Seasonality in carriage of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in the general population: a pooled analysis of nationwide cross-sectional studies

Abstract

Infections due to extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are often preceded by asymptomatic carriage. Higher incidences in enteric infectious diseases during summer have been reported. Here, we assessed whether the presence of seasonality in intestinal ESBL-Escherichia coli/Klebsiella pneumoniae (ESBL-E/K) carriage in the general Dutch population exists. From 2014 to 2017, the faecal carriage of ESBL-E/K in healthy individuals was determined in three cross-sectional studies in the Netherlands, including 5985 subjects. Results were pooled to identify seasonal trends in prevalence (by month of sampling). Multivariate logistic regression analysis was used to calculate pooled odds ratios and 95% confidence intervals. Results were adjusted for age, sex, antibiotic use and travel. Overall prevalence of ESBL-E/K carriage was 4.3% (n = 260 ESBL-E/K-positive), with differences between months ranging from 2.6% to 7.4%. Compared to January, the monthly prevalence of ESBL-E carriage was highest in August (OR 1.88, 95% CI 1.02–3.49) and September (OR 2.25, 95% CI 1.30–3.89). The observed monthly differences in ESBL-E/K carriage rates suggest that there is seasonal variation in exposure to ESBL-E/K other than due to travelling and antibiotic use. This should be taken into account in designing future ESBL-E prevalence studies in temperate regions.

Global prevalence and molecular characterization of extended-spectrum β-lactamase producing-Escherichia coli in dogs and cats – A scoping review and meta-analysis

“…The estimated prevalence of 6.29% [95% IC: 4.34–9.02%] of ESBL- E. coli in companion animals can be considered lower compared to estimations in livestock (50%–70%) [ [152] , [153] , [154] , [155] ], and in humans (2%–46%) [ [156] , [157] , [158] , [159] ]. No statistical differences of prevalence were observed between dogs (6.87%) and cats (5.04%) and we did not observe variation on the prevalence rates of ESBL- E. coli either in dogs or cats over years (meta-regression, p > 0.1).…”

Prevalence of Antimicrobial Resistance and Characteristics of Escherichia coli Isolates From Fecal and Manure Pit Samples on Dairy Farms in the Province of Québec, Canada

“…Seasonal variation in excretion of ESBL/AmpC is poorly described in veterinary medicine. A study in a human population reported that carriage of ESBL E. coli and Klebsiella pneumoniae was highest in the months at the end of summer/beginning of autumn (August/September) (54). Another study reported higher levels of excretion of ESBL between July and September, although this was inversely correlated with use of antimicrobials (55).…”

Seasonal Patterns in Incidence and Antimicrobial Resistance of Common Bacterial Pathogens in Nursing Home Patients and Their Rooms

“…Seasonality of bacterial infections has been investigated almost exclusively in acute care settings, and mostly limited to patient isolates, where seasonal trends have been established for several pathogens in a range of geographical settings ( 1 , 2 , 8 , 9 ), including antimicrobial-resistant strains ( 10 ), often linking higher temperatures to increases in rates of infections, especially those due to gram-negative bacteria. Notably, a study focused on S. aureus infections reports seasonality in hospitals, but not in NHs ( 4 ), highlighting the importance of obtaining specific data in post-acute and long-term care.…”