Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
J Antimicrob Chemother. 2018 Mar 1;73(3):607-614. doi: 10.1093/jac/dkx455.
The prevalence of ampicillin- and/or vancomycin-resistant Enterococcus faecium (AREf and VREf) has increased in hospitalized patients in the Netherlands.
To quantify the prevalence, risk factors and co-carriage of AREf and VREf in humans, cats and dogs in the Dutch population.
From 2014 to 2015, ∼2000 inhabitants of the Netherlands each month were randomly invited to complete a questionnaire and provide a faecal sample. Subjects owning pets were also asked to submit one dog or cat sample. Faecal samples were screened for AREf and VREf. The genetic relatedness of isolates was determined using core genome MLST. Logistic regression analysis was used to determine risk factors.
Of 25 365 subjects, 4721 (18.6%) completed the questionnaire and 1992 (42.2%) human, 277 dog and 118 cat samples were submitted. AREf was detected in 29 human (1.5%), 71 dog (25.6%) and 6 cat (5.1%) samples. VREf (vanA) was detected in one human and one dog. AREf/VREf co-carriage was not detected in 388 paired samples. The use of antibiotics (OR 4.2, 95% CI 1.7-11.2) and proton pump inhibitors (OR 2.7, 95% CI 1.1-6.3) were risk factors for AREf carriage in humans. In dogs, these were the use of antibiotics (OR 2.3, 95% CI 1.1-4.6) and eating raw meat (OR 3.2, 95% CI 1.4-6.6). Core genome MLST-based phylogenetic linkage indicated clonal relatedness for a minority of human (16.7%) and pet AREf isolates (23.8%) in three clusters.
Intestinal carriage with AREf or VREf is rare in the Dutch general population. Although AREf carriage is high in dogs, phylogenetic linkage between human and pet AREf isolates was limited.
耐氨苄西林和/或万古霉素粪肠球菌(AREf 和 VREf)在荷兰住院患者中的流行率有所增加。
定量评估荷兰人群中人类、猫和狗中 AREf 和 VREf 的流行率、风险因素和共同携带情况。
2014 年至 2015 年,每月随机邀请约 2000 名荷兰居民完成一份调查问卷并提供粪便样本。有宠物的受试者还被要求提交一份狗或猫的样本。对粪便样本进行 AREf 和 VREf 筛查。使用核心基因组 MLST 确定分离株的遗传相关性。使用逻辑回归分析确定风险因素。
在 25365 名受试者中,有 4721 名(18.6%)完成了问卷调查,1992 名(42.2%)提供了人类、277 只狗和 118 只猫的粪便样本。在 29 名人类(1.5%)、71 只狗(25.6%)和 6 只猫(5.1%)样本中检测到 AREf。在 1 名人类和 1 只狗中检测到 VREf(vanA)。在 388 对配对样本中未检测到 AREf/VREf 共同携带。人类 AREf 携带的风险因素为使用抗生素(OR 4.2,95%CI 1.7-11.2)和质子泵抑制剂(OR 2.7,95%CI 1.1-6.3)。在狗中,这些因素是使用抗生素(OR 2.3,95%CI 1.1-4.6)和食用生肉(OR 3.2,95%CI 1.4-6.6)。基于核心基因组 MLST 的系统发育链接表明,少数人类(16.7%)和宠物 AREf 分离株(23.8%)在三个聚类中存在克隆相关性。
在荷兰普通人群中,肠道携带 AREf 或 VREf 的情况很少见。尽管狗中 AREf 携带率较高,但人类和宠物 AREf 分离株之间的系统发育联系有限。