One decade of point-prevalence surveys for carriage of extended-spectrum beta-lactamase-producing enterobacterales: whole genome sequencing based prevalence and genetic characterization in a large Dutch teaching hospital from 2013 to 2022
Houkes, K M G; Weterings, V; van den Bijllaardt, W; Tinga, M A G M; Mulder, P G H; Kluytmans, J A J W; van Rijen, M M L; Verweij, J J; Murk, J L; Stohr, J J J M
(2024) Antimicrobial Resistance and Infection Control, volume 13, issue 1
(Article)
Abstract
OBJECTIVES: To determine the prevalence, trends, and potential nosocomial transmission events of the hidden reservoir of rectal carriage of extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E). METHODS: From 2013 to 2022, yearly point prevalence surveys were conducted in a large Dutch teaching hospital. On the day of the survey, all admitted patients were
... read more
screened for ESBL-E rectal carriage using peri-anal swabs and a consistent and sensitive selective culturing method. All Enterobacterales phenotypically suspected of ESBL production were analysed using whole genome sequencing for ESBL gene detection and clonal relatedness analysis. RESULTS: On average, the ESBL-E prevalence was 4.6% (188/4,119 patients), ranging from 2.1 to 6.6% per year. The ESBL-prevalence decreased on average 5.5% per year. After time trend correction, the prevalence in 2016 and 2020 was lower compared to the other year. Among the ESBL-E, Escherichia coli (80%) and CTX-M genes (85%) predominated. Potential nosocomial transmission events could be found in 5.9% (11/188) of the ESBL-E carriers. CONCLUSIONS: The ESBL-E rectal carriage prevalence among hospitalized patients was 4.6% with a downward trend from 2013 to 2022. The decrease in ESBL-E prevalence in 2020 could have been due to the COVID-19 pandemic and subsequent countrywide measures as no nosocomial transmission events were detected in 2020. However, the persistently low ESBL-E prevalences in 2021 and 2022 suggest that the decline in ESBL-E prevalence goes beyond the COVID-19 pandemic, indicating that overall ESBL-E carriage rates are declining over time. Continuous monitoring of ESBL-E prevalence and transmission rates can aid infection control policy to keep antibiotic resistance rates in hospitals low.
show less
Download/Full Text
Keywords: Humans, beta-Lactamases/genetics, Whole Genome Sequencing, Netherlands/epidemiology, Prevalence, Hospitals, Teaching, Enterobacteriaceae Infections/epidemiology, Carrier State/epidemiology, Male, Female, Enterobacteriaceae/genetics, Aged, Cross Infection/epidemiology, Middle Aged, Adult, Rectum/microbiology, Aged, 80 and over, Young Adult, Journal Article
ISSN: 2047-2994
Publisher: BioMed Central Ltd.
Note: © 2024. The Author(s).
(Peer reviewed)