RT Journal Article
T1 Household acquisition and transmission of extended-spectrum β-lactamase (ESBL) -producing Enterobacteriaceae after hospital discharge of ESBL-positive index patients.
A1 Riccio, Maria E
A1 Verschuuren, Tess
A1 Conzelmann, Nadine
A1 Martak, Daniel
A1 Meunier, Alexandre
A1 Salamanca, Elena
A1 Delgado, Mercedes
A1 Guther, Julia
A1 Peter, Silke
A1 Paganini, Julian
A1 Martischang, Romain
A1 Sauser, Julien
A1 de Kraker, Marlieke E A
A1 Cherkaoui, Abdessalam
A1 Fluit, Ad C
A1 Cooper, Ben S
A1 Hocquet, Didier
A1 Kluytmans, Jan A J W
A1 Tacconelli, Evelina
A1 Rodriguez-Baño, Jesús
A1 Harbarth, Stephan
A1 MODERN WP2 study group, 
K1 Acquisition
K1 Extended-spectrum β-lactamase
K1 Household
K1 Prospective cohort study
K1 Transmission
AB This study aimed to determine rates and risk factors of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) acquisition and transmission within households after hospital discharge of an ESBL-PE-positive index patient. Two-year prospective cohort study in five European cities. Patients colonized with ESBL-producing Escherichia coli (ESBL-Ec) or Klebsiella pneumoniae (ESBL-Kp), and their household contacts were followed up for 4 months after hospital discharge of the index case. At each follow up, participants provided a faecal sample and personal information. ESBL-PE whole-genome sequences were compared using pairwise single nucleotide polymorphism-based analysis. We enrolled 71 index patients carrying ESBL-Ec (n = 45), ESBL-Kp (n = 20) or both (n = 6), and 102 household contacts. The incidence of any ESBL-PE acquisition among household members initially free of ESBL-PE was 1.9/100 participant-weeks at risk. Nineteen clonally related household transmissions occurred (case to contact: 13; contact to case: 6), with an overall rate of 1.18 transmissions/100 participant-weeks at risk. Most of the acquisition and transmission events occurred within the first 2 months after discharge. The rate of ESBL-Kp household transmission (1.16/100 participant-weeks) was higher than of ESBL-Ec (0.93/100 participant-weeks), whereas more acquisitions were noted for ESBL-Ec (1.06/100 participant-weeks) compared with ESBL-Kp (0.65/100 participant-weeks). Providing assistance for urinary and faecal excretion to the index case by household members increased the risk of ESBL-PE transmission (adjusted prevalence ratio 4.3; 95% CI 1.3-14.1). ESBL-PE cases discharged from the hospital are an important source of ESBL-PE transmission within households. Most acquisition and transmission events occurred during the first 2 months after hospital discharge and were causally related to care activities at home, highlighting the importance of hygiene measures in community settings. German Clinical Trials Register, DRKS-ID: DRKS00013250.
YR 2021
FD 2021-01-07
LK http://hdl.handle.net/10668/16945
UL http://hdl.handle.net/10668/16945
LA en
DS RISalud
RD Apr 18, 2025