Eurosurveillance
Volume 24, Issue 8, 2019

No evidence of carbapenemase-producing Enterobacteriaceae in stool samples of 1,544 asylum seekers arriving in Rhineland-Palatinate, Germany, April 2016 to March, 2017 (Article) (Open Access)

Ehlkes L. , Pfeifer Y. , Werner G. , Ignatius R. , Vogt M. , Eckmanns T. , Zanger P.* , Walter J.
  • a Federal State Agency for Consumer & Health Protection Rhineland-Palatinate, Koblenz, Germany, Robert Koch Institute, Berlin, Germany, European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
  • b Robert Koch Institute, Nosocomial Pathogens and Antibiotic Resistance, Wernigerode, Germany
  • c Robert Koch Institute, Nosocomial Pathogens and Antibiotic Resistance, Wernigerode, Germany
  • d MVZ Labor 28, Berlin, Germany, Institute of Microbiology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
  • e Federal State Agency for Consumer & Health Protection Rhineland-Palatinate, Koblenz, Germany
  • f Robert Koch Institute, Nosocomial Infections and Surveillance of Antibiotic Resistance, Berlin, Germany
  • g Heidelberg Institute of Global Health, Unit of Epidemiology and Biostatistics, University Hospitals, Heidelberg, Germany, Department of Infectious Diseases, Medical Microbiology and Hygiene, University Hospitals, Heidelberg, Germany
  • h Robert Koch Institute, Nosocomial Infections and Surveillance of Antibiotic Resistance, Berlin, Germany

Abstract

Introduction: Since 2015, increased migration from Asia and Africa to Europe has raised public health concerns about potential importation of extended-spectrum Β-lactamase-producing Enterobacteriaceae (ESBL-PE), specifically those producing carbapenemases (C-PE), into European hospitals. Aims: To inform infection control practices about ESBL-PE prevalence in asylum seekers and to investigate whether C-PE prevalence exceeds that in the German population. Methods: Cross-sectional study from April 2016-March 2017. Routinely collected stool samples from asylum seekers were tested for antibiotic resistant Enterobacteriaceae. Country/region of origin and demographic characteristics were explored as risk factors for faecal colonisation. Results: Of 1,544 individuals, 294 tested positive for ESBL-PE colonisation (19.0%; 95% confidence intervals (CI): 17.0-21.0). Asylum seekers originating from Afghanistan/Pakistan/Iran had a prevalence of 29.3% (95% CI: 25.6-33.2), from Syria 20.4% (95% CI: 16.1- 25.2) and from Eritrea/Somalia 11.9% (95% CI: 8.7- 15.7). CTX-M-15 (79%) and CTX-M-27 (10%) were the most common ESBL determinants. Highest ESBL-PE prevalences were observed in boys under 10 years and women aged 20-39 years (interaction: p = 0.03). No individuals tested positive for C-PE. Faecal C-PE colonisation prevalence in asylum seekers was not statistically significantly different from prevalence reported in German communities. Conclusion: In absence of other risk factors, being a newly arrived asylum seeker from a region with increased faecal ESBL-PE colonisation prevalence is not an indicator for C-PE colonisation and thus not a reason for pre-emptive screening and isolation upon hospital admission. © 2019, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

Author Keywords

[No Keywords available]

Index Keywords

Germany Escherichia coli demography bacterium isolation human feces analysis nonhuman screening asylum seeker evidence based practice cross-sectional study Adolescent male female Infant risk factor newborn Klebsiella pneumoniae Article microbial colonization infection control adult carbapenemase producing Enterobacteriaceae antibiotic resistance Pseudomonas aeruginosa beta lactamase CTX M bacterial colonization Morganella morganii Pseudomonas putida bacterium culture Citrobacter freundii Acinetobacter baumannii Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85063453665&doi=10.2807%2f1560-7917.ES.2019.24.8.1800030&partnerID=40&md5=9b42a3ca7ef9c9bd4d1b871c4bb2a384
DOI: 10.2807/1560-7917.ES.2019.24.8.1800030
ISSN: 1025496X
Original Language: English