Maris S Arcilla1, Jarne M Van Hattem2, Martin C J Bootsma3, Perry J J van Genderen4, Abraham Goorhuis5, Martin P Grobusch5, Corné H W Klaassen6, Astrid M Oude Lashof7, Constance Schultsz8, Ellen E Stobberingh7, Menno D de Jong8, John Penders9, Henri A Verbrugh6, Damian C Melles10. 1. Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, the Netherlands. Electronic address: m.arcilla@erasmusmc.nl. 2. Department of Medical Microbiology, Central Bacteriology and Serology Laboratory (CBSL), Tergooi Hospital, the Netherlands; Department of Medical Microbiology, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, the Netherlands. 3. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Department of Mathematics, Faculty of Science, Utrecht University, the Netherlands. 4. Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, the Netherlands; Institute for Tropical Diseases, Harbor Hospital Rotterdam, the Netherlands. 5. Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, the Netherlands. 6. Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, the Netherlands. 7. School for Public Health and Primary Care (Caphri), Department of Medical Microbiology, Maastricht University Medical Center, the Netherlands. 8. Department of Medical Microbiology, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, the Netherlands. 9. School for Public Health and Primary Care (Caphri), Department of Medical Microbiology, Maastricht University Medical Center, the Netherlands; School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, the Netherlands. 10. Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, the Netherlands; Department of Medical Microbiology, Meander Medical Center, the Netherlands.
Abstract
BACKGROUND: We investigated prevalence and predictive factors for ESBL-E carriage in a population of mostly travellers prior to their travel (n = 2216). In addition, we examined ESBL genotype before travel and compared these to returning travellers. METHOD: A questionnaire and faecal sample were collected before travel, and a second faecal sample was collected immediately after travel. Faecal samples were analysed for ESBL-E, with genotypic characterization by PCR and sequencing. Risk factors for ESBL-E carriage prior to travel were identified by logistic regression analyses. RESULTS: Before travel, 136 participants (6.1%) were colonized with ESBL-E. Antibiotic use in the past three months (ORadjusted 2.57; 95% CI 1.59-4.16) and travel outside of Europe in the past year (1.92, 1.28-2.87) were risk factors for ESBL-E colonisation prior to travel. Travel outside of Europe carried the largest attributable risk (39.8%). Prior to travel 31.3% (40/128) of participants carried blaCTX-M 15 and 21.9% (28/128) blaCTX-M 14/18. In returning travellers 633 acquired ESBL-E of who 53.4% (338/633) acquired blaCTX-M 15 and 17.7% (112/633) blaCTX-M 14/18. CONCLUSION: In our population of Dutch travellers we found a pre-travel ESBL-E prevalence of 6.1%. Prior to travel, previous antibiotic use and travel outside of Europe were the strongest independent predictors for ESBL-E carriage, with travel outside of Europe carrying the largest attributable risk. Our molecular results suggest ESBL genes found in our study population prior to travel were in large part travel related.
BACKGROUND: We investigated prevalence and predictive factors for ESBL-E carriage in a population of mostly travellers prior to their travel (n = 2216). In addition, we examined ESBL genotype before travel and compared these to returning travellers. METHOD: A questionnaire and faecal sample were collected before travel, and a second faecal sample was collected immediately after travel. Faecal samples were analysed for ESBL-E, with genotypic characterization by PCR and sequencing. Risk factors for ESBL-E carriage prior to travel were identified by logistic regression analyses. RESULTS: Before travel, 136 participants (6.1%) were colonized with ESBL-E. Antibiotic use in the past three months (ORadjusted 2.57; 95% CI 1.59-4.16) and travel outside of Europe in the past year (1.92, 1.28-2.87) were risk factors for ESBL-E colonisation prior to travel. Travel outside of Europe carried the largest attributable risk (39.8%). Prior to travel 31.3% (40/128) of participants carried blaCTX-M 15 and 21.9% (28/128) blaCTX-M 14/18. In returning travellers 633 acquired ESBL-E of who 53.4% (338/633) acquired blaCTX-M 15 and 17.7% (112/633) blaCTX-M 14/18. CONCLUSION: In our population of Dutch travellers we found a pre-travel ESBL-E prevalence of 6.1%. Prior to travel, previous antibiotic use and travel outside of Europe were the strongest independent predictors for ESBL-E carriage, with travel outside of Europe carrying the largest attributable risk. Our molecular results suggest ESBL genes found in our study population prior to travel were in large part travel related.
Authors: Daloha Rodríguez-Molina; Fanny Berglund; Hetty Blaak; Carl-Fredrik Flach; Merel Kemper; Luminita Marutescu; Gratiela Pircalabioru Gradisteanu; Marcela Popa; Beate Spießberger; Laura Wengenroth; Mariana Carmen Chifiriuc; D G Joakim Larsson; Dennis Nowak; Katja Radon; Ana Maria de Roda Husman; Andreas Wieser; Heike Schmitt Journal: Int J Environ Res Public Health Date: 2022-04-14 Impact factor: 4.614
Authors: Margreet C Vos; Anne F Voor In 't Holt; Adriënne S van der Schoor; Juliëtte A Severin; Anna S van der Weg; Nikolaos Strepis; Corné H W Klaassen; Johannes P C van den Akker; Marco J Bruno; Johanna M Hendriks Journal: Antimicrob Resist Infect Control Date: 2022-06-02 Impact factor: 6.454