Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in Amsterdam

E.A. Reuland, N. al Naiemi, A.M. Kaiser, M. Heck, J.A. Kluytmans, P.H. Savelkoul, P.J. Elders, C.M. Vandenbroucke-Grauls

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

OBJECTIVES: The objectives of this study were to determine the prevalence of carriage of ESBL-producing Enterobacteriaceae (ESBL-E) in a representative sample of the general adult Dutch community, to identify risk factors and to gain understanding of the epidemiology of these resistant strains. METHODS: Adults enrolled in five general practices in Amsterdam were approached by postal mail and asked to fill in a questionnaire and to collect a faecal sample. Samples were analysed for the presence of ESBL-E. ESBL genes were characterized by PCR and sequencing. Strains were typed using MLST and amplified fragment length polymorphism (AFLP) and plasmids were identified by PCR-based replicon typing. Risk factors for carriage were investigated by multivariate analysis. RESULTS: ESBL-E were found in 145/1695 (8.6%) samples; 91% were Escherichia coli. Most ESBL genes were of the CTX-M group (blaCTX-M-1 and blaCTX-M-15). MLST ST131 was predominant and mainly associated with CTX-M-15-producing E. coli. One isolate with reduced susceptibility to ertapenem produced OXA-48. In multivariate analyses, use of antimicrobial agents, use of antacids and travel to Africa, Asia and Northern America were associated with carriage of ESBL-E, in particular strains with blaCTX-M-14/15. CONCLUSIONS: This study showed a high prevalence of ESBL-E carriage in the general Dutch community. Also, outside hospitals, the use of antibiotics was a risk factor; interestingly, use of antacids increased the risk of carriage. A major risk factor in the general population was travel to countries outside Europe, in particular to Asia, Africa and Northern America.
Original languageEnglish
Pages (from-to)1076-1082
Number of pages7
JournalJournal of Antimicrobial Chemotherapy
Volume71
Issue number4
Early online date10 Jan 2016
DOIs
Publication statusPublished - 1 Apr 2016

Keywords

  • SPECTRUM-BETA-LACTAMASE
  • ESCHERICHIA-COLI
  • CHICKEN MEAT
  • CTX-M
  • COMMUNITY
  • HUMANS
  • GENES
  • TRENDS
  • PCR

Cite this

Reuland, E. A., al Naiemi, N., Kaiser, A. M., Heck, M., Kluytmans, J. A., Savelkoul, P. H., ... Vandenbroucke-Grauls, C. M. (2016). Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in Amsterdam. Journal of Antimicrobial Chemotherapy, 71(4), 1076-1082. https://doi.org/10.1093/jac/dkv441
Reuland, E.A. ; al Naiemi, N. ; Kaiser, A.M. ; Heck, M. ; Kluytmans, J.A. ; Savelkoul, P.H. ; Elders, P.J. ; Vandenbroucke-Grauls, C.M. / Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in Amsterdam. In: Journal of Antimicrobial Chemotherapy. 2016 ; Vol. 71, No. 4. pp. 1076-1082.
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abstract = "OBJECTIVES: The objectives of this study were to determine the prevalence of carriage of ESBL-producing Enterobacteriaceae (ESBL-E) in a representative sample of the general adult Dutch community, to identify risk factors and to gain understanding of the epidemiology of these resistant strains. METHODS: Adults enrolled in five general practices in Amsterdam were approached by postal mail and asked to fill in a questionnaire and to collect a faecal sample. Samples were analysed for the presence of ESBL-E. ESBL genes were characterized by PCR and sequencing. Strains were typed using MLST and amplified fragment length polymorphism (AFLP) and plasmids were identified by PCR-based replicon typing. Risk factors for carriage were investigated by multivariate analysis. RESULTS: ESBL-E were found in 145/1695 (8.6{\%}) samples; 91{\%} were Escherichia coli. Most ESBL genes were of the CTX-M group (blaCTX-M-1 and blaCTX-M-15). MLST ST131 was predominant and mainly associated with CTX-M-15-producing E. coli. One isolate with reduced susceptibility to ertapenem produced OXA-48. In multivariate analyses, use of antimicrobial agents, use of antacids and travel to Africa, Asia and Northern America were associated with carriage of ESBL-E, in particular strains with blaCTX-M-14/15. CONCLUSIONS: This study showed a high prevalence of ESBL-E carriage in the general Dutch community. Also, outside hospitals, the use of antibiotics was a risk factor; interestingly, use of antacids increased the risk of carriage. A major risk factor in the general population was travel to countries outside Europe, in particular to Asia, Africa and Northern America.",
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Reuland, EA, al Naiemi, N, Kaiser, AM, Heck, M, Kluytmans, JA, Savelkoul, PH, Elders, PJ & Vandenbroucke-Grauls, CM 2016, 'Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in Amsterdam', Journal of Antimicrobial Chemotherapy, vol. 71, no. 4, pp. 1076-1082. https://doi.org/10.1093/jac/dkv441

Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in Amsterdam. / Reuland, E.A.; al Naiemi, N.; Kaiser, A.M.; Heck, M.; Kluytmans, J.A.; Savelkoul, P.H.; Elders, P.J.; Vandenbroucke-Grauls, C.M.

In: Journal of Antimicrobial Chemotherapy, Vol. 71, No. 4, 01.04.2016, p. 1076-1082.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in Amsterdam

AU - Reuland, E.A.

AU - al Naiemi, N.

AU - Kaiser, A.M.

AU - Heck, M.

AU - Kluytmans, J.A.

AU - Savelkoul, P.H.

AU - Elders, P.J.

AU - Vandenbroucke-Grauls, C.M.

PY - 2016/4/1

Y1 - 2016/4/1

N2 - OBJECTIVES: The objectives of this study were to determine the prevalence of carriage of ESBL-producing Enterobacteriaceae (ESBL-E) in a representative sample of the general adult Dutch community, to identify risk factors and to gain understanding of the epidemiology of these resistant strains. METHODS: Adults enrolled in five general practices in Amsterdam were approached by postal mail and asked to fill in a questionnaire and to collect a faecal sample. Samples were analysed for the presence of ESBL-E. ESBL genes were characterized by PCR and sequencing. Strains were typed using MLST and amplified fragment length polymorphism (AFLP) and plasmids were identified by PCR-based replicon typing. Risk factors for carriage were investigated by multivariate analysis. RESULTS: ESBL-E were found in 145/1695 (8.6%) samples; 91% were Escherichia coli. Most ESBL genes were of the CTX-M group (blaCTX-M-1 and blaCTX-M-15). MLST ST131 was predominant and mainly associated with CTX-M-15-producing E. coli. One isolate with reduced susceptibility to ertapenem produced OXA-48. In multivariate analyses, use of antimicrobial agents, use of antacids and travel to Africa, Asia and Northern America were associated with carriage of ESBL-E, in particular strains with blaCTX-M-14/15. CONCLUSIONS: This study showed a high prevalence of ESBL-E carriage in the general Dutch community. Also, outside hospitals, the use of antibiotics was a risk factor; interestingly, use of antacids increased the risk of carriage. A major risk factor in the general population was travel to countries outside Europe, in particular to Asia, Africa and Northern America.

AB - OBJECTIVES: The objectives of this study were to determine the prevalence of carriage of ESBL-producing Enterobacteriaceae (ESBL-E) in a representative sample of the general adult Dutch community, to identify risk factors and to gain understanding of the epidemiology of these resistant strains. METHODS: Adults enrolled in five general practices in Amsterdam were approached by postal mail and asked to fill in a questionnaire and to collect a faecal sample. Samples were analysed for the presence of ESBL-E. ESBL genes were characterized by PCR and sequencing. Strains were typed using MLST and amplified fragment length polymorphism (AFLP) and plasmids were identified by PCR-based replicon typing. Risk factors for carriage were investigated by multivariate analysis. RESULTS: ESBL-E were found in 145/1695 (8.6%) samples; 91% were Escherichia coli. Most ESBL genes were of the CTX-M group (blaCTX-M-1 and blaCTX-M-15). MLST ST131 was predominant and mainly associated with CTX-M-15-producing E. coli. One isolate with reduced susceptibility to ertapenem produced OXA-48. In multivariate analyses, use of antimicrobial agents, use of antacids and travel to Africa, Asia and Northern America were associated with carriage of ESBL-E, in particular strains with blaCTX-M-14/15. CONCLUSIONS: This study showed a high prevalence of ESBL-E carriage in the general Dutch community. Also, outside hospitals, the use of antibiotics was a risk factor; interestingly, use of antacids increased the risk of carriage. A major risk factor in the general population was travel to countries outside Europe, in particular to Asia, Africa and Northern America.

KW - SPECTRUM-BETA-LACTAMASE

KW - ESCHERICHIA-COLI

KW - CHICKEN MEAT

KW - CTX-M

KW - COMMUNITY

KW - HUMANS

KW - GENES

KW - TRENDS

KW - PCR

U2 - 10.1093/jac/dkv441

DO - 10.1093/jac/dkv441

M3 - Article

VL - 71

SP - 1076

EP - 1082

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

IS - 4

ER -