Ina Willemsen1, Jolande Nelson2, Yvonne Hendriks1, Ans Mulders3, Sandrien Verhoeff3, Paul Mulder4, Robert Roosendaal5, Kim van der Zwaluw6, Carlo Verhulst1, Marjolein Kluytmans-van den Bergh7, Jan Kluytmans1. 1. 1Laboratory for Microbiology and Infection Control,Amphia Hospital,Breda,The Netherlands. 2. 2Department for Infection Control and Microbiology,St. Elisabeth Hospital,Tilburg,The Netherlands. 3. 3THEBE,Healthcare Organisation including Nursing Homes,Breda,The Netherlands. 4. 4Amphia Academy,Amphia Hospital,Breda,The Netherlands. 5. 5Department for Medical Microbiology and Infection control,VUmc Medical Center,Amsterdam,The Netherlands. 6. 6Center for Infectious Disease Control,National Institute for Public Health and the Environment (RIVM),Bilthoven,The Netherlands. 7. 7Amphia Academy Infectious Disease Foundation,Amphia Hospital,Breda,The Netherlands.
Abstract
OBJECTIVE: Risk factors for rectal carriage of ESBL-E and transmission were investigated in an outbreak of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E). DESIGN: Rectal carriage of ESBL-E was determined in a cross-sectional survey by culture of perianal swabs or fecal samples. Both phenotypical and genotypical methods were used to detect the production of ESBL. Nosocomial transmission was defined as the presence of genotypically related strains in ≥2 residents within the NH. Patient characteristics and variables in infection control practices were registered to investigate risk factors for transmission. SETTING: A nursing home (NH) in the southern Netherlands. PARTICIPANTS: Of 189 residents, 160 residents (84.7%) were screened for ESBL-E carriage. Of these 160 residents, 33 (20.6%) were ESBL-E positive. ESBL carriage rates varied substantially between wards (range, 0-47%). Four different ESBL-E clusters were observed. A bla CTX-M1-15 positive E. coli ST131 constituted the largest cluster (n=21) and was found in multiple wards (n=7). RESULTS: Our investigation revealed extensive clonal dissemination of bla CTX-M1-15-positive E. coli ST131 in a nursing home. Unexplained differences in ESBL prevalence were detected among the wards. CONCLUSIONS: As NHs constitute potential sources of multidrug-resistant bacteria, it is important to gain a better understanding of the risks factors and routes of transmission of ESBL-E.
OBJECTIVE: Risk factors for rectal carriage of ESBL-E and transmission were investigated in an outbreak of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E). DESIGN: Rectal carriage of ESBL-E was determined in a cross-sectional survey by culture of perianal swabs or fecal samples. Both phenotypical and genotypical methods were used to detect the production of ESBL. Nosocomial transmission was defined as the presence of genotypically related strains in ≥2 residents within the NH. Patient characteristics and variables in infection control practices were registered to investigate risk factors for transmission. SETTING: A nursing home (NH) in the southern Netherlands. PARTICIPANTS: Of 189 residents, 160 residents (84.7%) were screened for ESBL-E carriage. Of these 160 residents, 33 (20.6%) were ESBL-E positive. ESBL carriage rates varied substantially between wards (range, 0-47%). Four different ESBL-E clusters were observed. A bla CTX-M1-15 positive E. coli ST131 constituted the largest cluster (n=21) and was found in multiple wards (n=7). RESULTS: Our investigation revealed extensive clonal dissemination of bla CTX-M1-15-positive E. coli ST131 in a nursing home. Unexplained differences in ESBL prevalence were detected among the wards. CONCLUSIONS: As NHs constitute potential sources of multidrug-resistant bacteria, it is important to gain a better understanding of the risks factors and routes of transmission of ESBL-E.
Authors: Veronica Weterings; Wouter van den Bijllaardt; Martin Bootsma; Yvonne Hendriks; Linda Kilsdonk; Ans Mulders; Jan Kluytmans Journal: Antimicrob Resist Infect Control Date: 2022-07-15 Impact factor: 6.454
Authors: Apostolos Liakopoulos; Gerrita van den Bunt; Yvon Geurts; Martin C J Bootsma; Mark Toleman; Daniela Ceccarelli; Wilfrid van Pelt; Dik J Mevius Journal: Front Microbiol Date: 2018-02-21 Impact factor: 5.640
Authors: Veronica Weterings; Jacobien Veenemans; Amanda Kleefman; Marjolein Kluytmans-van den Bergh; Paul Mulder; Carlo Verhulst; Ina Willemsen; Jan Kluytmans Journal: Antimicrob Resist Infect Control Date: 2019-06-18 Impact factor: 4.887
Authors: Eline van Dulm; Aletta T R Tholen; Annika Pettersson; Martijn S van Rooijen; Ina Willemsen; Peter Molenaar; Marjolein Damen; Paul Gruteke; Paul Oostvogel; Ed J Kuijper; Cees M P M Hertogh; Christina M J E Vandenbroucke-Grauls; Maarten Scholing Journal: PLoS One Date: 2019-09-12 Impact factor: 3.240
Authors: Stefan Hagel; Oliwia Makarewicz; Anita Hartung; Daniel Weiß; Claudia Stein; Christian Brandt; Ulrike Schumacher; Ralf Ehricht; Vladimir Patchev; Mathias W Pletz Journal: PLoS One Date: 2019-01-14 Impact factor: 3.240