Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in a population of Dutch travellers: A cross-sectional study,Travel Medicine and Infectious Disease

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Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in a population of Dutch travellers: A cross-sectional study
Travel Medicine and Infectious Disease ( IF 12.0 ) Pub Date : 2019-12-17 , DOI: 10.1016/j.tmaid.2019.101547
Maris S. Arcilla , Jarne M. Van Hattem , Martin C.J. Bootsma , Perry J.J. van Genderen , Abraham Goorhuis , Martin P. Grobusch , Corné H.W. Klaassen , Astrid M. Oude Lashof , Constance Schultsz , Ellen E. Stobberingh , Menno D. de Jong , John Penders , Henri A. Verbrugh , Damian C. Melles

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 (OR_adjusted 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.

中文翻译：

在荷兰旅行者中携带产生ESBL的肠杆菌科细菌的患病率和危险因素：一项横断面研究

背景

我们调查了大多数旅客出行前（n = 2216）ESBL-E运送的患病率和预测因素。此外，我们在出行前检查了ESBL基因型，并将其与回程旅行者进行了比较。

方法

旅行前收集一份问卷和粪便样本，旅行后立即收集第二份粪便样本。通过PCR和测序对粪便样品进行ESBL-E分析，并进行基因型鉴定。通过逻辑回归分析确定旅行前进行ESBL-E运输的危险因素。

结果

旅行前，有136名参与者（6.1％）被ESBL-E殖民。在过去三个月中使用抗生素（OR_调整后为2.57； 95％CI为1.59-4.16）和过去一年在欧洲以外的旅行（1.92，1.28-2.87）是旅行前ESBL-E定植的危险因素。欧洲以外的旅行承担最大的归因风险（39.8％）。出行前31.3％（40/128）的参与者携带bla CTX-M 15，21.9％（28/128）的参与者携带bla CTX-M 14/18。返回的旅客中有633人获得了ESBL-E，其中53.4％（338/633）获得了bla CTX-M 15和17.7％（112/633）获得了bla CTX-M 14/18。