International Travel as a Risk Factor for Carriage of Extended-Spectrum β-Lactamase-Producing Escherichia coli in a Large Sample of European Individuals-The AWARE Study
Rodríguez-Molina, Daloha; Berglund, Fanny; Blaak, Hetty; Flach, Carl-Fredrik; Kemper, Merel; Marutescu, Luminita; Pircalabioru Gradisteanu, Gratiela; Popa, Marcela; Spießberger, Beate; Wengenroth, Laura; Chifiriuc, Mariana Carmen; Larsson, D G Joakim; Nowak, Dennis; Radon, Katja; de Roda Husman, Ana Maria; Wieser, Andreas; Schmitt, Heike
(2022) International Journal of Environmental Research and Public Health, volume 19, issue 8, pp. 1 - 19
(Article)
Abstract
Antibiotic resistance (AR) is currently a major threat to global health, calling for a One Health approach to be properly understood, monitored, tackled, and managed. Potential risk factors for AR are often studied in specific high-risk populations, but are still poorly understood in the general population. Our aim was to
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explore, describe, and characterize potential risk factors for carriage of Extended-Spectrum Beta-Lactamase-resistant Escherichia coli (ESBL-EC) in a large sample of European individuals aged between 16 and 67 years recruited from the general population in Southern Germany, the Netherlands, and Romania. Questionnaire and stool sample collection for this cross-sectional study took place from September 2018 to March 2020. Selected cultures of participants' stool samples were analyzed for detection of ESBL-EC. A total of 1183 participants were included in the analyses: 333 from Germany, 689 from the Netherlands, and 161 from Romania. Travels to Northern Africa (adjusted Odds Ratio, aOR 4.03, 95% Confidence Interval, CI 1.67-9.68), Sub-Saharan Africa (aOR 4.60, 95% CI 1.60-13.26), and Asia (aOR 4.08, 95% CI 1.97-8.43) were identified as independent risk factors for carriage of ESBL-EC. Therefore, travel to these regions should continue to be routinely asked about by clinical practitioners as possible risk factors when considering antibiotic therapy.
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Keywords: ESBL E. coli, antibiotic resistance, antimicrobial resistance, risk factors, travels, Pollution, Public Health, Environmental and Occupational Health, Health, Toxicology and Mutagenesis
ISSN: 1661-7827
Publisher: MDPI AG
Note: Funding Information: Funding: AWARE (Antibiotic Resistance in Wastewater: Transmission Risks for Employees and Residents around Wastewater Treatment Plants) is supported by the European Commission (JPI-EC-AMR ERA-Net Cofund grant no 681055), the Bundesministerum für Bildung und Forschung, DLR Projektträger (01KI1708), UEFISCDI project ERANET-JPI-EC-AMR-AWARE-WWTP No. 26/2017, the Netherlands Organisation for Health Research and Development, The Hague, the Netherlands (ZonMw, grant 547001007), and the Swedish Research Council VR Grant No. 2016-06512. Funding Information: Acknowledgments: AWARE (Antibiotic Resistance in Wastewater: Transmission Risks for Employees and Residents around Wastewater Treatment Plants) is supported by the European Commission (JPI-EC-AMR ERA-Net Cofund grant no 681055), the Bundesministerum für Bildung und Forschung, DLR Projektträger (01KI1708), UEFISCDI project ERANET-JPI-EC-AMR-AWARE-WWTP No. 26/2017, the Netherlands Organisation for Health Research and Development, The Hague, the Netherlands (ZonMw, grant 547001007), and the Swedish Research Council VR Grant No. 2016-06512. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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