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Epidemiology and molecular typing of multidrug-resistant bacteria in day care centres in Flanders, Belgium

Stefanie van Kleef-van Koeveringe1,2, Veerle Matheeussen1,2, Hilde Jansens1,3

  • 1Laboratory of Medical Microbiology, University Hospital Antwerp, Edegem, Belgium.

Epidemiology and Infection
|September 15, 2023
PubMed

Insights

Multidrug-resistant organisms (MDROs) are a growing concern. This study found a high prevalence of extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) in Flemish day care centres, indicating potential transmission and the need for strict hygiene.

Area of Science:

  • Microbiology
  • Public Health
  • Epidemiology

Background:

  • Multidrug-resistant organisms (MDROs) pose a significant global public health threat.
  • Day care centre (DCC) attendance is a known risk factor for MDRO carriage in children and their environments.
  • Understanding MDRO epidemiology in DCCs is crucial for community infection control.

Purpose of the Study:

  • To investigate the prevalence and potential transmission of MDROs in Flemish day care centres.
  • To identify specific types of MDROs, including extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E), carbapenemase-producing Enterobacterales (CPE), and vancomycin-resistant Enterococci (VRE).
  • To analyze resistance genes and assess clonal relatedness of isolates.

Main Methods:

  • A cross-sectional survey was conducted in 18 Flemish DCCs between November 2018 and February 2019.
  • Faecal samples from 448 children were analyzed using selective chromogenic culture media.
  • Detected MDROs underwent resistance gene sequencing to determine clonal relatedness.

Main Results:

  • 15.8% of samples (71/448) yielded ESBL-E, predominantly Escherichia coli carrying the blaCTX-M-15 gene.
  • ESBL-E prevalence varied significantly between centres (0-50%), with evidence of transmission.
  • One case of CPE (E. coli with OXA-244) was detected; VRE was absent.

Conclusions:

  • The prevalence of ESBL-E in Flemish DCCs is notably high compared to previous studies.
  • Findings highlight the importance of robust hygiene protocols in DCCs to mitigate MDRO spread.
  • Continued surveillance and control measures are essential to curb community transmission of MDROs.
Keywords:
MDROday care centresmolecular typingscreeningtransmissionwgMLSTwhole-genome sequencing

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