BACKGROUND: Gut colonization is a risk factor for infections with extended-spectrum beta-lactamase (ESBL)-producing organisms. We aimed to determine the ESBL class A reservoir among healthy individuals. METHODS: We searched PubMed and EMBASE (through 10 July 2015) looking for studies that contained data for fecal colonization with ESBL class A bacteria among healthy individuals for each World Health Organization-defined region. Distribution of isolates among cefotaximase (CTX-M), sulfhydryl variable, and temoneira enzymes and data on previous antibiotic use, international travel, previous hospitalization, and animal contacts were extracted. RESULTS: Sixty-six of 17 479 studies on 28 909 healthy individuals were included. The pooled prevalence of ESBL class A colonization was 14% (95% confidence interval [CI], 9, 20), with an increasing trend of 5.38% annually (P = .003). The pooled prevalence was higher in Asia and Africa (ranging from 46%, 95% CI, 29, 63 to 15%, 95% CI, 4, 31) and lower but still significant in central (3%, 95% CI, 1, 5), northern (4%, 95% CI, 2, 6), and southern Europe (6%, 95% CI, 1, 12) and the Americas (2%, 95% CI, 0, 5). CTX-Ms were the prevalent ESBL enzyme (69%). Antibiotic use for the prior 4 or 12 months was associated with a high colonization risk (risk ratio [RR] = 1.63; 95% CI, 1.19, 2.24 and RR = 1.58; 95% CI, 1.16, 2.16, respectively). International travel was also correlated with ESBL colonization [(RR = 4.06, (95% CI, 1.33, 12.41)]. CONCLUSIONS: The ESBL colonization rate among healthy individuals is significant worldwide. This should be taken into consideration in infection control and antibiotic management decisions.
BACKGROUND: Gut colonization is a risk factor for infections with extended-spectrum beta-lactamase (ESBL)-producing organisms. We aimed to determine the ESBL class A reservoir among healthy individuals. METHODS: We searched PubMed and EMBASE (through 10 July 2015) looking for studies that contained data for fecal colonization with ESBL class A bacteria among healthy individuals for each World Health Organization-defined region. Distribution of isolates among cefotaximase (CTX-M), sulfhydryl variable, and temoneira enzymes and data on previous antibiotic use, international travel, previous hospitalization, and animal contacts were extracted. RESULTS: Sixty-six of 17 479 studies on 28 909 healthy individuals were included. The pooled prevalence of ESBL class A colonization was 14% (95% confidence interval [CI], 9, 20), with an increasing trend of 5.38% annually (P = .003). The pooled prevalence was higher in Asia and Africa (ranging from 46%, 95% CI, 29, 63 to 15%, 95% CI, 4, 31) and lower but still significant in central (3%, 95% CI, 1, 5), northern (4%, 95% CI, 2, 6), and southern Europe (6%, 95% CI, 1, 12) and the Americas (2%, 95% CI, 0, 5). CTX-Ms were the prevalent ESBL enzyme (69%). Antibiotic use for the prior 4 or 12 months was associated with a high colonization risk (risk ratio [RR] = 1.63; 95% CI, 1.19, 2.24 and RR = 1.58; 95% CI, 1.16, 2.16, respectively). International travel was also correlated with ESBL colonization [(RR = 4.06, (95% CI, 1.33, 12.41)]. CONCLUSIONS: The ESBL colonization rate among healthy individuals is significant worldwide. This should be taken into consideration in infection control and antibiotic management decisions.
Authors: Michael J Satlin; Kalyan D Chavda; Thomas M Baker; Liang Chen; Elena Shashkina; Rosemary Soave; Catherine B Small; Samantha E Jacobs; Tsiporah B Shore; Koen van Besien; Lars F Westblade; Audrey N Schuetz; Vance G Fowler; Stephen G Jenkins; Thomas J Walsh; Barry N Kreiswirth Journal: Clin Infect Dis Date: 2018-11-13 Impact factor: 9.079
Authors: D C Richter; T Brenner; A Brinkmann; B Grabein; M Hochreiter; A Heininger; D Störzinger; J Briegel; M Pletz; M A Weigand; C Lichtenstern Journal: Anaesthesist Date: 2019-10 Impact factor: 1.041
Authors: Munther S Alnajjar; Mamoon A Aldeyab; Michael G Scott; Mary P Kearney; Glenda Fleming; Fiona Glimore; David Farren; James C McElnay Journal: Infection Date: 2019-05-07 Impact factor: 3.553
Authors: Sofia Ny; Roman Kozlov; Uga Dumpis; Petra Edquist; Kirsi Gröndahl-Yli-Hannuksela; Anna-Maria Kling; Danuta O Lis; Christoph Lübbert; Monika Pomorska-Wesołowska; Ivan Palagin; Aija Vilde; Jaana Vuopio; Jan Walter; Karin Tegmark Wisell Journal: Eur J Clin Microbiol Infect Dis Date: 2018-10-18 Impact factor: 3.267