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Dequeker S, van Hensbergen M, den Heijer CDJ, Dhaeze W, Raven SFH, Ewalts-Hakkoer H, Tolsma P, Willemsen I, van Drunen-Kamp KJ, van der Slikke-Verstraten K, Goossens H, Kluytmans-van den Bergh MFQ, Hoebe CJPA. Cross-border differences in the prevalence and risk factors for carriage of antimicrobial resistance in children attending daycare centers: a point prevalence study in the Netherlands and Belgium. BMC Infect Dis 2024; 24:131. [PMID: 38267878 PMCID: PMC10809597 DOI: 10.1186/s12879-024-08996-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 01/09/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Day care centres (DCCs) are ideal settings for drug-resistant bacteria to emerge. Prevalence numbers of faecal carriage of antimicrobial resistant bacteria in these settings are rare. We aimed to determine the prevalence of faecal antimicrobial resistant bacteria carriage in children attending DCCs and to assess and identify infection risk factors within DCCs in The Netherlands and Belgium. METHODS A point-prevalence study was conducted in 28 Dutch (499 children) and 18 Belgian (448 children) DCCs. Stool samples were taken from the children's diapers and a questionnaire was filled in by their parents. Hygiene related to stool and toilet use, hygiene related to food, environmental contamination, hand hygiene and hygiene guidelines were assessed conform a standardized questionnaire by the infection prevention and control expert visiting the DCC. Multilevel logistical regression analyses were used to define which characteristics predicted the presence of extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E), carbapenemase-producing Enterobacterales (CPE), vancomycin-resistant enterococci (VRE), and ciprofloxacin-resistant Enterobacterales (CipR-E). RESULTS The ESBL-E prevalence was 16% (n = 71) in Belgium and 6% (n = 30) in the Netherlands. The CipR-E prevalence was 17% (n = 78) in Belgium and 8% (n = 38) in the Netherlands. Antimicrobial use (RR: 0.30; 95% CI: 0.33-0.48) and hospital admissions (RR: 0.37; 95% CI: 0.25-0.54) were lower in the Netherlands. Children travelling to Asia were at higher risk of being an ESBL-E carrier. Children using antimicrobials were at higher risk of being a CipR-E carrier. Cleaning the changing mat after each use was found as a protective factor for CipR-E carriage. CONCLUSIONS We established a significant difference in ESBL-E and CipR-E carriage and antimicrobial use and hospital admissions between the Netherlands and Belgium among children attending DCCs. The differences between both countries should be further studied to improve the policy on anti-microbial use and hospital admissions in children.
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Affiliation(s)
- Sara Dequeker
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium.
- Agency for Care and Health, Infection Prevention and Control, Government of Flanders, Brussels, Belgium.
| | - Mitch van Hensbergen
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, The Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, PO Box 616, 6200, MD, Maastricht, The Netherlands
| | - Casper D J den Heijer
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, The Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, PO Box 616, 6200, MD, Maastricht, The Netherlands
| | - Wouter Dhaeze
- Agency for Care and Health, Infection Prevention and Control, Government of Flanders, Brussels, Belgium
| | - Stijn F H Raven
- Department of Infectious Diseases, Public Health Service region Utrecht, Zeist, The Netherlands
| | | | - Paulien Tolsma
- Public Health Service Brabant-Zuidoost, Eindhoven, The Netherlands
| | - Ina Willemsen
- Contrain Infectiepreventiecoach, Breda, The Netherlands
- Amphia Hospital, Breda, The Netherlands
| | | | | | | | | | - Christian J P A Hoebe
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, The Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, PO Box 616, 6200, MD, Maastricht, The Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre (MUMC+), PO Box 5800, 6202, AZ, Maastricht, The Netherlands
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Infections due to carbapenemase-producing bacteria, clinical burden, and impact of screening strategies on outcome. Med Mal Infect 2020; 50:658-664. [PMID: 32035722 DOI: 10.1016/j.medmal.2019.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/27/2019] [Accepted: 12/23/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To characterize the risk factors, impact of screening, and clinical burden of colonization and/or infection by carbapenemase-producing bacteria (CPB) in hospitalized patients. METHOD Retrospective study in a tertiary care hospital between 2008 and 2016. RESULTS Among 88 included patients, 41% were colonized, 59% developed an infection, and 69% of all cases were hospital-acquired. Risk factors for CPB contamination included recent invasive medical device (94% of patients), antibiotic therapy (82%), travel abroad (17%), and hospitalization (>50%) with 80% of all patients with underlying chronic condition. Intestinal carriage represented 89% of all colonization cases and 50% of infections were located in the urinary tract. The recent use of mechanical ventilation devices was significantly more observed in infected patients than colonized patients. The most frequent CPB was Klebsiella pneumoniae and the most frequent carbapenemase was OXA-48. Overall mortality rate was 19%. Prevalence of CPB detection in intensive care units (ICU) based on systematical rectal screen swab upon admission remained <0.5%. The infected/colonized ratio (CPB colonization cases evolving into an infection) was 23%. The time between CPB infection diagnosis and start of appropriate antimicrobial therapy increased from 1 day in previously screened patients with positive CPB to 4 days in patients with previous negative or absent screening. CONCLUSION Our results emphasize the importance of CPB screening in all ICU patients and in at-risk patients hospitalized in other units, to allow earlier adequate antibiotic therapy in case of infection which occurred in 23% of the colonized patients.
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Amarillas L, Lightbourn‐Rojas L, Angulo‐Gaxiola AK, Basilio Heredia J, González‐Robles A, León‐Félix J. The antibacterial effect of chitosan‐based edible coating incorporated with a lytic bacteriophage against
Escherichia coli
O157:H7 on the surface of tomatoes. J Food Saf 2018. [DOI: 10.1111/jfs.12571] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Luis Amarillas
- Centro de Investigación en Alimentación y Desarrollo Culiacán Sinaloa Mexico
- Instituto de Investigación Lightbourn Chihuahua Mexico
| | | | | | - J. Basilio Heredia
- Centro de Investigación en Alimentación y Desarrollo Culiacán Sinaloa Mexico
| | - Arturo González‐Robles
- Centro de Investigación y de Estudios AvanzadosInstituto Politécnico Nacional Ciudad de México Mexico
| | - Josefina León‐Félix
- Centro de Investigación en Alimentación y Desarrollo Culiacán Sinaloa Mexico
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Pulcrano G, Pignanelli S, Vollaro A, Esposito M, Iula VD, Roscetto E, Soriano AA, Catania MR. Isolation of Enterobacter aerogenes carrying blaTEM-1 and blaKPC-3 genes recovered from a hospital Intensive Care Unit. APMIS 2016; 124:516-21. [PMID: 27004836 DOI: 10.1111/apm.12528] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 01/29/2016] [Indexed: 11/28/2022]
Abstract
Enterobacter aerogenes has recently emerged as an important hospital pathogen. In this study, we showed the emergence of E. aerogenes isolates carrying the blaKPC gene in patients colonized by carbapenem-resistant Klebsiella pneumoniae strains. Two multiresistant E. aerogenes isolates were recovered from bronchial aspirates of two patients hospitalized in the Intensive Care Unit at the "Santa Maria della Scaletta" Hospital, Imola. The antimicrobial susceptibility test showed the high resistance to carbapenems and double-disk synergy test confirmed the phenotype of KPC and AmpC production. Other investigation revealed that ESBL and blaKPC genes were carried on the conjugative pKpQIL plasmid. This is a relevant report in Italy that describes a nosocomial infection due to the production of KPC beta-lactamases by an E. aerogenes isolate in patients previously colonized by K. pneumoniae carbapenem-resistant. In conclusion, it's necessary a continuous monitoring of multidrug-resistant strains for the detection of any KPC-producing bacteria that could expand the circulation of carbapenem-resistant pathogens.
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Affiliation(s)
- Giovanna Pulcrano
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, Naples, Italy
| | - Salvatore Pignanelli
- Department of Diagnostic Services, S. Maria della Scaletta Hospital, Imola, Italy
| | - Adriana Vollaro
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, Naples, Italy
| | - Matilde Esposito
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, Naples, Italy
| | - Vita Dora Iula
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, Naples, Italy
| | - Emanuela Roscetto
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, Naples, Italy
| | - Amata Amy Soriano
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, Naples, Italy
| | - Maria Rosaria Catania
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, Naples, Italy
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