Institute of Hygiene and Environmental Medicine, Charité University Medicine Berlin, Hindenburgdamm 27, 12203, Berlin, Germany.
Infection. 2012 Dec;40(6):685-7. doi: 10.1007/s15010-012-0324-8. Epub 2012 Sep 13.
The purpose of this study was to determine the prevalence of extended-spectrum β-lactamase (ESBL) and vancomycin-resistant enterococci (VRE) colonisation among healthy infection control personnel and to determine risk factors for ESBL or VRE colonisation within this group.
Participants were recruited at an infection control symposium in 2011. Volunteers were asked to perform a rectal swab and to fill in questionnaires on risk factors of ESBL or VRE carriage (report on diet, contact with domestic or production animals, travel, hospital stay and antibiotic use all within the last 12 months). Rectal swabs were inoculated onto ESBL and VRE chromogenic agar; species identification and susceptibility testing was done by using a VITEK 2 system. In the multivariable analysis, a logistic regression with stepwise forward variable selection was performed.
Two hundred and thirty people participated in the study, i.e. 36 % of the symposium attendees (231/639). No VRE faecium or faecalis were isolated, whereas ESBL were isolated from 8 out of 231 individuals, i.e. 3.5 % (95 % confidence interval 1.5-6.7). In the multivariable analysis, travel to Greece or Africa and contact with pets were independently associated with ESBL positivity. The odds ratios were as follows: travel to Greece 15.2, travel to Africa 14.8 and for having a pet animal 6.7.
This is the first report showing that contact with pets increases by almost seven-fold the chance to be colonised with ESBL Escherichia coli. A colonisation rate of 3.5 % with ESBL-producing enterobacteriaceae among infection control personnel is of concern and reflects probably less an occupational health risk but the reservoir of and the expansion into the community, especially in persons with pet animals and travel history to high-endemicity countries.
本研究旨在确定健康感染控制人员中广谱β-内酰胺酶（ESBL）和万古霉素耐药肠球菌（VRE）定植的流行率，并确定该人群中 ESBL 或 VRE 定植的危险因素。
2011 年在感染控制研讨会上招募参与者。志愿者被要求进行直肠拭子检查，并填写关于 ESBL 或 VRE 携带危险因素的问卷（报告过去 12 个月内的饮食、与家庭或生产动物的接触、旅行、住院和抗生素使用情况）。直肠拭子接种到 ESBL 和 VRE 显色琼脂上；使用 VITEK 2 系统进行种属鉴定和药敏试验。在多变量分析中，采用逐步向前变量选择的逻辑回归进行分析。
231 人参加了研究，即研讨会参与者的 36%（231/639）。未分离到屎肠球菌或粪肠球菌，但从 231 人中分离出 8 株 ESBL，即 3.5%（95%置信区间 1.5-6.7）。在多变量分析中，前往希腊或非洲旅行以及与宠物接触与 ESBL 阳性独立相关。优势比如下：前往希腊 15.2，前往非洲 14.8，养宠物动物 6.7。
这是第一项表明与宠物接触使 ESBL 大肠杆菌定植的机会增加近 7 倍的报告。感染控制人员中 ESBL 产肠杆菌科的定植率为 3.5%令人担忧，这可能反映出职业健康风险较小，而是在有宠物动物和前往高流行国家旅行史的人群中，ESBL 成为社区中的储菌库并不断扩张。
