High Prevalence of Intra-Familial Co-colonization by Extended-Spectrum Cephalosporin Resistant in Preschool Children and Their Parents in Dutch Households.
Apostolos Liakopoulos, Gerrita van den Bunt, Yvon Geurts, Martin C J Bootsma, Mark Toleman, Daniela Ceccarelli, Wilfrid van Pelt, Dik J Mevius
Author Information
Apostolos Liakopoulos: Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Lelystad, Netherlands.
Gerrita van den Bunt: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
Yvon Geurts: Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Lelystad, Netherlands.
Martin C J Bootsma: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
Mark Toleman: Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, United Kingdom.
Daniela Ceccarelli: Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Lelystad, Netherlands.
Wilfrid van Pelt: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.
Dik J Mevius: Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Lelystad, Netherlands.
Extended-spectrum cephalosporin-resistant (ESC) pose a serious infection control challenge for public health. The emergence of the ESC phenotype is mostly facilitated by plasmid-mediated horizontal extended-spectrum β-lactamases (ESBLs) and AmpC gene transfer within . Current data regarding the plasmid contribution to this emergence within the Dutch human population is limited. Hence, the aim of this study was to gain insight into the role of plasmids in the dissemination of ESBL/AmpC genes inside Dutch households with preschool children and precisely delineate co-colonization. In 87 ESC from fecal samples of parents and preschool children within 66 Dutch households, genomic localization, plasmid type and insertion sequences linked to ESBL/AmpC genes were determined. Chromosomal location of ESBL/AmpC genes was confirmed when needed. An epidemiologically relevant subset of the isolates based on household co-carriage was assessed by Multilocus Sequence Typing and Pulsed-Field Gel Electrophoresis for genetic relatedness. The narrow-host range I1α and F plasmids were the major facilitators of ESBL/AmpC-gene dissemination. Interestingly, we documented a relatively high occurrence of chromosomal integration of typically plasmid-encoded ESBL/AmpC-genes. A high diversity of non-epidemic sequence types (STs) was revealed; the predominant STs belonged to the pandemic lineages of extraintestinal pathogenic ST131 and ST69. Intra-familiar co-carriage by identical ESC was documented in 7 households compared to 14 based on sole gene typing, as previously reported. Co-carriage was more frequent than expected based on pure chance, suggesting clonal transmission between children and parents within the household.
