The best strategy to control ESBL-producing Escherichia coli (ESBL-EC) spread in the community is lacking. We developed an individual-based transmission model to evaluate the impact of hand hygiene (HH) improvement and reduction in antibiotic use on the within-household transmission of ESBL-EC. We used data from the literature and incorporated key elements of ESBL-EC transmission such as the frequency and nature of contacts among household members, antibiotic use in the community and hand hygiene behaviour. We introduced in a household a single ESBL-EC colonised person and simulated the transmission dynamics of ESBL-EC over a one-year time horizon. The probability of ESBL-EC transmission depended on the household composition and the profile of the initial carrier. In the two-person household, the probability of ESBL-EC transmission was 5.3% (95% CI 5.0–5.6) or 6.6% (6.3–6.9) when the index person was a woman or a man, respectively. In a four-person household, the probability of transmission varied from 61.4% (60.9–62.0) to 68.8% (68.3–69.3) and was the highest when the index patient was the baby. Improving HH by 50% reduced the probability of transmission by 33–62%. Antibiotic restriction by 50% reduced the transmission by 2–6%. The transmission of ESBL-EC is frequent in households and especially those with a baby. Antibiotic reduction had little impact on ESBL-EC. Improvement of hygiene in the community could help prevent transmission of ESBL-EC.

中文翻译：

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改善手部卫生或限制抗生素以控制产超广谱 β-内酰胺酶大肠杆菌的家庭传播：数学模型研究。

缺乏控制产 ESBL 大肠杆菌 (ESBL-EC) 在社区中传播的最佳策略。我们开发了一种基于个体的传播模型，以评估手卫生 (HH) 的改善和抗生素使用的减少对 ESBL-EC 家庭内部传播的影响。我们使用了文献中的数据并纳入了 ESBL-EC 传播的关键要素，例如家庭成员之间接触的频率和性质、社区中的抗生素使用和手部卫生行为。我们在一个家庭中引入了一个单一的 ESBL-EC 殖民者，并模拟了一年时间范围内 ESBL-EC 的传播动态。ESBL-EC 传输的概率取决于家庭组成和初始携带者的概况。在两人家庭中，ESBL-EC 传播的概率为 5。当指标人是女性或男性时，分别为 3% (95% CI 5.0–5.6) 或 6.6% (6.3–6.9)。在一个四口之家中，传播概率从 61.4% (60.9–62.0) 到 68.8% (68.3–69.3) 不等，并且在指示患者为婴儿时最高。将 HH 提高 50% 可将传播概率降低 33-62%。抗生素限制 50% 减少了 2-6% 的传播。ESBL-EC 的传播在家庭中很常见，尤其是有婴儿的家庭。抗生素减少对 ESBL-EC 影响不大。改善社区卫生有助于防止 ESBL-EC 的传播。3) 且在指标患者为婴儿时最高。将 HH 提高 50% 可将传播概率降低 33-62%。抗生素限制 50% 减少了 2-6% 的传播。ESBL-EC 的传播在家庭中很常见，尤其是有婴儿的家庭。抗生素减少对 ESBL-EC 影响不大。改善社区卫生有助于防止 ESBL-EC 的传播。3) 且在指标患者为婴儿时最高。将 HH 提高 50% 可将传播概率降低 33-62%。抗生素限制 50% 减少了 2-6% 的传播。ESBL-EC 的传播在家庭中很常见，尤其是有婴儿的家庭。抗生素减少对 ESBL-EC 影响不大。改善社区卫生有助于防止 ESBL-EC 的传播。