TY - JOUR
T1 - Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in a population of Dutch travellers
T2 - A cross-sectional study
AU - Arcilla, Maris S.
AU - Van Hattem, Jarne M.
AU - Bootsma, Martin C.J.
AU - van Genderen, Perry J.J.
AU - Goorhuis, Abraham
AU - Grobusch, Martin P.
AU - Klaassen, Corné H.W.
AU - Oude Lashof, Astrid M.
AU - Schultsz, Constance
AU - Stobberingh, Ellen E.
AU - de Jong, Menno D.
AU - Penders, John
AU - Verbrugh, Henri A.
AU - Melles, Damian C.
PY - 2020/1
Y1 - 2020/1
N2 - 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 (ORadjusted 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.
AB - 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 (ORadjusted 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.
KW - Carriage
KW - Community
KW - ESBL
KW - Travel
UR - http://www.scopus.com/inward/record.url?scp=85077308693&partnerID=8YFLogxK
U2 - 10.1016/j.tmaid.2019.101547
DO - 10.1016/j.tmaid.2019.101547
M3 - Article
C2 - 31862246
AN - SCOPUS:85077308693
SN - 1477-8939
VL - 33
JO - Travel Medicine and Infectious Disease
JF - Travel Medicine and Infectious Disease
M1 - 101547
ER -