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van Kleef, Esther; Wielders, Cornelia C H; Schouls, Leo M; Feenstra, Sabiena G; Hertogh, Cees M P M; Bonten, Marc J M; van Weert, Yolanda; Tostmann, Alma; van der Lubben, Mariken; de Greeff, Sabine C; Glasner, Corinna; Fokkert, Karin; Rademakers, Emma; Terwee, Marja; van Nimwegen, Dagmar; Paulich, Hans; de Raadt, Lisa; Punt, Else; den Boogert, Elke; Jansen, Thera Habben; Voss, Andreas; Kluytmans, Jan; Vos, Greet; Schultsz, Constance; [...]

National point prevalence study on carriage of multidrug-resistant microorganisms in Dutch long-term care facilities in 2018

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  • Media type: E-Article
  • Title: National point prevalence study on carriage of multidrug-resistant microorganisms in Dutch long-term care facilities in 2018
  • Contributor: van Kleef, Esther; Wielders, Cornelia C H; Schouls, Leo M; Feenstra, Sabiena G; Hertogh, Cees M P M; Bonten, Marc J M; van Weert, Yolanda; Tostmann, Alma; van der Lubben, Mariken; de Greeff, Sabine C; Glasner, Corinna; Fokkert, Karin; Rademakers, Emma; Terwee, Marja; van Nimwegen, Dagmar; Paulich, Hans; de Raadt, Lisa; Punt, Else; den Boogert, Elke; Jansen, Thera Habben; Voss, Andreas; Kluytmans, Jan; Vos, Greet; Schultsz, Constance; [...]
  • imprint: Oxford University Press (OUP), 2021
  • Published in: Journal of Antimicrobial Chemotherapy
  • Language: English
  • DOI: 10.1093/jac/dkab042
  • ISSN: 0305-7453; 1460-2091
  • Keywords: Infectious Diseases ; Pharmacology (medical) ; Pharmacology ; Microbiology (medical)
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objectives</jats:title> <jats:p>Long-term care facilities (LTCFs) may act as a reservoir of ESBL-producing Enterobacterales (ESBL-E) and carbapenemase-producing Enterobacterales (CPE) for hospitals and the general population. In this study, we estimated the prevalence and molecular epidemiology of rectal carriage with ESBL-E and CPE in residents of Dutch LTCFs between March 2018 and December 2018.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>LTCFs were geographically selected across the country. For each LTCF, a random sample of residents were tested for ESBL-E and CPE in 2018. To identify risk factors for high carriage prevalence and/or individual carriage, characteristics of LTCFs and of a subset of the tested residents were collected. WGS was conducted on isolates from LTCFs with an ESBL-E prevalence of &amp;gt;10% and all CPE isolates to identify institutional clonal transmission.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 4420 residents of 159 LTCFs were included. The weighted mean ESBL-E prevalence was 8.3% (95% CI: 6.8–10.0) and no CPE were found. In 53 LTCFs (33%), where ESBL-E prevalence was &amp;gt;10%, MLST using WGS (wgMLST) was performed. This included 264 isolates, the majority being Escherichia coli (n = 224) followed by Klebsiella pneumoniae (n = 30). Genetic clusters were identified in more than half (30/53; 57%) of high ESBL-positive LTCFs. Among the E. coli isolates, blaCTX-M-15 (92/224; 41%) and blaCTX-M-27 (40/224; 18%) were the most prevalent ESBL-encoding genes. For K. pneumoniae isolates, the most common was blaCTX-M-15 (23/30; 80%).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The estimated prevalence of ESBL-E rectal carriage in Dutch LTCFs is 8.3% and resistance is observed mainly in E. coli with predominance of blaCTX-M-15 and blaCTX-M-27. ESBL-E prevalence in LTCFs seems comparable to previously reported prevalence in hospitals and the general population.</jats:p> </jats:sec>
  • Access State: Open Access