Ravensbergen, S. (Sofanne) (2019) Emerging strains of multidrug-resistant Enterobacteriaceae found by asylum seekers arriving in the Netherlands – only small clusters of transmission found. thesis, Medicine.
Full text available on request.Abstract
Background. The prevalence of multidrug-resistant micro-organisms (MDROs) amongst asylum seekers is high. Little is known about the carriage patterns and genetic relationship of MDROs in asylum seekers or potential outbreaks of MDROs that might have occurred. This information is needed to optimize treatment of asylum seekers with clinical infections and to improve hospital hygiene strategies. Material and Methods. All extended spectrum beta-lactamase (ESBL)-producing E. coli and K. pneumoniae isolates from asylum seekers, obtained as part of standard care in one of the nine hospitals in the north eastern part of the Netherlands from 1st of January 2016 through 31st of October 2016, were retrospectively collected and sequenced by high throughput analysis. Results. 63.2% of the study population was female, and mainly originated from Syria (50%). In total, 84 isolates were sequenced originating from 77 asylum seekers, of which 80 ESBL-E. coli and four ESBL-K. pneumoniae isolates. ST-131 and ST-10 were the most frequently observed sequence type. All isolates were phenotypically resistant for the penicillin and the cephalosporin group. Other co resistance observed was resistance for trimethoprim/sulfamethoxazole (40/84), aminoglycosides (31/84) and fluoroquinolones (31/84). Most frequently observed resistance gene for beta lactam resistance was blaCTX-M-15 followed by blaTEM-1B. Phylogenetic relatedness showed three clonal clusters in E. coli within different asylum seekers, however no clear transmission pattern or outbreak was distinguished. Conclusion. A large variability within the isolates was observed regarding sequence type, phenotype, genotype and phylogenetic relatedness. No clear transmission pattern was observed. This large variability is worrisome since every clone could develop in a high-risk clone, complicating the development of targeted screening protocols.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Stienstra, Prof. Dr. Ymkje and Department of Internal Medicine and Infectious Diseases Univ |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:51 |
| Last Modified: | 25 Jun 2020 10:51 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1191 |
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