiling, Sjoerd |e investigator |4 oth | |
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| 700 | 1 | |a van Alebeek, Josie |e investigator |4 oth | |
| 700 | 1 | |a Vermolen, Julika |e investigator |4 oth | |
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| 700 | 1 | |a van Maurik, Arnold |e investigator |4 oth | |
| 700 | 1 | |a Smeets, Elma |e investigator |4 oth | |
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