OBJECTIVES: Empiric antibiotic treatment should be based on recent surveillance data. Therefore, we conducted a surveillance of (multidrug) resistance of Escherichia coli and antibiotic use among Dutch nursing home (NH) residents. Pulsed-field gel electrophoresis and multilocus sequence typing were used to describe the spread of multidrug-resistant strains. DESIGN: Observational study. SETTING: Five NHs in the southern part of The Netherlands. PARTICIPANTS: A total of 337 NH residents from both somatic and psychogeriatric wards. MEASUREMENTS: The prevalence and spread of antibiotic resistance and multidrug resistant E. coli isolates collected from urine samples and antibiotic use among the NH residents were investigated. RESULTS: A total of 208 E. coli isolates were collected from 308 urine samples. Resistance to amoxicillin-clavulanic acid was 23% and resistance to ciprofloxacin was 16%. Resistance to trimethoprim-sulfamethoxazole was 19%, whereas nitrofurantoin resistance was less than 1%. Multidrug resistance was observed in 28 of the 208 isolates (13%). Several isolates showed a similar pulsed-field gel electrophoresis pulsotype and multilocus sequence typing type. Sequence type (ST) 131 was the most prevalent (48%) and was demonstrated in all NHs and with four different pulsotypes. Consumption of antibiotics for systemic use was 64.4 defined daily dose (DDD)/1000 residents/day. Amoxicillin-clavulanic acid was most frequently prescribed (20.92 DDD/1000 residents/day), followed by the quinolones (14.8 DDD/1000 residents/day). CONCLUSION: We observed a high prevalence of antibiotic resistance and antibiotic use. In particular, the use of and resistance to fluoroquinolones is concerning. Because of the high prevalence of resistance, many agents are no longer suitable for empiric treatment. E. coli ST131, which has also been demonstrated in this study, poses a potential risk to this vulnerable population. We have clearly demonstrated that the resistance among NH residents is different from elderly living at home and hospitalized patients, and with the emergence of resistant strains, such as ST131, NHs are a potential reservoir for multidrug resistant bacteria.
OBJECTIVES: Empiric antibiotic treatment should be based on recent surveillance data. Therefore, we conducted a surveillance of (multidrug) resistance of Escherichia coli and antibiotic use among Dutch nursing home (NH) residents. Pulsed-field gel electrophoresis and multilocus sequence typing were used to describe the spread of multidrug-resistant strains. DESIGN: Observational study. SETTING: Five NHs in the southern part of The Netherlands. PARTICIPANTS: A total of 337 NH residents from both somatic and psychogeriatric wards. MEASUREMENTS: The prevalence and spread of antibiotic resistance and multidrug resistant E. coli isolates collected from urine samples and antibiotic use among the NH residents were investigated. RESULTS: A total of 208 E. coli isolates were collected from 308 urine samples. Resistance to amoxicillin-clavulanic acid was 23% and resistance to ciprofloxacin was 16%. Resistance to trimethoprim-sulfamethoxazole was 19%, whereas nitrofurantoin resistance was less than 1%. Multidrug resistance was observed in 28 of the 208 isolates (13%). Several isolates showed a similar pulsed-field gel electrophoresis pulsotype and multilocus sequence typing type. Sequence type (ST) 131 was the most prevalent (48%) and was demonstrated in all NHs and with four different pulsotypes. Consumption of antibiotics for systemic use was 64.4 defined daily dose (DDD)/1000 residents/day. Amoxicillin-clavulanic acid was most frequently prescribed (20.92 DDD/1000 residents/day), followed by the quinolones (14.8 DDD/1000 residents/day). CONCLUSION: We observed a high prevalence of antibiotic resistance and antibiotic use. In particular, the use of and resistance to fluoroquinolones is concerning. Because of the high prevalence of resistance, many agents are no longer suitable for empiric treatment. E. coli ST131, which has also been demonstrated in this study, poses a potential risk to this vulnerable population. We have clearly demonstrated that the resistance among NH residents is different from elderly living at home and hospitalized patients, and with the emergence of resistant strains, such as ST131, NHs are a potential reservoir for multidrug resistant bacteria.
Authors: Amee R Manges; Hyun Min Geum; Alice Guo; Thaddeus J Edens; Chad D Fibke; Johann D D Pitout Journal: Clin Microbiol Rev Date: 2019-06-12 Impact factor: 26.132
Authors: C F M van der Donk; M I A Rijnders; G A Donker; A J de Neeling; S Nys; E E Stobberingh Journal: Eur J Clin Microbiol Infect Dis Date: 2013-02-10 Impact factor: 3.267
Authors: Mary J Burgess; James R Johnson; Stephen B Porter; Brian Johnston; Connie Clabots; Brian D Lahr; James R Uhl; Ritu Banerjee Journal: Open Forum Infect Dis Date: 2015-02-17 Impact factor: 3.835
Authors: Ilse Overdevest; Manon Haverkate; Jacobien Veenemans; Yvonne Hendriks; Carlo Verhulst; Ans Mulders; Willemijn Couprie; Martin Bootsma; James Johnson; Jan Kluytmans Journal: Euro Surveill Date: 2016-10-20
Authors: Quinten R Ducarmon; Elisabeth M Terveer; Romy D Zwittink; Ed J Kuijper; Sam Nooij; Michelle N Bloem; Karuna E W Vendrik; Monique A A Caljouw; Ingrid M J G Sanders; Sofie M van Dorp; Man C Wong Journal: Genome Med Date: 2021-04-07 Impact factor: 11.117
Authors: Barbara Nesta; Maria Valeri; Angela Spagnuolo; Roberto Rosini; Marirosa Mora; Paolo Donato; Christopher J Alteri; Mariangela Del Vecchio; Scilla Buccato; Alfredo Pezzicoli; Isabella Bertoldi; Lapo Buzzigoli; Giovanna Tuscano; Maria Falduto; Valentina Rippa; Yaqoub Ashhab; Giuliano Bensi; Maria Rita Fontana; Kate L Seib; Harry L T Mobley; Mariagrazia Pizza; Marco Soriani; Laura Serino Journal: PLoS Pathog Date: 2014-05-08 Impact factor: 6.823