1University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
2ESCMID study group for infections in travelers and migrants, Basel, Switzerland.
Antimicrob Resist Infect Control. 2019 Jan 7;8:6. doi: 10.1186/s13756-018-0455-5. eCollection 2019.
Several studies have shown a high prevalence of multi-drug resistant organisms (MDRO) amongst asylum seekers when compared to the general population. The aim of this study is to assess the duration of MDRO carriage in this population.
Data were retrospectively collected between January 1st 2014 through December 31st 2016. Study material included screening samples for MDRO carriage and clinical samples from asylum seekers in need of medical care. The study focused on methicillin-resistant (MRSA) and multi-drug resistant Enterobacteriaceae (MDRE). The rates of MRSA and MDRE detected were calculated every four weeks after arrival in the Netherlands.
Samples from 2091 asylum seekers were included. 1270 (60.7%) were female, median age was 26 years (IQR 20-34) and median number of days in the Netherlands until first sample was 67 (IQR 4-235). In the patients' first obtained samples, the rate of MRSA varied between 4.5 and 13.0% per time interval after arrival. The rate of MDRE fluctuated between 7.4% and 25.0%. No particular decline in positivity rates in first obtained samples was observed after arrival in the Netherlands. In the group of asylum seekers who arrived more than one year ago, MRSA was isolated in a percentage of 5.1% ( = 273, median months after arrival 34.1 (IQR 16.5-63.1)) and MDRE in 9.4% ( = 276, median months after arrival 35.4 (IQR 17-65)).
To our knowledge, this is the first study demonstrating that carriage rate of MDRO in asylum seekers remains high even after prolonged stay in the Netherlands. Longitudinal data on MDRO carriage after arrival in countries with a low MDRO prevalence are needed to determine optimal screening strategies, infection control measures and empirical antibiotic therapy.
与普通人群相比，寻求庇护者中耐多药生物体（MDRO）的患病率较高。本研究旨在评估该人群中 MDRO 携带的持续时间。
数据于 2014 年 1 月 1 日至 2016 年 12 月 31 日期间回顾性收集。研究材料包括 MDRO 携带筛查样本和需要医疗护理的寻求庇护者的临床样本。该研究重点关注耐甲氧西林金黄色葡萄球菌（MRSA）和多药耐药肠杆菌科（MDRE）。到达荷兰后每四周计算一次 MRSA 和 MDRE 的检出率。
共纳入 2091 名寻求庇护者的样本。1270 名（60.7%）为女性，中位年龄 26 岁（IQR 20-34），到达荷兰后首次取样的中位数天数为 67 天（IQR 4-235）。在患者首次获得的样本中，MRSA 的检出率在到达后每一时间间隔内变化范围为 4.5%至 13.0%。MDRE 的检出率在 7.4%至 25.0%之间波动。到达荷兰后，首次获得的样本中阳性率并未明显下降。在到达一年以上的寻求庇护者组中，MRSA 的分离率为 5.1%（ = 273，到达后中位月数为 34.1（IQR 16.5-63.1）），MDRE 的分离率为 9.4%（ = 276，到达后中位月数为 35.4（IQR 17-65））。
据我们所知，这是第一项表明在荷兰长期逗留后，寻求庇护者中 MDRO 携带率仍然很高的研究。需要在 MDRO 患病率较低的国家到达后的 MDRO 携带的纵向数据来确定最佳筛查策略、感染控制措施和经验性抗生素治疗。
