Dynamics of Intestinal Carriage of Extended-Spectrum Beta-lactamase–Producing Enterobacteriaceae in the Dutch General Population, 2014–2016
Autor: | van den Bunt, Gerrita, Fluit, Ad C, Bootsma, Martin C J, van Duijkeren, Engeline, Scharringa, Jelle, van Pelt, Wilfrid, Bonten, Marc J M, Sub Mathematical Modeling, Afd Mathematisch Instituut, Mathematical Modeling |
---|---|
Přispěvatelé: | Sub Mathematical Modeling, Afd Mathematisch Instituut, Mathematical Modeling |
Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Microbiology (medical)
Average duration Asia longitudinal medicine.medical_treatment Population extended-spectrum beta-lactamase Logistic regression general population beta-Lactamases Feces Enterobacteriaceae Medicine Humans education Netherlands education.field_of_study biology business.industry the Netherlands Enterobacteriaceae Infections Odds ratio biology.organism_classification Confidence interval Infectious Diseases Carriage Carrier State Beta-lactamase business producing Enterobacteriaceae Demography ESBL-E |
Zdroj: | Clinical Infectious Diseases, 71(8), 1847. Univ. of Chicago Press |
ISSN: | 1058-4838 |
Popis: | Background In the Netherlands, the prevalence of intestinal extended-spectrum beta-lactamase–producing Enterobacteriaceae (ESBL-E) carriage in community-dwelling subjects is ~5%. Little is known about the dynamics of ESBL-E carriage. Methods In a nationwide, population-based study (2014–2016) with 4177 community-dwelling subjects, fecal samples from 656 subjects were collected after 1 (time point [T] = 1) and 6 (T = 2) months. The growth of ESBL-E was quantified and a whole-genome sequence analysis was performed. Subjects were categorized as either an incidental, short-term, or long-term carrier or as a noncarrier. Risk factors were determined by random forest models and logistic regression. The transmissibility and duration of ESBL-E carriage was quantified using a transmission model, which also incorporated previous study data. Results Out of 656 participants, 96 were ESBL-E carriers at T = 0. Of these, 66 (10.1%) subjects were incidental carriers, 22 (3.3%) were short-term carriers, and 38 (5.8%) were long-term carriers; the remaining 530 (80.8%) were noncarriers. The risk factors for long-term carriage were travelling to Asia, swimming in a sea/ocean, and not changing the kitchen towel daily. The log-transformed colony forming units ratio at T = 0 was predictive for ESBL-E carriage at T = 1 (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.2–1.6) and T = 2 (OR, 1.2; 95% CI, 1.1–1.4). Model simulations revealed a median decolonization rate of 2.83/year, an average duration of carriage of 0.35 years, and an acquisition rate of 0.34/year. The trend of the acquisition rate during the study period was close to 0. Conclusions The risk factors for long-term ESBL-E carriage were travel- and hygiene-related. The dynamics of ESBL-E carriage in the general Dutch population are characterized by balancing decolonization and acquisition rates. |
Databáze: | OpenAIRE |
Externí odkaz: |