No evidence of carbapenemase-producing Enterobacteriaceae in stool samples of 1,544 asylum seekers arriving in Rhineland-Palatinate, Germany, April 2016 to March, 2017.
Euro Surveill
; 24(8)2019 Feb.
Article
in En
| MEDLINE
| ID: mdl-30808444
ABSTRACT
INTRODUCTION:
Since 2015, increased migration from Asia and Africa to Europe has raised public health concerns about potential importation of extended-spectrum ß-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.Key words
Afghanistan; E. coli ST131; ESBL, beta-lactamase CTX-M-27; Eritrea; Escherichia coli; Iran; Pakistan; Somalia; Syria; beta-lactamase CTX-M-15; carbapenem-resistant Enterobacteriaceae; communicable diseases; cross-sectional studies; drug resistance; emerging; epidemiology; human migration; infectious disease transmission; mass screening; microbial; plasmid mediated fluoroquinolone resistance; prevalence; refugees
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Refugees
/
Feces
/
Carbapenem-Resistant Enterobacteriaceae
Type of study:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
Euro Surveill
Journal subject:
DOENCAS TRANSMISSIVEIS
Year:
2019
Type:
Article
Affiliation country:
Germany