Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Clin Microbiol Infect. 2017 Feb;23(2):120.e1-120.e8. doi: 10.1016/j.cmi.2016.10.013. Epub 2016 Oct 20.
In the Netherlands there is an ongoing debate regarding environmental health risks of livestock farming for neighbouring residents. This explorative study aims to determine the prevalence of carriage of extended-spectrum β-lactamase and/or plasmid-mediated AmpC-producing Enterobacteriaceae (ESBL/pAmpC-E) in the general population living in a livestock-dense area, and to study associations between determinants, including exposure through contact with animals and the environment, and human carriage of ESBL/pAmpC-E.
A cross-sectional study was performed among 2432 adults (aged 20-72 years) in 12 temporary research centres in the south of the Netherlands, consisting of a questionnaire and analysis of a faecal sample to assess carriage of ESBL/pAmpC-E. Risk factors were analysed using logistic regression.
The prevalence for carriage of ESBL/pAmpC-E was 4.5% (109/2432; 95% CI 3.7-5.4) ranging from 1.4% to 10.9% among the research centres. ESBL/pAmpC resistance genes were detected in Escherichia coli and Klebsiella pneumoniae isolates obtained from these 109 persons and the most common ESBL-resistance genes were bla, bla and bla, originating from 76 participants. Travel in the previous 12 months to Africa, Asia or Latin America (OR 2.82; 95% CI 1.71-4.63), having kept cows for a hobby in the previous 5 years (OR 3.77; 95% CI 1.22-11.64), usage of proton-pump inhibitors (OR 1.84; 95% CI 1.05-3.23), and living within 1000 m of a mink farm (OR 2.26; 95% CI 1.28-3.98) were identified as risk factors. Exposure to poultry was not identified as a risk factor.
Overall, living in close proximity to livestock animals and farms does not seem to be a risk factor for carriage of ESBL/pAmpC-E.
在荷兰，围绕家畜养殖对周边居民的环境健康风险，存在着一场持续的争论。本探索性研究旨在确定生活在畜牧业密集地区的普通人群中携带超广谱β-内酰胺酶和/或质粒介导的 AmpC 型肠杆菌科（ESBL/pAmpC-E）的流行率，并研究包括通过与动物和环境接触的暴露在内的决定因素与人类携带 ESBL/pAmpC-E 之间的关联。
在荷兰南部的 12 个临时研究中心，对 2432 名年龄在 20-72 岁的成年人进行了横断面研究，内容包括问卷调查和粪便样本分析，以评估 ESBL/pAmpC-E 的携带情况。使用逻辑回归分析危险因素。
ESBL/pAmpC-E 的携带率为 4.5%（2432 人中 109 例；95%CI 3.7-5.4），各研究中心的携带率范围为 1.4%-10.9%。从这 109 名患者中获得的大肠杆菌和肺炎克雷伯菌分离物中检测到 ESBL/pAmpC 耐药基因，最常见的 ESBL 耐药基因是 blaCTX-M-15、blaCTX-M-3 和 blaCTX-M-14，分别来自 76 名参与者。在过去 12 个月内前往非洲、亚洲或拉丁美洲旅行（OR 2.82；95%CI 1.71-4.63）、过去 5 年内有养奶牛的爱好（OR 3.77；95%CI 1.22-11.64）、使用质子泵抑制剂（OR 1.84；95%CI 1.05-3.23）和居住在距离貂养殖场 1000 米以内（OR 2.26；95%CI 1.28-3.98）被确定为危险因素。接触家禽未被确定为危险因素。
总体而言，生活在靠近家畜动物和农场的地方似乎不是携带 ESBL/pAmpC-E 的危险因素。
