Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in a population of Dutch travellers: A cross-sectional study

Maris S Arcilla; Jarne M Van Hattem; Martin C J Bootsma; Perry J J van Genderen; Abraham Goorhuis; Martin P Grobusch; Corné H W Klaassen; Astrid M Oude Lashof; Constance Schultsz; Ellen E Stobberingh; Menno D de Jong; John Penders; Henri A Verbrugh; Damian C Melles

doi:10.1016/j.tmaid.2019.101547

Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in a population of Dutch travellers: A cross-sectional study

Maris S Arcilla^*, Jarne M Van Hattem, Martin C J Bootsma, Perry J J van Genderen, Abraham Goorhuis, Martin P Grobusch, Corné H W Klaassen, Astrid M Oude Lashof, Constance Schultsz, Ellen E Stobberingh, Menno D de Jong, John Penders, Henri A Verbrugh, Damian C Melles

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: We investigated prevalence and predictive factors for ESBL-E carriage in a population of mostly travellers prior to their travel (n = 2216). In addition, we examined ESBL genotype before travel and compared these to returning travellers.

METHOD: A questionnaire and faecal sample were collected before travel, and a second faecal sample was collected immediately after travel. Faecal samples were analysed for ESBL-E, with genotypic characterization by PCR and sequencing. Risk factors for ESBL-E carriage prior to travel were identified by logistic regression analyses.

RESULTS: Before travel, 136 participants (6.1%) were colonized with ESBL-E. Antibiotic use in the past three months (ORadjusted 2.57; 95% CI 1.59-4.16) and travel outside of Europe in the past year (1.92, 1.28-2.87) were risk factors for ESBL-E colonisation prior to travel. Travel outside of Europe carried the largest attributable risk (39.8%). Prior to travel 31.3% (40/128) of participants carried blaCTX-M 15 and 21.9% (28/128) blaCTX-M 14/18. In returning travellers 633 acquired ESBL-E of who 53.4% (338/633) acquired blaCTX-M 15 and 17.7% (112/633) blaCTX-M 14/18.

CONCLUSION: In our population of Dutch travellers we found a pre-travel ESBL-E prevalence of 6.1%. Prior to travel, previous antibiotic use and travel outside of Europe were the strongest independent predictors for ESBL-E carriage, with travel outside of Europe carrying the largest attributable risk. Our molecular results suggest ESBL genes found in our study population prior to travel were in large part travel related.

Original language	English
Article number	101547
Number of pages	7
Journal	Travel Medicine and Infectious Disease
Volume	33
DOIs	https://doi.org/10.1016/j.tmaid.2019.101547
Publication status	Published - 2020

Keywords

ESBL
Carriage
Community
Travel
LACTAMASE-PRODUCING ENTEROBACTERIACEAE
ESCHERICHIA-COLI
FECAL CARRIAGE
COLONIZATION
COMMUNITY
ANIMALS

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Arcilla, M. S., Van Hattem, J. M., Bootsma, M. C. J., van Genderen, P. J. J., Goorhuis, A., Grobusch, M. P., Klaassen, C. H. W., Oude Lashof, A. M., Schultsz, C., Stobberingh, E. E., de Jong, M. D., Penders, J., Verbrugh, H. A., & Melles, D. C. (2020). Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in a population of Dutch travellers: A cross-sectional study. Travel Medicine and Infectious Disease, 33, Article 101547. https://doi.org/10.1016/j.tmaid.2019.101547

@article{8d1b417710344adda0b8eb3a16f74371,

title = "Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in a population of Dutch travellers: A cross-sectional study",

abstract = "BACKGROUND: We investigated prevalence and predictive factors for ESBL-E carriage in a population of mostly travellers prior to their travel (n = 2216). In addition, we examined ESBL genotype before travel and compared these to returning travellers.METHOD: A questionnaire and faecal sample were collected before travel, and a second faecal sample was collected immediately after travel. Faecal samples were analysed for ESBL-E, with genotypic characterization by PCR and sequencing. Risk factors for ESBL-E carriage prior to travel were identified by logistic regression analyses.RESULTS: Before travel, 136 participants (6.1%) were colonized with ESBL-E. Antibiotic use in the past three months (ORadjusted 2.57; 95% CI 1.59-4.16) and travel outside of Europe in the past year (1.92, 1.28-2.87) were risk factors for ESBL-E colonisation prior to travel. Travel outside of Europe carried the largest attributable risk (39.8%). Prior to travel 31.3% (40/128) of participants carried blaCTX-M 15 and 21.9% (28/128) blaCTX-M 14/18. In returning travellers 633 acquired ESBL-E of who 53.4% (338/633) acquired blaCTX-M 15 and 17.7% (112/633) blaCTX-M 14/18.CONCLUSION: In our population of Dutch travellers we found a pre-travel ESBL-E prevalence of 6.1%. Prior to travel, previous antibiotic use and travel outside of Europe were the strongest independent predictors for ESBL-E carriage, with travel outside of Europe carrying the largest attributable risk. Our molecular results suggest ESBL genes found in our study population prior to travel were in large part travel related.",

keywords = "ESBL, Carriage, Community, Travel, LACTAMASE-PRODUCING ENTEROBACTERIACEAE, ESCHERICHIA-COLI, FECAL CARRIAGE, COLONIZATION, COMMUNITY, ANIMALS",

author = "Arcilla, {Maris S} and {Van Hattem}, {Jarne M} and Bootsma, {Martin C J} and {van Genderen}, {Perry J J} and Abraham Goorhuis and Grobusch, {Martin P} and Klaassen, {Corn{\'e} H W} and {Oude Lashof}, {Astrid M} and Constance Schultsz and Stobberingh, {Ellen E} and {de Jong}, {Menno D} and John Penders and Verbrugh, {Henri A} and Melles, {Damian C}",

year = "2020",

doi = "10.1016/j.tmaid.2019.101547",

language = "English",

volume = "33",

journal = "Travel Medicine and Infectious Disease",

issn = "1477-8939",

publisher = "ELSEVIER SCI LTD",

}

Arcilla, MS, Van Hattem, JM, Bootsma, MCJ, van Genderen, PJJ, Goorhuis, A, Grobusch, MP, Klaassen, CHW, Oude Lashof, AM, Schultsz, C, Stobberingh, EE, de Jong, MD, Penders, J, Verbrugh, HA & Melles, DC 2020, 'Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in a population of Dutch travellers: A cross-sectional study', Travel Medicine and Infectious Disease, vol. 33, 101547. https://doi.org/10.1016/j.tmaid.2019.101547

TY - JOUR

T1 - Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in a population of Dutch travellers

T2 - A cross-sectional study

AU - Arcilla, Maris S

AU - Van Hattem, Jarne M

AU - Bootsma, Martin C J

AU - van Genderen, Perry J J

AU - Goorhuis, Abraham

AU - Grobusch, Martin P

AU - Klaassen, Corné H W

AU - Oude Lashof, Astrid M

AU - Schultsz, Constance

AU - Stobberingh, Ellen E

AU - de Jong, Menno D

AU - Penders, John

AU - Verbrugh, Henri A

AU - Melles, Damian C

PY - 2020

Y1 - 2020

N2 - BACKGROUND: We investigated prevalence and predictive factors for ESBL-E carriage in a population of mostly travellers prior to their travel (n = 2216). In addition, we examined ESBL genotype before travel and compared these to returning travellers.METHOD: A questionnaire and faecal sample were collected before travel, and a second faecal sample was collected immediately after travel. Faecal samples were analysed for ESBL-E, with genotypic characterization by PCR and sequencing. Risk factors for ESBL-E carriage prior to travel were identified by logistic regression analyses.RESULTS: Before travel, 136 participants (6.1%) were colonized with ESBL-E. Antibiotic use in the past three months (ORadjusted 2.57; 95% CI 1.59-4.16) and travel outside of Europe in the past year (1.92, 1.28-2.87) were risk factors for ESBL-E colonisation prior to travel. Travel outside of Europe carried the largest attributable risk (39.8%). Prior to travel 31.3% (40/128) of participants carried blaCTX-M 15 and 21.9% (28/128) blaCTX-M 14/18. In returning travellers 633 acquired ESBL-E of who 53.4% (338/633) acquired blaCTX-M 15 and 17.7% (112/633) blaCTX-M 14/18.CONCLUSION: In our population of Dutch travellers we found a pre-travel ESBL-E prevalence of 6.1%. Prior to travel, previous antibiotic use and travel outside of Europe were the strongest independent predictors for ESBL-E carriage, with travel outside of Europe carrying the largest attributable risk. Our molecular results suggest ESBL genes found in our study population prior to travel were in large part travel related.

AB - BACKGROUND: We investigated prevalence and predictive factors for ESBL-E carriage in a population of mostly travellers prior to their travel (n = 2216). In addition, we examined ESBL genotype before travel and compared these to returning travellers.METHOD: A questionnaire and faecal sample were collected before travel, and a second faecal sample was collected immediately after travel. Faecal samples were analysed for ESBL-E, with genotypic characterization by PCR and sequencing. Risk factors for ESBL-E carriage prior to travel were identified by logistic regression analyses.RESULTS: Before travel, 136 participants (6.1%) were colonized with ESBL-E. Antibiotic use in the past three months (ORadjusted 2.57; 95% CI 1.59-4.16) and travel outside of Europe in the past year (1.92, 1.28-2.87) were risk factors for ESBL-E colonisation prior to travel. Travel outside of Europe carried the largest attributable risk (39.8%). Prior to travel 31.3% (40/128) of participants carried blaCTX-M 15 and 21.9% (28/128) blaCTX-M 14/18. In returning travellers 633 acquired ESBL-E of who 53.4% (338/633) acquired blaCTX-M 15 and 17.7% (112/633) blaCTX-M 14/18.CONCLUSION: In our population of Dutch travellers we found a pre-travel ESBL-E prevalence of 6.1%. Prior to travel, previous antibiotic use and travel outside of Europe were the strongest independent predictors for ESBL-E carriage, with travel outside of Europe carrying the largest attributable risk. Our molecular results suggest ESBL genes found in our study population prior to travel were in large part travel related.

KW - ESBL

KW - Carriage

KW - Community

KW - Travel

KW - LACTAMASE-PRODUCING ENTEROBACTERIACEAE

KW - ESCHERICHIA-COLI

KW - FECAL CARRIAGE

KW - COLONIZATION

KW - COMMUNITY

KW - ANIMALS

U2 - 10.1016/j.tmaid.2019.101547

DO - 10.1016/j.tmaid.2019.101547

M3 - Article

C2 - 31862246

SN - 1477-8939

VL - 33

JO - Travel Medicine and Infectious Disease

JF - Travel Medicine and Infectious Disease

M1 - 101547

ER -