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

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

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