PLoS ONE
Volume 12, Issue 1, 2017

A cross-sectional study of colonization rates with Methicillin-Resistant Staphylococcus aureus (MRSA) and Extended-Spectrum Beta-Lactamase (ESBL) and carbapenemase-producing Enterobacteriaceae in four Swiss refugee centres (Article) (Open Access)

Piso R.J.* , Käch R. , Pop R. , Zillig D. , Schibli U. , Bassetti S. , Meinel D. , Egli A.
  • a Medical Clinic, Cantonal Hospital of Olten, Olten, Switzerland
  • b Medical Clinic, Cantonal Hospital of Olten, Olten, Switzerland
  • c Medical Clinic, Cantonal Hospital of Olten, Olten, Switzerland
  • d Medical Clinic, Cantonal Hospital of Olten, Olten, Switzerland
  • e Bakt Institut Olten BIO AG, Olten, Switzerland
  • f Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
  • g Clinical Microbiology, University Hospital Basel, Basel, Switzerland, Applied Microbiology Research, Department Biomedicine, University of Basel, Basel, Switzerland
  • h Clinical Microbiology, University Hospital Basel, Basel, Switzerland, Applied Microbiology Research, Department Biomedicine, University of Basel, Basel, Switzerland

Abstract

Background: The recent crisis of refugees seeking asylum in European countries challenges public health on many levels. Most refugees currently arrive from Syria, Afghanistan, or Eritrea. Data about multidrug resistant bacteria (MDR) prevalence are not present for these countries. However, when entering the European heath care systems, data about colonisation rates regarding highly resistant bacterial pathogens are important. Methods: We performed a cross-sectional screening in four Swiss refugee centres to determine the colonization rates for MRSA and ESBL- and carbapenemase-producing Enterobacteriaceae. We used pharyngeal, nasal, and inguinal swabs for MRSA and rectal swabs and urine for ESBL and carbapenemase screening using standard microbiological procedures. Whole genome sequencing (WGS) was used to determine the relatedness of MRSA isolates with high resolution due to a suspected outbreak. Results: 41/261(15.7%) refugees were colonized with MRSA. No differences regarding the country of origin were observed. However, in a single centre significantly more were colonized, which was confirmed to be a recent local outbreak. 57/241 (23.7%) refugees were colonized with ESBL with significantly higher colonisation in persons originating from the Middle East (35.1%, p<0.001). No carbapenemase producers were detected. Conclusion: The colonisation rate of the refugees was about 10 times higher for MRSA and 2-5 times higher for ESBL compared to the Swiss population. Contact precaution is warranted for these persons if they enter medical care. In cases of infections, MRSA and ESBL-producing Enterobacteriaceae should be considered regarding antibiotic treatment choices. © 2017 Piso et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Author Keywords

[No Keywords available]

Index Keywords

Afghanistan refugee tetracycline Swiss metabolism Syrian Arab Republic quinolone derivative human clindamycin Refugees Staphylococcal Infections Middle East bacterial virulence universal precaution nonhuman fusidic acid Cross-Sectional Studies cross-sectional study Humans Enterobacteriaceae Adolescent male heterozygote female Africa adult Enterobacteriaceae Infections population research erythromycin prevalence isolation and purification Article epidemic cotrimoxazole Eritrean enzymology Syrian Phylogeny antibiotic therapy Methicillin-Resistant Staphylococcus aureus beta lactamase Syria carbapenemase bacterium detection antibiotic sensitivity beta-Lactamases microbiology carbapenemase producing Enterobacteriaceae bacterial infection bacterium isolate rifampicin bacterial colonization Carrier State medical care whole genome sequencing Bacterial Proteins bacterial protein Switzerland methicillin resistant Staphylococcus aureus extended spectrum beta lactamase producing Enterobacteriaceae
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85009290705&doi=10.1371%2fjournal.pone.0170251&partnerID=40&md5=bcf3831ff090b6be6eed62dcf871e0aa
DOI: 10.1371/journal.pone.0170251
ISSN: 19326203
Cited by: 14
Original Language: English