Household Transmission of Carbapenemase-producing Enterobacterales in Ontario, Canada.

Autor:	Jamal AJ; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Faheem A; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Farooqi L; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Zhong XZ; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Armstrong I; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.; Communicable Disease Control, Toronto Public Health, Toronto, Ontario, Canada., Boyd DA; Antimicrobial Resistance and Nosocomial Infections, National Microbiology Laboratory, Winnipeg, Manitoba, Canada., Borgundvaag E; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Coleman BL; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Green K; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Jayasinghe K; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Johnstone J; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Katz K; Department of Infection Prevention and Control, North York General Hospital, Toronto, Ontario, Canada., Kohler P; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Li AX; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Mataseje L; Antimicrobial Resistance and Nosocomial Infections, National Microbiology Laboratory, Winnipeg, Manitoba, Canada., Melano R; Bacteriology, Public Health Ontario Laboratory, Toronto, Ontario, Canada., Muller MP; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.; Department of Infection Prevention and Control, St. Michael's Hospital, Toronto, Ontario, Canada., Mulvey MR; Antimicrobial Resistance and Nosocomial Infections, National Microbiology Laboratory, Winnipeg, Manitoba, Canada., Nayani S; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Patel SN; Bacteriology, Public Health Ontario Laboratory, Toronto, Ontario, Canada., Paterson A; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Poutanen S; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Rebbapragada A; Scientific Affairs and Market Access, Hologic Inc., Toronto, Ontario, Canada., Richardson D; Department of Infection Prevention and Control, William Osler Health System, Brampton, Ontario, Canada., Sarabia A; Department of Infection Prevention and Control, Trillium Health Partners, Mississauga, Ontario, Canada., Shafinaz S; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Simor AE; Department of Infection Prevention and Control, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada., Willey BM; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., Wisely L; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada., McGeer AJ; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.; Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2021 Dec 06; Vol. 73 (11), pp. e4607-e4615.
DOI:	10.1093/cid/ciaa1295
Abstrakt:	Background: Data on household transmission of carbapenemase-producing Enterobacterales (CPE) remain limited. We studied risk of CPE household co-colonization and transmission in Ontario, Canada. Methods: We enrolled CPE index cases (identified via population-based surveillance from January 2015 to October 2018) and their household contacts. At months 0, 3, 6, 9, and 12, participants provided rectal and groin swabs. Swabs were cultured for CPE until September 2017, when direct polymerase chain reaction (PCR; with culture of specimens if a carbapenemase gene was detected) replaced culture. CPE risk factor data were collected by interview and combined with isolate whole-genome sequencing to determine likelihood of household transmission. Risk factors for household contact colonization were explored using a multivariable logistic regression model with generalized estimating equations. Results: Ninety-five households with 177 household contacts participated. Sixteen (9%) household contacts in 16 (17%) households were CPE-colonized. Household transmission was confirmed in 3/177 (2%) cases, probable in 2/177 (1%), possible in 9/177 (5%), and unlikely in 2/177 (1%). Household contacts were more likely to be colonized if they were the index case's spouse (odds ratio [OR], 6.17; 95% confidence interval [CI], 1.05-36.35), if their index case remained CPE-colonized at household enrollment (OR, 7.00; 95% CI, 1.92-25.49), or if they had at least 1 set of specimens processed after direct PCR was introduced (OR, 6.46; 95% CI, 1.52-27.40). Conclusions: Nine percent of household contacts were CPE-colonized; 3% were a result of household transmission. Hospitals may consider admission screening for patients known to have CPE-colonized household contacts. (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu