TY - JOUR
T1 - Cross-border differences in the prevalence and risk factors for carriage of antimicrobial resistance in children attending daycare centers
T2 - a point prevalence study in the Netherlands and Belgium
AU - Dequeker, Sara
AU - van Hensbergen, Mitch
AU - den Heijer, Casper D J
AU - Dhaeze, Wouter
AU - Raven, Stijn F H
AU - Ewalts-Hakkoer, Helen
AU - Tolsma, Paulien
AU - Willemsen, Ina
AU - van Drunen-Kamp, Karine J
AU - van der Slikke-Verstraten, Krista
AU - Goossens, Herman
AU - Kluytmans-van den Bergh, Marjolein F Q
AU - Hoebe, Christian J P A
AU - i-4-1-Health Study Group
AU - van Alphen, Lieke
AU - den Heijer, Casper
AU - Jamin, Casper
PY - 2024/1/24
Y1 - 2024/1/24
N2 - BACKGROUND: Day care centres (DCCs) are ideal settings for drug-resistant bacteria to emerge. Prevalence numbers of faecal carriage of antimicrobial resistant bacteria in these settings are rare. We aimed to determine the prevalence of faecal antimicrobial resistant bacteria carriage in children attending DCCs and to assess and identify infection risk factors within DCCs in The Netherlands and Belgium. METHODS: A point-prevalence study was conducted in 28 Dutch (499 children) and 18 Belgian (448 children) DCCs. Stool samples were taken from the children's diapers and a questionnaire was filled in by their parents. Hygiene related to stool and toilet use, hygiene related to food, environmental contamination, hand hygiene and hygiene guidelines were assessed conform a standardized questionnaire by the infection prevention and control expert visiting the DCC. Multilevel logistical regression analyses were used to define which characteristics predicted the presence of extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E), carbapenemase-producing Enterobacterales (CPE), vancomycin-resistant enterococci (VRE), and ciprofloxacin-resistant Enterobacterales (CipR-E). RESULTS: The ESBL-E prevalence was 16% (n =?71) in Belgium and 6% (n =?30) in the Netherlands. The CipR-E prevalence was 17% (n =?78) in Belgium and 8% (n =?38) in the Netherlands. Antimicrobial use (RR: 0.30; 95% CI: 0.33-0.48) and hospital admissions (RR: 0.37; 95% CI: 0.25-0.54) were lower in the Netherlands. Children travelling to Asia were at higher risk of being an ESBL-E carrier. Children using antimicrobials were at higher risk of being a CipR-E carrier. Cleaning the changing mat after each use was found as a protective factor for CipR-E carriage. CONCLUSIONS: We established a significant difference in ESBL-E and CipR-E carriage and antimicrobial use and hospital admissions between the Netherlands and Belgium among children attending DCCs. The differences between both countries should be further studied to improve the policy on anti-microbial use and hospital admissions in children.
AB - BACKGROUND: Day care centres (DCCs) are ideal settings for drug-resistant bacteria to emerge. Prevalence numbers of faecal carriage of antimicrobial resistant bacteria in these settings are rare. We aimed to determine the prevalence of faecal antimicrobial resistant bacteria carriage in children attending DCCs and to assess and identify infection risk factors within DCCs in The Netherlands and Belgium. METHODS: A point-prevalence study was conducted in 28 Dutch (499 children) and 18 Belgian (448 children) DCCs. Stool samples were taken from the children's diapers and a questionnaire was filled in by their parents. Hygiene related to stool and toilet use, hygiene related to food, environmental contamination, hand hygiene and hygiene guidelines were assessed conform a standardized questionnaire by the infection prevention and control expert visiting the DCC. Multilevel logistical regression analyses were used to define which characteristics predicted the presence of extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E), carbapenemase-producing Enterobacterales (CPE), vancomycin-resistant enterococci (VRE), and ciprofloxacin-resistant Enterobacterales (CipR-E). RESULTS: The ESBL-E prevalence was 16% (n =?71) in Belgium and 6% (n =?30) in the Netherlands. The CipR-E prevalence was 17% (n =?78) in Belgium and 8% (n =?38) in the Netherlands. Antimicrobial use (RR: 0.30; 95% CI: 0.33-0.48) and hospital admissions (RR: 0.37; 95% CI: 0.25-0.54) were lower in the Netherlands. Children travelling to Asia were at higher risk of being an ESBL-E carrier. Children using antimicrobials were at higher risk of being a CipR-E carrier. Cleaning the changing mat after each use was found as a protective factor for CipR-E carriage. CONCLUSIONS: We established a significant difference in ESBL-E and CipR-E carriage and antimicrobial use and hospital admissions between the Netherlands and Belgium among children attending DCCs. The differences between both countries should be further studied to improve the policy on anti-microbial use and hospital admissions in children.
KW - Belgium
KW - Children
KW - CipR-E
KW - Day care centres
KW - ESBL-E
KW - The Netherlands
KW - Child
KW - Humans
KW - Belgium/epidemiology
KW - Netherlands/epidemiology
KW - Prevalence
KW - Anti-Bacterial Agents/pharmacology
KW - Cross-Sectional Studies
KW - Drug Resistance, Bacterial
KW - Risk Factors
KW - Ciprofloxacin
U2 - 10.1186/s12879-024-08996-9
DO - 10.1186/s12879-024-08996-9
M3 - Article
SN - 1471-2334
VL - 24
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
IS - 1
M1 - 131
ER -