Prevalence and associated factors for carriage of Enterobacteriaceae producing ESBLs or carbapenemase and methicillin-resistant Staphylococcus aureus in Hong Kong community

• Published in: The Journal of infection Vol. 81; no. 2; pp. 242 - 247
• Main Authors: Kwok, Kin-On, Chan, Emily, Chung, Pui-Hong, Tang, Arthur, Wei, Wan-In, Zhu, Chendi, Riley, Steven, Ip, Margaret
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2020
• Subjects: Bacterial Proteins; beta-Lactamases - genetics; Carbapenemase; Carrier State - epidemiology; Community prevalence; Cross-Sectional Studies; Enterobacteriaceae - genetics; Enterobacteriaceae Infections - epidemiology; Escherichia coli; Extended spectrum beta-lactamase; Hong Kong - epidemiology; Humans; Methicillin-resistant Staphylococcus aureus; Methicillin-Resistant Staphylococcus aureus - genetics; Multidrug resistance; Prevalence; Hong Kong; Carbapenemase; Community prevalence; Extended spectrum beta-lactamase; Multidrug resistance; Methicillin-resistant Staphylococcus aureus
• ISSN: 0163-4453; 1532-2742; 1532-2742
• DOI: 10.1016/j.jinf.2020.05.033

•Abundance of ESBL-E in Hong Kong community are causes of concern.•Antibiotic use is associated with ESBL-E carriage.•Presence of MRSA and CPE in the community hints on a change in their epidemiology. We conducted a cross-sectional study in Hong Kong community to estimate the carriage prevalence, associated factors and genotypes of extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E), methicillin-resistant Staphylococcus aureus (MRSA) and carbapenemase-producing Enterobacteriaceae (CPE). Seemingly healthy subjects were asked to provide nasal, handprint and stool samples from March to April 2017. Isolates were characterized by molecular methods. We used multivariable logistic regression models within a generalized estimating equation framework to identify risk factors for ESBL-E carriage. Characteristics of MRSA/CPE carriage were summarized. The prevalence of ESBL-E, MRSA and CPE were 52.8% (104/197), 2.5% (5/197) and 0.5% (1/197) respectively. Most ESBL-E isolates were E. coli (85.6%; 113/132). Most ESBL genes belonged to blaCTX−M-G9 (68.9%) and blaTEM (53.0%) types. Self-reported antibiotic consumption (≥2 courses) in the past six months was associated with ESBL-E carriage (adjusted odds ratio: 4.71–5.47). Abundance of ESBL-E in the community are causes of concern, and antibiotic use is associated with its carriage. Presence of MRSA and CPE in community members without clear healthcare exposure hints on a change in their epidemiology. This study establishes a baseline to formulate infection control policies and future studies in combating antimicrobial resistance.