Research output

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

Research output: Contribution to journalArticleAcademicpeer-review

Associated researcher

  • Reuland, E. A.
  • al Naiemi, N.
  • Kaiser, A. M.
  • Heck, M.
  • Kluytmans, J. A.
  • Savelkoul, P.H.M.

  • Elders, P. J.
  • Vandenbroucke-Grauls, C. M.

Associated organisations

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.

    Research areas

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

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