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High prevalence of multidrug resistant Enterobacteriaceae among residents of long term care facilities in Amsterdam, the Netherlands


Autoři: Eline van Dulm aff001;  Aletta T. R. Tholen aff002;  Annika Pettersson aff003;  Martijn S. van Rooijen aff001;  Ina Willemsen aff004;  Peter Molenaar aff005;  Marjolein Damen aff006;  Paul Gruteke aff007;  Paul Oostvogel aff001;  Ed J. Kuijper aff008;  Cees M. P. M. Hertogh aff009;  Christina M. J. E. Vandenbroucke-Grauls aff003;  Maarten Scholing aff007
Působiště autorů: Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands aff001;  Centre for Zoonoses and Environmental Microbiology, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands aff002;  Department of Medical Microbiology and Infection Control, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands aff003;  Department of Medical Microbiology and Infection Control, Amphia Hospital, Breda, the Netherlands aff004;  National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands aff005;  Department of Medical Microbiology, Maasstad General Hospital, Rotterdam, the Netherlands aff006;  Department of Medical Microbiology, OLVG Lab BV, Amsterdam, the Netherlands aff007;  Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands aff008;  Department of General Practice & Elderly Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands aff009
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222200

Souhrn

Introduction

The aim of this study was to determine the rate of asymptomatic carriage and spread of multidrug-resistant micro-organisms (MDRO) and to identify risk factors for extended spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) carriage in 12 long term care facilities (LTCFs) in Amsterdam, the Netherlands.

Materials and methods

From November 2014 to august 2015, feces and nasal swabs from residents from LTCFs in Amsterdam, the Netherlands were collected and analyzed for presence of multidrug-resistant Gram-negative bacteria (MDRGN), including ESBL-E, carbapenemase-producing Enterobacteriaceae (CPE), colistin-resistant Enterobacteriaceae and methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). Logistic regression analysis was performed to assess associations between variables and ESBL-carriage.

Results

In total, 385 residents from 12 LTCFs (range 15–48 residents per LTCF) were enrolled. The prevalence of carriage of MDRGN was 18.2% (range among LTCFs 0–47%) and the prevalence of ESBL-E alone was 14.5% (range among LTCFs: 0–34%). Of 63 MDRGN positive residents, 50 (79%) were ESBL-E positive of which 43 (86%) produced CTX-M. Among 44 residents with ESBL-E positive fecal samples of whom data on contact precautions were available at the time of sampling, only 9 (20%) were already known as ESBL-E carriers. The prevalence for carriage of MRSA was 0.8% (range per LTCF: 0–7%) and VRE 0%. One CPE colonized resident was found. All fecal samples tested negative for presence of plasmid mediated resistance for colistin (MCR-1). Typing of isolates by Amplified Fragment Length Polymorphism (AFLP) showed five MDRGN clusters, of which one was found in multiple LTCFs and four were found in single LTCFs, suggesting transmission within and between LTCFs. In multivariate analysis only the presence of MDRO in the preceding year remained a risk factor for ESBL-E carriage.

Conclusions

The ESBL-carriage rate of residents in LTCFs is nearly two times higher than in the general population but varies considerably among LTCFs in Amsterdam, whereas carriage of MRSA and VRE is low. The majority (80%) of ESBL-E positive residents had not been detected by routine culture of clinical specimens at time of sampling. Current infection control practices in LTCFs in Amsterdam do not prevent transmission. Both improvement of basic hygiene, and funding for laboratory screening, should allow LTCFs in Amsterdam to develop standards of care to prevent transmission of ESBL-E.

Klíčová slova:

Biology and life sciences – Organisms – Research and analysis methods – Molecular biology – Molecular biology techniques – Medicine and health sciences – Microbiology – Medical microbiology – Microbial pathogens – Bacterial pathogens – Bacteria – Pathology and laboratory medicine – Pathogens – Health care – Health care facilities – Hospitals – Pharmacology – Staphylococcus – Staphylococcus aureus – Methicillin-resistant Staphylococcus aureus – Microbial control – Artificial gene amplification and extension – Polymerase chain reaction – Epidemiology – Medical risk factors – Antimicrobial resistance – Antibiotic resistance – Enterobacteriaceae – Nursing homes – Amplified fragment length polymorphism


Zdroje

1. Spellberg B, Guidos R, Gilbert D, Bradley J, Boucher HW, Scheld WM, et al. The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America. Clin Infect Dis. 2008;46(2):155–64. doi: 10.1086/524891 18171244

2. European Antimicrobial Resistance Surveillance Network (EARS-Net). Data from the ECDC Surveillance Atlas—Antimicrobial resistance [Internet]. Available from: https://ecdc.europa.eu/en/antimicrobial-resistance/surveillance-and-disease-data/data-ecdc.

3. WIP richtlijn Bijzonder resistente micro-organismen. Verpleeghuizen, woonzorgcentra en voorzieningen voor kleinschalig wonen voor ouderen. http://www.rivm.nl/dsresource?objectid=513c8b7b-189c-4bcd-a124-cdeb80af520a&type=org&disposition=inline2014.

4. Tacconelli E, Cataldo MA, Dancer SJ, De Angelis G, Falcone M, Frank U, et al. ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients. Clin Microbiol Infect. 2014;20 Suppl 1:1–55.

5. Reuland EA, Overdevest IT, Al NN, Kalpoe JS, Rijnsburger MC, Raadsen SA, et al. High prevalence of ESBL-producing Enterobacteriaceae carriage in Dutch community patients with gastrointestinal complaints. Clin Microbiol Infect. 2013;19(6):542–9. doi: 10.1111/j.1469-0691.2012.03947.x 22757622

6. Reuland EA, Al NN, Kaiser AM, Heck M, Kluytmans JA, Savelkoul PH, et al. Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in Amsterdam. J Antimicrob Chemother. 2016;71(4):1076–82. doi: 10.1093/jac/dkv441 26755493

7. Molenaar M, Jansen RR. Screening voor BRMO Enterobacteriaceae in ziekenhuizen. Vissen we bewust in de verkeerde vijver? NVMM Najaarsvergadering 2015, Amersfoort, the Netherlands.

8. Willemsen I, Nelson J, Hendriks Y, Mulders A, Verhoeff S, Mulder P, et al. Extensive dissemination of extended spectrum beta-lactamase-producing Enterobacteriaceae in a Dutch nursing home. Infect Control Hosp Epidemiol. 2015;36(4):394–400. doi: 10.1017/ice.2014.76 25782893

9. Verhoef L, Roukens M, de GS, Meessen N, Natsch S, Stobberingh E. Carriage of antimicrobial-resistant commensal bacteria in Dutch long-term-care facilities. J Antimicrob Chemother. 2016;71(9):2586–92. doi: 10.1093/jac/dkw183 27246237

10. Verhoef, Stobberingh, Smid, Kuijper, Greeff D, Heck. Intestinal carriage of resistant bacteria and Clostridium difficile in nursing homes in the Netherlands—a point prevalence study. European Congress of Clinical Microbiology and Infectious Diseases; Vienna2017.

11. Platteel TN, Leverstein-van Hall MA, Cohen Stuart JW, Thijsen SF, Mascini EM, van Hees BC, et al. Predicting carriage with extended-spectrum beta-lactamase-producing bacteria at hospital admission: a cross-sectional study. Clin Microbiol Infect. 2015;21(2):141–6. doi: 10.1016/j.cmi.2014.09.014 25658554

12. Willemsen I, Nelson-Melching J, Hendriks Y, Mulders A, Verhoeff S, Kluytmans-Vandenbergh M, et al. Measuring the quality of infection control in Dutch nursing homes using a standardized method; the Infection prevention RIsk Scan (IRIS). Antimicrob Resist Infect Control. 2014;3:26. doi: 10.1186/2047-2994-3-26 25243067

13. Bonten MJ. [The threat of antibiotic resistance to nursing homes]. Ned Tijdschr Geneeskd. 2016;160(0):D852.

14. van den Dool C, Haenen A, Leenstra T, Wallinga J. The Role of Nursing Homes in the Spread of Antimicrobial Resistance Over the Healthcare Network. Infect Control Hosp Epidemiol. 2016;37(7):761–7. doi: 10.1017/ice.2016.59 27052880

15. The European Committee on Antimicrobial Susceptibility Testing—EUCAST. Breakpoint Tables for Interpretation of MICs and Zone Diameters. [Internet]. Available from: http://www.eucast.org/clinical_breakpoints/.

16. NVMM Guideline Laboratory detection of highly resistant microorganisms, version 2.0, 2012. http://www.nvmm.nl/media/1051/2012_hrmo_mrsa_esbl.pdf.

17. Doumith M, Day MJ, Hope R, Wain J, Woodford N. Improved multiplex PCR strategy for rapid assignment of the four major Escherichia coli phylogenetic groups. J Clin Microbiol. 2012;50(9):3108–10. doi: 10.1128/JCM.01468-12 22785193

18. Dhanji H, Doumith M, Clermont O, Denamur E, Hope R, Livermore DM, et al. Real-time PCR for detection of the O25b-ST131 clone of Escherichia coli and its CTX-M-15-like extended-spectrum beta-lactamases. Int J Antimicrob Agents. 2010;36(4):355–8. doi: 10.1016/j.ijantimicag.2010.06.007 20691573

19. Mulvey MR, Soule G, Boyd D, Demczuk W, Ahmed R, Multi-provincial Salmonella Typhimurium Case Control Study G. Characterization of the first extended-spectrum beta-lactamase-producing Salmonella isolate identified in Canada. J Clin Microbiol. 2003;41(1):460–2. doi: 10.1128/JCM.41.1.460-462.2003 12517894

20. Agerso Y, Aarestrup FM, Pedersen K, Seyfarth AM, Struve T, Hasman H. Prevalence of extended-spectrum cephalosporinase (ESC)-producing Escherichia coli in Danish slaughter pigs and retail meat identified by selective enrichment and association with cephalosporin usage. J Antimicrob Chemother. 2012;67(3):582–8. doi: 10.1093/jac/dkr507 22207594

21. Jia B, Raphenya AR, Alcock B, Waglechner N, Guo P, Tsang KK, et al. CARD 2017: expansion and model-centric curation of the comprehensive antibiotic resistance database. Nucleic Acids Res. 2017;45(D1):D566–D73. doi: 10.1093/nar/gkw1004 27789705

22. Nijhuis RH, Veldman KT, Schelfaut J, Van Essen-Zandbergen A, Wessels E, Claas EC, et al. Detection of the plasmid-mediated colistin-resistance gene mcr-1 in clinical isolates and stool specimens obtained from hospitalized patients using a newly developed real-time PCR assay. J Antimicrob Chemother. 2016;71(8):2344–6. doi: 10.1093/jac/dkw192 27261263

23. Terveer EM, Nijhuis RHT, Crobach MJT, Knetsch CW, Veldkamp KE, Gooskens J, et al. Prevalence of colistin resistance gene (mcr-1) containing Enterobacteriaceae in feces of patients attending a tertiary care hospital and detection of a mcr-1 containing, colistin susceptible E. coli. PLoS One. 2017;12(6):e0178598. doi: 10.1371/journal.pone.0178598 28575076

24. IGZ, Eindrapportage toezicht IGZ op 150 verpleegzorginstellingen, Utrecht, July 2016. http://www.igz.nl/zoeken/download.aspx?download=Eindrapportage+toezicht+IGZ+op+150+verpleegzorginstellingen.pdf.

25. Dautzenberg MJ, Haverkate MR, Bonten MJ, Bootsma MC. Epidemic potential of Escherichia coli ST131 and Klebsiella pneumoniae ST258: a systematic review and meta-analysis. BMJ Open. 2016;6(3):e009971. doi: 10.1136/bmjopen-2015-009971 26988349

26. Overdevest I, Haverkate M, Veenemans J, Hendriks Y, Verhulst C, Mulders A, et al. Prolonged colonisation with Escherichia coli O25:ST131 versus other extended-spectrum beta-lactamase-producing E. coli in a long-term care facility with high endemic level of rectal colonisation, the Netherlands, 2013 to 2014. Euro Surveill. 2016;21(42).

27. Price LB, Johnson JR, Aziz M, Clabots C, Johnston B, Tchesnokova V, et al. The epidemic of extended-spectrum-beta-lactamase-producing Escherichia coli ST131 is driven by a single highly pathogenic subclone, H30-Rx. MBio. 2013;4(6):e00377–13. doi: 10.1128/mBio.00377-13 24345742

28. Adler A, Gniadkowski M, Baraniak A, Izdebski R, Fiett J, Hryniewicz W, et al. Transmission dynamics of ESBL-producing Escherichia coli clones in rehabilitation wards at a tertiary care centre. Clin Microbiol Infect. 2012;18(12):E497–505. doi: 10.1111/j.1469-0691.2012.03999.x 22963432

29. Kluytmans-van den Bergh MF, Rossen JW, Bruijning-Verhagen PC, Bonten MJ, Friedrich AW, Vandenbroucke-Grauls CM, et al. Whole-Genome Multilocus Sequence Typing of Extended-Spectrum-Beta-Lactamase-Producing Enterobacteriaceae. J Clin Microbiol. 2016;54(12):2919–27. doi: 10.1128/JCM.01648-16 27629900

30. Tschudin-Sutter S, Frei R, Dangel M, Stranden A, Widmer AF. Rate of transmission of extended-spectrum beta-lactamase-producing enterobacteriaceae without contact isolation. Clin Infect Dis. 2012;55(11):1505–11. doi: 10.1093/cid/cis770 22955436

31. Hilty M, Betsch BY, Bogli-Stuber K, Heiniger N, Stadler M, Kuffer M, et al. Transmission dynamics of extended-spectrum beta-lactamase-producing Enterobacteriaceae in the tertiary care hospital and the household setting. Clin Infect Dis. 2012;55(7):967–75. doi: 10.1093/cid/cis581 22718774

32. van Buul LW, van der Steen JT, Veenhuizen RB, Achterberg WP, Schellevis FG, Essink RT, et al. Antibiotic use and resistance in long term care facilities. J Am Med Dir Assoc. 2012;13(6):568 e1-13.


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