Quantifying within-household transmission of extended-spectrum β-lactamase-producing bacteria

Haverkate, Manon; Platteel, Tamara N; Fluit, Ad C.; Stuart, J.W. Cohen; Hall, Maurine A. Leverstein–van; Thijsen, Steven; Scharringa, Jelle; Kloosterman, R.C.; Bonten, Marc J. M.; Bootsma, Martin

doi:10.1016/j.cmi.2016.08.021

Cited by 54 publications

(59 citation statements)

References 35 publications

(25 reference statements)

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“…The high CRE colonisation rate among hospital patients results in a high risk for spread within the family and community when CRE colonised patients are discharged. 33 Implementation of IPC strategies is particularly important when neonates are discharged, since parents and others in the household take care of them and their faeces (changing diapers), which may lead to transmission of CRE within the family and near environment. What can be done to reduce colonisation and prevent infections caused by CRE?…”

Section: Main Findingsmentioning

confidence: 99%

High prevalence of colonisation with carbapenem-resistant Enterobacteriaceae among patients admitted to Vietnamese hospitals: Risk factors and burden of disease

Tran

Larsson

Olson

et al. 2019

Journal of Infection

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Section: Main Findingsmentioning

confidence: 99%

High prevalence of colonisation with carbapenem-resistant Enterobacteriaceae among patients admitted to Vietnamese hospitals: Risk factors and burden of disease

Tran

Larsson

Olson

et al. 2019

Journal of Infection

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“…They indicated humans as the most important cause; however, the other sources also represented a large reservoir of ESBLs. In our model, we included the daily probability of ESBL-EC background acquisition from a recent study and based on a speci c epidemiological situation in Dutch population [3]. This value was much lower that the probability of colonisation due to cross-transmission considered here.…”

Section: Discussionmentioning

confidence: 99%

“…by contaminated meat/vegetables, pets or the environment). By simpli cation we included in the model a single parameter representing the background acquisition, based on a recent study [3].…”

Section: Transmission Modelmentioning

confidence: 99%

Hand hygiene improvement or antibiotic restriction to control the household transmission of extended-spectrum β-lactamase-producing Escherichia coli: a mathematical modelling study

Kardaś-Słoma

Yazdanpanah

Perozziello

et al. 2020

Preprint

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Background The best strategy to control ESBL-producing Escherichia coli (ESBL-EC) spread in the community is lacking. Methods We developed an individual-based transmission model to evaluate the impact of hand hygiene (HH) improvement and reduction in antibiotic use on the within-household transmission of ESBL-EC. We used data from the literature and incorporated key elements of ESBL-EC transmission such as the frequency and nature of contacts among household members, antibiotic use in the community and hand hygiene behaviour. We introduced in a household a single ESBL-EC colonised person and simulated the transmission dynamics of ESBL-EC over a one-year time horizon. Results The probability of ESBL-EC transmission depended on the household composition and the profile of the initial carrier. In the two-person household, the probability of ESBL-EC transmission was 5.3% (95% CI 5.0-5.6) or 6.6% (6.3-6.9) when the index person was a woman or a man, respectively. In a four-person household, the probability of transmission varied from 61.4% (60.9-62.0) to 68.8% (68.3- 69.3) and was the highest when the index patient was the baby. Improving HH by 50% reduced the probability of transmission by 33-62%. Antibiotic restriction by 50% reduced the transmission by 2-6%.Conclusions The transmission of ESBL-EC is frequent in households and especially those with a baby. Antibiotic reduction had little impact on ESBL-EC. Improvement of hygiene in the community could help prevent transmission of ESBL-EC.

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“…We observed no signi cant increase or decrease of acquired ESBL-producing bacteria after the intervention, neither did Thompson & al (17) when similar interventions were performed. Numerous studies have been reported that nowadays the transmission are predominant in the community (18,19). Acquisition of ESBLE seems to be much more common in the community than in healthcare setting.…”

Section: Discussionmentioning

confidence: 99%

Effects of Discontinuing Contact Precaution on Control of Extended-Spectrum β-lactamase-producing Enterobacteriaceae Nosocomial Acquisition: An Interrupted Time Series Analysis

Regad

Renaudin

Lizon

et al. 2020

Preprint

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Background: Interest of contact precautions (CP) to prevent cross-transmission in addition to standard precautions (SP) is actually debated in the literature for some microorganisms, like extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBLE). We took advantage of the decision to stop CP for ESBLE in our hospital to study in real life if this discontinuing has an impact on the ESBLE acquisition rate. Methods: An interrupted time series (ITS) was performed in 3 wards and the week was used as the temporal unit. The ESBLE acquisition and importation incidence density (ID) and potential risks factors (colonization and selective pressure, Alcohol-Based hand rub solution consumption rates, demographic patients data) were collected between two periods: the pre-intervention (July 2018 to June 2019) when patients infected or colonized by ESBLE were cared with PC and SP and the post-intervention (September 2019 to March 2020) when patients were cared with SP only. Results: ESBLE acquisition ID were of 1.32 ± 1.36 and 1.17 ± 1.25 cases per 1000 patient-days for the pre- and post-intervention period respectively with no significant change in slope (p = 0.15). The only confounding variable significant (p = 0.04) in ITS was the antibiotics consumption, with a positive increasing trend. Conclusion: This study showed that the SP alone in order to control the ESBLE nosocomial did not lead to increasing the ESBLE nosocomial cross-transmission.

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Quantifying within-household transmission of extended-spectrum β-lactamase-producing bacteria

Abstract: There is frequent transmission of ESBL-producing bacteria in households, which may contribute to the observed endemicity of ESBL carriage in the Netherlands. However, the population model suggests that there is not a single dominant acquisition route in the community.

Cited by 54 publications

References 35 publications

High prevalence of colonisation with carbapenem-resistant Enterobacteriaceae among patients admitted to Vietnamese hospitals: Risk factors and burden of disease

High prevalence of colonisation with carbapenem-resistant Enterobacteriaceae among patients admitted to Vietnamese hospitals: Risk factors and burden of disease

Hand hygiene improvement or antibiotic restriction to control the household transmission of extended-spectrum β-lactamase-producing Escherichia coli: a mathematical modelling study

Effects of Discontinuing Contact Precaution on Control of Extended-Spectrum β-lactamase-producing Enterobacteriaceae Nosocomial Acquisition: An Interrupted Time Series Analysis

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