High carriage of ESBL-producing Enterobacteriaceae associated

被引:6
|
作者
van Bilsen, Ward P. H. [1 ]
van Dulm, Eline [1 ]
Matser, Amy [1 ]
Linde, Ineke [1 ]
van Duijnhoven, Yvonne T. H. P. [1 ]
Prins, Jan M. [2 ]
Prins, Maria [1 ,2 ]
Boyd, Anders [1 ,3 ]
van Dam, Alje P. [1 ]
机构
[1] Publ Hlth Serv Amsterdam, Dept Infect Dis, Amsterdam, Netherlands
[2] Univ Amsterdam, Dept Internal Med, Div Infect Dis, Amsterdam UMC, Amsterdam, Netherlands
[3] HIV Monitoring Fdn, Amsterdam, Netherlands
关键词
Antimicrobial resistance; ESBL; Men who have sex with men; Sexual activity; Transmission; LACTAMASE-PRODUCING ENTEROBACTERIACEAE; SPECTRUM BETA-LACTAMASES; ESCHERICHIA-COLI; RISK-FACTORS; PREVALENCE; COMMUNITY; COLONIZATION; INFECTIONS; HOSPITALS;
D O I
10.1016/j.ijantimicag.2021.106276
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: Extended-spectrum beta-lactamase Enterobacteriaceae (ESBL-E) may be sexually transmitted. Men who have sex with men (MSM) have different sexual behaviour than the general population, and thus may be at risk for ESBL-E carriage. This study determined the prevalence of ESBL-E carriage and its association with sexual behaviour among MSM in Amsterdam, The Netherlands. Materials and methods: In total, 583 HIV-positive and HIV-negative MSM from the Amsterdam Cohort Study were screened for rectal ESBL-E carriage between April and December 2018. Participants completed a self-administered questionnaire on (sexual) behaviour and risk factors for antimicrobial resistance. The proportion of the study population with ESBL-E carriage was compared by number of sexual partners using logistic regression, and across clusters of sexual behaviours with steady and casual partners, separately, using latent class analyses; all results were adjusted for recent use of antibiotics, travel and hospitalization. Results: Overall, 16.3% [95% confidence interval (CI) 13.4-19.5] of the study population tested positive for ESBL-E. The odds of ESBL-E carriage increased as number of sexual partners increased [adjusted odds ratio per ln(partner+1), 1.57, 95% CI 1.26-1.94; P<0.001]. There was no association between ESBL-E carriage and sexual behaviour with steady partner(s). Compared with participants in the 'no sex with casual partner(s)' cluster, adjusted odds of being ESBL-E positive were 2.95-fold higher (95% CI 1.52-5.80) for participants in the 'rimming and frottage' cluster (P=0.001) and 2.28-fold higher (95% CI 0.98-5.31) for participants in the 'toy use and fisting' cluster (P = 0.056). Conclusions: The prevalence of ESBL-E in MSM is higher compared with the overall Dutch population, likely due to sexual transmission with casual partners. This implies that sexually active MSM should be considered a risk group for ESBL-E carriage. (C) 2021 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.
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页数:7
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