Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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Comparing four diagnostic tests for Giardia duodenalis in dogs using latent class analysis
Uiterwijk, Mathilde ; Nijsse, Rolf ; Kooyman, Frans N.J. ; Wagenaar, Jaap A. ; Mughini-Gras, Lapo ; Koop, Gerrit ; Ploeger, Harm W. - \ 2018
Parasites & Vectors 11 (2018)1. - ISSN 1756-3305
Bayesian analysis - Canine - Diagnosis - Giardiasis - Prevalence

Background: To accurately diagnose giardiosis in dogs, knowledge of diagnostic test characteristics and expected prevalence are required. The aim of this work was to estimate test characteristics (sensitivity and specificity) of four commonly used diagnostic tests for detection of Giardia duodenalis in dogs. Methods: Fecal samples from 573 dogs originating from four populations (household dogs, shelter dogs, hunting dogs and clinical dogs) were examined with centrifugation sedimentation flotation (CSF) coproscopical analysis, direct immunofluorescence assay (DFA, Merifluor Cryptosporidium/Giardia®), a rapid enzyme immunochromatographic assay (IDEXX SNAP Giardia®) and qPCR (SSU rDNA) for presence of G. duodenalis. Bayesian latent class analysis was used to determine test performance characteristics and to estimate G. duodenalis prevalence of each of the four dog populations. Results: All tests were highly specific. IDEXX SNAP Giardia® showed the highest specificity (99.6%) and qPCR the lowest (85.6%). The sensitivities were much more variable, with qPCR showing the highest (97.0%) and CSF the lowest (48.2%) sensitivity. DFA was more sensitive than IDEXX SNAP Giardia®, but slightly less specific. Prevalences of G. duodenalis differed substantially between populations, with the hunting dogs showing the highest G. duodenalis prevalence (64.9%) and the household dogs the lowest (7.9%). Conclusions: This study identifies qPCR as a valuable screening tool because of its high sensitivity, whereas methods using microscopy for cyst identification or cyst wall detection should be used in situations where high specificity is required. G. duodenalis is a prevalent gastro-intestinal parasite in Dutch dogs, especially in dogs living in groups (hunting and shelter dogs) and clinical dogs.

Weather correlates of Campylobacter prevalence in broilers at slaughter under tropical conditions in Sri Lanka
Kalupahana, R.S. ; Mughini-Gras, L. ; Kottawatta, S.A. ; Somarathne, S. ; Gamage, C. ; Wagenaar, J.A. - \ 2018
Epidemiology and Infection 146 (2018)8. - ISSN 0950-2688 - p. 972 - 979.
Campylobacter - poultry - seasonality - tropical weather
Campylobacter is the primary agent of human bacterial gastroenteritis worldwide. In contrast to temperate zones, weather effects on Campylobacter prevalence in broilers under tropical conditions are under-researched. We examined the association between weather and Campylobacter prevalence in slaughtered broilers in Sri Lanka, a tropical country with weather variations led by monsoons. Each month (October 2009–July 2011), 20–30 broiler batches referring to two semi-automated slaughterhouses from five Sri Lankan provinces were tested for Campylobacter contamination and analysed in relation to temperature, humidity and rainfall. Overall prevalence was 63.8% (95% CI 59.6–67.9%, n = 542), peaking in September–November. Each 1 °C increase in monthly mean temperature up to 26 °C increased Campylobacter-positive batches by 16.4% (95% CI 0.4–35.1%). For each 10 mm increase in monthly total rainfall up to 300 mm, Campylobacter-positive batches increased significantly by 0.8% (0.1–1.5%) at 1-month lag. For each 1% increase in relative humidity up to 80% at 1- and 2-month lags, Campylobacter-positive batches increased of respectively 4.2% (1.9–6.7%) and 4.0% (1.5–6.5), and decreased by 3.6% (2.6–4.6%) and 4.0% (2.6–5.4%) for unit increases above 80%. These results suggest that even in tropical countries without marked seasons, there are weather effects possibly reflecting Campylobacter potential to colonise its preferred host and/or survive in the environment.
Samenvatting ESBL-Attributieanalyse (ESBLAT) : Op zoek naar de bronnen van antibioticaresistentie bij de mens
Mevius, Dik ; Heederik, Dick ; Duijkeren, Engeline ; Veldman, Kees ; Essen, Alieda van; Kant, Arie ; Liakopoulos, Apostolos ; Geurts, Yvon ; Pelt, Wilfrid van; Mughini Gras, Lapo ; Schmitt, Heike ; Dierikx, Cindy ; Hoek, Angela van; Evers, Eric ; Roda Husman, Annemaria de; Blaak, Hetty ; Dissel, Jaap van; Smid, Joost ; Dohmen, Wietske ; Dorado-Garcia, Alejandro ; Havelaar, Arie ; Hordijk, Joost ; Wagenaar, Jaap ; Fluit, Ad ; Bunt, Gerrita van den; Bonten, Marc ; Velthuis, Annet ; Heuvelink, Annet ; Buter, Rianne ; Gonggrijp, Maaike ; Santman-Berends, Inge ; Lam, Theo ; Urlings, Bert ; Heres, Lourens ; Bouwknecht, Martijn ; Groot, Jacques de - \ 2018
Netherlands : De Stichting TKI Agri&Food (TKI) - 11 p.
Rapport ESBL-Attributieanalyse (ESBLAT) : Op zoek naar de bronnen van antibioticaresistentie bij de mens
Mevius, Dik ; Heederik, Dick ; Duijkeren, Engeline ; Veldman, Kees ; Essen, Alieda van; Kant, Arie ; Liakopoulos, Apostolos ; Geurts, Yvon ; Pelt, Wilfrid van; Mughini Gras, Lapo ; Schmitt, Heike ; Dierikx, Cindy ; Hoek, Angela van; Evers, Eric ; Roda Husman, Annemaria de; Blaak, Hetty ; Dissel, Jaap van; Smid, Joost ; Dohmen, Wietske ; Dorado-Garcia, Alejandro ; Havelaar, Arie ; Hordijk, Joost ; Wagenaar, Jaap ; Fluit, Ad ; Bunt, Gerrita van den; Bonten, Marc ; Velthuis, Annet ; Heuvelink, Annet ; Buter, Rianne ; Gonggrijp, Maaike ; Santman-Berends, Inge ; Lam, Theo ; Urlings, Bert ; Heres, Lourens ; Bouwknecht, Martijn ; Groot, Jacques de - \ 2018
Netherlands : De Stichting TKI Agri&Food (TKI) - 73
Campylobacter epidemiology-sources and routes of transmission for human infection
Newell, Diane G. ; Mughini-Gras, Lapo ; Kalupahana, R.S. ; Wagenaar, Jaap A. - \ 2017
In: Campylobacter: Features, Detection, and Prevention of Foodborne Disease / Klein, Günter, Elsevier Inc. Academic Press - ISBN 9780128036235 - p. 85 - 110.
Campylobacter - Environment - Epidemiology - Outbreak - Reservoir - Source attribution - Subtyping - Transmission route

The identification of the sources and routes of transmission of Campylobacter jejuni/coli is essential to the prevention and control of human campylobacteriosis. However, this has proved a significant challenge over the past 35 years because these organisms were so unlike other enteric bacteria, especially Escherichia coli and Salmonella spp. Our current understanding of Campylobacter epidemiology is derived from a range of approaches, including epidemiological studies, and microbiological subtyping. These approaches indicate that poultry is the primary reservoir for campylobacters causing human disease. However, although campylobacteriosis is generally considered a foodborne disease primarily acquired through the handling and consumption of poultry meat, discrepancies between source attribution data from case-control studies and those based on subtyping strongly suggest that transmission routes through environmental exposure may be as, if not more, important.

Species composition of larvae cultured after anthelmintic treatment indicates reduced moxidectin susceptibility of immature Cylicocyclus species in horses
Kooyman, F.N. ; Doorn, D.C. van; Geurden, T. ; Mughini-Gras, Lapo ; Ploeger, Harm W. ; Wagenaar, J.A. - \ 2016
Veterinary Parasitology 227 (2016). - ISSN 0304-4017 - p. 77 - 84.
For the control of cyathostomins in horses, the macrocyclic lactones (MLs), moxidectin (MOX) and ivermectin (IVM) are the most commonly used anthelmintics. However, reduced activity, observed as shortening of the egg reappearance period (ERP) has been described. Shortening of the ERP may be caused by a decreased susceptibility of immature worms for MLs. Alternatively, immature worms may develop faster into egg producing adults as a result of repeated ML treatments. The species composition of the larval cultures obtained shortly after ML and pyrantel (PYR) treatment can confirm the hypothesis of decreased ML susceptibility, as this is often class-specific, whereas faster development would also occur after treatment with anthelmintics with a different mode of action. From 3 farms with a known history of shortened ERP, 8 horses per farm were selected and divided into 2 groups. The MOX-PYR-MOX group was treated twice with MOX (day 0 and 126) and once with PYR (day 84) and the IVM-PYR-IVM group was treated twice with IVM (day 0 and 98) and once with PYR (day 56). Cultured infective larvae (L3s) were counted and differentiated with the reverse line blot on pooled samples. Per cyathostomin species, the number of larvae per gram was calculated. The efficacy of all ML treatments was 100% and a shortened ERP was found on all 3 farms. The species composition of the larval cultures after ML treatment did not differ significantly from that after PYR treatment in the IVM-PYR-IVM group, but it did differ in the MOX-PYR-MOX group. The larval cultures obtained after MOX treatment consisted mostly of Cylicocyclus nassatus, while after PYR treatment Cylicostephanus longibursatus was the most abundant species. In the cultures from 42 days after MOX treatment 6 cyathostomin species from 3 genera were found on the farm with the lowest activity (farm 1), while on the farm with the highest activity (farm 3) only 3 species from one genus were found in the same number of examined L3s. The high numbers of L3s of Cylicocyclus species 42 days after MOX treatment and the low numbers 42 days after PYR treatment can be explained by reduced susceptibility of the immature worms to MOX, but not by a faster development. In conclusion, shortening of the ERP following MOX treatment is most likely a process in which an increasing number of immature worms from an increasing number of species is becoming less susceptible to the active compound.
Trends in Salmonella bij de mens, landbouwhuisdieren en in voedsel
Pelt, W. van; Voort, M. van der; Bouwknegt, M. ; Veldman, K.T. ; Wit, B. ; Heck, M. ; Mughini-Gras, Lapo - \ 2016
Infectieziekten bulletin 27 (2016)8. - ISSN 0925-711X - p. 243 - 250.
Sinds het begin van deze eeuw is het aantal patiënten met salmonellose meer dan gehalveerd. Een ontwikkeling die gereflecteerd wordt door de bevindingen in de surveillance van landbouwhuisdieren en van vlees in de winkel, die in dit artikel worden beschreven. De bestrijdingsprogramma’s bij landbouwhuisdieren en verbeteringen in de hygiëne van het voedselproductie proces hebben dus effect gehad. Met een incidentie in de afgelopen 3 jaar van 9,1-9,3 bevestigde salmonellosegevallen per 100.000 inwoners en naar schatting 27.000 gevallen van acute gastro-enteritis door Salmonella-infecties in de bevolking, heeft Nederland een van de laagste incidenties van Europa.
ESBL/AmpC-producing Enterobacteriaceae in households with children of preschool age: prevalence, risk factors and co-carriage
Bunt, G. van den; Liakopoulos, A. ; Mevius, D.J. ; Geurts, Y. ; Fluit, A.C. ; Bonten, M.J.M. ; Mughini-Gras, Lapo ; Pelt, W. van - \ 2016
Journal of Antimicrobial Chemotherapy 72 (2016)2. - ISSN 0305-7453 - p. 589 - 595.
Objectives ESBL/AmpC-producing Enterobacteriaceae are an emerging public health concern. As households with preschool children may substantially contribute to the community burden of antimicrobial resistance, we determined the prevalence, risk factors and co-carriage of ESBL/AmpC-producing bacteria in preschool children and their parents. Methods From April 2013 to January 2015, each month 2000 preschool children were randomly selected from Dutch population registries. The parents were invited to complete an epidemiological questionnaire and to obtain and send a faecal sample from the selected child and from one parent. Samples were tested for ESBL/AmpC-producing bacteria. Logistic regression was used to identify risk factors for ESBL/AmpC carriage in children and parents, and findings were internally validated by bootstrapping. Results In total, 1016 families were included and ESBL/AmpC prevalence was 4.0% (95% CI 3.2%–5.0%); 3.5% (95% CI 2.5%–4.8%) in children and 4.5% (95% CI 3.4%–6.0%) in parents. Attending a daycare centre (DCC) was the only significant risk factor for children (OR 2.1, 95% CI 1.0–4.3). For parents, the only significant risk factor was having one or more children attending DCCs (OR 2.2, 95% CI 1.2–4.8). For parents of ESBL/AmpC-positive children the OR for ESBL/AmpC carriage was 19.7 (95% CI 9.2–42.4). Co-carriage of specific ESBL/AmpC genotypes in child and parent occurred more often than expected by chance (14.6% versus 1.1%, P < 0.001). Conclusions In this study, intestinal carriage with ESBL/AmpCs was detected in ∼4% of households with preschool children. DCC attendance was a risk factor in both children and parents and co-carriage of specific genotypes frequently occurred in child–parent pairs. These findings suggest household transmission or/and family-specific exposure to common sources of ESBL/AmpC-producing bacteria.
Recurrent patent infections with Toxocara canis in household dogs older than six months : a prospective study
Nijsse, Rolf ; Mughini-Gras, Lapo ; Wagenaar, Jaap A. ; Ploeger, Harm W. - \ 2016
Parasites & Vectors 9 (2016)1. - ISSN 1756-3305 - 11 p.
Deworming - Dogs - Longitudinal study - Recurrent patent infections - Toxocara canis

Background: To reduce environmental contamination with Toxocara canis eggs, the current general advice is to deworm all dogs older than six months on average four times a year. However, only a small proportion of non-juvenile household dogs actually shed T. canis eggs, and some dogs shed eggs more frequently than others. The identification of these frequent shedders and the associated risk factors is an important cornerstone for constructing evidence-based deworming regimens. The purpose of this study is to identify risk factors associated with recurrence of periods of shedding Toxocara eggs in a cohort of household dogs older than six months. Methods: We performed a prospective study (July 2011 to October 2014) on shedding Toxocara eggs in a cohort of 938 household dogs older than six months from all over the Netherlands. The median follow-up time was 14 months. Monthly, owners sent faecal samples of their dogs for Toxocara testing and completed a questionnaire. Dogs were dewormed only after diagnosis of a patent infection (PI). Survival analysis was used to assess factors influencing the time to first diagnosed PIs (FPI) and the time to recurrent PIs (RPI). Results: The overall prevalence of PIs was 4.5 %, resulting in an estimated average incidence of 0.54 PIs/dog/year. No PI was diagnosed in 67.9 % of the dogs, 17.5 % of the dogs went through only one PI and 14.6 % had > 1 PI. Prevalence of PIs always peaked during wintertime. Increased hazards for first diagnosed PIs were associated with coprophagy, geophagy, walking off-leash for = 80 % of walking time, reported worms in the faeces, feeding a commercial diet and suffering from urologic or respiratory conditions. Median time to reinfection was nine months. Factors associated with increased hazards for recurrent PIs were taking corticosteroids, changing dog's main purpose, and proxies for veterinary care-seeking behaviours. Conclusions: We concluded that targeted anthelmintic treatments in household dogs may be feasible as PIs tend to (re)occur in specific periods and in groups of dogs at high risk. Moreover, recurrent PIs appear to be influenced more by factors related to impaired immunity than environmental exposure to Toxocara eggs.

Enteropathogen infections in canine puppies: (Co-)occurrence, clinical relevance and risk factors
Duijvestijn, Mirjam ; Mughini-gras, Lapo ; Schuurman, Nancy ; Schijf, Wim ; Wagenaar, Jaap A. ; Egberink, Herman - \ 2016
Veterinary Microbiology 195 (2016). - ISSN 0378-1135 - p. 115 - 122.
Laboratory confirmation of the causative agent(s) of diarrhoea in puppies may allow for appropriate treatment. The presence of potential pathogens however, does not prove a causal relationship with diarrhoea. The aim of this study was to identify specific enteropathogens in ≤12 month old puppies with and without acute diarrhoea and to assess their associations with clinical signs, putative risk factors and pathogen co-occurrence. Faecal samples from puppies with (n = 113) and without (n = 56) acute diarrhoea were collected and screened for Canine Parvovirus (CPV), Canine Coronavirus (CCoV), Salmonella spp., Campylobacter spp., Clostridium perfringens, Clostridium difficile, β-hemolytic Eschericha coli (hEC), Giardia spp., Toxocara spp., Cystoisospora spp., and Cyniclomyces guttulatus. One or more pathogens were detected in 86.5% of diarrhoeic puppies and in 77.8% of asymptomatic puppies. Significant positive associations were found between CPV and CCoV, CPV and Cystoisospora spp., Toxocara spp. and hEC, Giardia spp. and C. guttulatus. Only CPV and CCoV were significantly associated with diarrhoea, hEC with a subset of puppies that had diarrhoea and severe clinical signs. CPV was more prevalent in puppies under 3 months of age. Puppies from high-volume dog breeders were significantly at increased risk for CPV (OR 4.20), CCoV (OR 4.50) and Cystoisospora spp. (OR 3.60). CCoV occurred significantly more often in winter (OR 3.35), and CPV in winter (OR 3.78) and spring (OR 4.72) as compared to summer.

We conclude that routine screening for CPV, CCoV and hEC is recommended in puppies with acute diarrhoea, especially if they are under 3 months of age and originate from high-volume dog breeders. Routine screening for other pathogens may lead to less conclusive results.
Prevalence and risk factors for patent Toxocara infections in cats and cat owners’ attitude towards deworming
Nijsse, R. ; Ploeger, H.W. ; Wagenaar, J.A. ; Mughini-Gras, L. - \ 2016
Parasitology Research 115 (2016)12. - ISSN 0932-0113 - p. 4519 - 4525.
Cat owners - Deworming - Household cats - Public health - Risk factors - Toxocara cati

The prevalence of and risk factors for shedding Toxocara eggs in cats older than 6 months were determined by examining 670 faecal samples collected in 4 cross-sectional studies in the Netherlands. Additionally, cat owners provided information on their attitude towards routine deworming. Samples were examined using the centrifugal sedimentation flotation method. Overall Toxocara prevalence was 7.2 %. Multivariable logistic regression analysis revealed that young age and living in rural areas were significant risk factors for shedding Toxocara eggs. Moreover, the more time a cat was allowed to roam outdoors, the higher was its risk to shed Toxocara as compared to cats with no outdoor access at all. For 199 cats (81.6 % of cats subjected to a deworming regimen) owners provided the reason for treatment. The main reason for routine deworming (80.4 %) concerned the cat’s health and only 10.6 % of the cats were treated for public health reasons. Moreover, the generally advocated four-times-a-year deworming advice was applied on only 24.5 % of cats. We concluded that free roaming is a key factor in the acquisition of patent Toxocara infections leading to the environmental contamination with Toxocara eggs. Additionally, the knowledge of cat owners is still insufficient to expect them to make sound decisions on routine deworming.

Quantifying potential sources of surface water contamination with Campylobacter jejuni and Campylobacter coli
Mughini-Gras, Lapo ; Penny, Christian ; Ragimbeau, Catherine ; Schets, Franciska M. ; Blaak, Hetty ; Duim, Birgitta ; Wagenaar, Jaap A. ; Boer, Albert de; Cauchie, Henry-Michel ; Mossong, Joel ; Pelt, Wilfrid Van - \ 2016
Water Research 101 (2016). - ISSN 0043-1354 - p. 36 - 45.
campylobacter - surface water - water quality - pollution - water pollution - microbiology - wild birds - poultry - campylobacter jejuni - campylobacter coli - netherlands - luxembourg - oppervlaktewater - waterkwaliteit - verontreiniging - waterverontreiniging - microbiologie - wilde vogels - pluimvee - nederland - luxemburg
Campylobacter is the most common causative agent of human bacterial gastroenteritis and is frequently found in surface water, where it indicates recent contamination with animal faeces, sewage effluent, and agricultural run-off. The contribution of different animal reservoirs to surface water contamination with Campylobacter is largely unknown. In the Netherlands, the massive poultry culling to control the 2003 avian influenza epidemic coincided with a 44–50% reduction in human campylobacteriosis cases in the culling areas, suggesting substantial environment-mediated spread of poultry-borne Campylobacter. We inferred the origin of surface water Campylobacter jejuni and Campylobacter coli strains in Luxembourg and the Netherlands, as defined by multilocus sequence typing, by comparison to strains from poultry, pigs, ruminants, and wild birds, using the asymmetric island model for source attribution. Most Luxembourgish water strains were attributed to wild birds (61.0%), followed by poultry (18.8%), ruminants (15.9%), and pigs (4.3%); whereas the Dutch water strains were mainly attributed to poultry (51.7%), wild birds (37.3%), ruminants (9.8%), and pigs (1.2%). Attributions varied over seasons and surface water types, and geographical variation in the relative contribution of poultry correlated with the magnitude of poultry production at either the national or provincial level, suggesting that environmental dissemination of Campylobacter from poultry farms and slaughterhouses can be substantial in poultry-rich regions.
Environmental contamination with Toxocara eggs : A quantitative approach to estimate the relative contributions of dogs, cats and foxes, and to assess the efficacy of advised interventions in dogs
Nijsse, Rolf ; Mughini-Gras, Lapo ; Wagenaar, J.A. ; Franssen, Frits ; Ploeger, Harm W. - \ 2015
Parasites & Vectors 8 (2015)1. - ISSN 1756-3305
Cats - Clean-up - Contamination - Contribution - Deworming - Dogs - Eggs - Environment - Foxes - Toxocara

Background: Environmental contamination with Toxocara eggs is considered the main source of human toxocariasis. The contribution of different groups of hosts to this contamination is largely unknown. Current deworming advices focus mainly on dogs. However, controversy exists about blind deworming regimens for >6-month-old dogs, as most of them do not actually shed Toxocara eggs. We aim to estimate the contribution of different non-juvenile hosts to the environmental Toxocara egg contamination and to assess the effects of different Toxocara-reducing interventions for dogs. Methods: A stochastic model was developed to quantify the relative contribution to the environmental contamination with Toxocara eggs of household dogs, household cats, stray cats, and foxes, all older than 6 months in areas with varying urbanization degrees. The model was built upon an existing model developed by Morgan et al. (2013). We used both original and published data on host density, prevalence and intensity of infection, coprophagic behaviour, faeces disposal by owners, and cats' outdoor access. Scenario analyses were performed to assess the expected reduction in dogs' egg output according to different deworming regimens and faeces clean-up compliances. Estimates referred to the Netherlands, a country free of stray dogs. Results: Household dogs accounted for 39 % of the overall egg output of >6-month-old hosts in the Netherlands, followed by stray cats (27 %), household cats (19 %), and foxes (15 %). In urban areas, egg output was dominated by stray cats (81 %). Intervention scenarios revealed that only with a high compliance (90 %) to the four times a year deworming advice, dogs' contribution would drop from 39 to 28 %. Alternatively, when 50 % of owners would always remove their dogs' faeces, dogs' contribution would drop to 20 %. Conclusion: Among final hosts of Toxocara older than 6 months, dogs are the main contributors to the environmental egg contamination, though cats in total (i.e. both owned and stray) transcend this contribution. A higher than expected compliance to deworming advice is necessary to reduce dogs' egg output meaningfully. Actions focusing solely on household dogs and cats are unlikely to sufficiently reduce environmental contamination with eggs, as stray cats and foxes are also important contributors.

Prevalence and Risk Factors for Colonization With Extended-Spectrum Cephalosporin-Resistant Escherichia coli in Children Attending Daycare Centers: A Cohort Study in the Netherlands
Koningstein, M. ; Leenen, M.A. ; Mughini-Gras, L. ; Scholts, R.M.C. ; Huisstede-Vlaanderen, K.W. van; Enserink, R. ; Zuidema, R. ; Kooistra-Smid, M.A.M.D. ; Veldman, K.T. ; Mevius, D.J. ; Pelt, W. van - \ 2015
Journal of the Pediatric Infectious Diseases Society 4 (2015)4. - ISSN 2048-7193 - p. e93 - e99.
Background The purpose of this study was to determine the prevalence and risk factors for colonization with extended-spectrum cephalosporin-resistant (ESC-R) Escherichia coli in daycare center (DCC)-attending children. Methods This is a prospective cohort study including 44 DCCs in the Netherlands, combining DCC characteristics and monthly collected stool samples from their attendees, and was performed in 2010–2012. During a 22-month study period, 852 stool samples were collected and screened for ESC-R E coli. Risk factors were studied using logistic regression analysis. Results In DCC-attending children (<4 years old), the overall prevalence of ESC-R E coli was 4.5%, and it was 8% in <1-year-old attendees. Among the 38 children carrying ESC-R E coli, the most common types were blaCMY-2 (26%), blaCTX-M-1 (16%), and chromosomal AmpC type 3 promoter mutants (13%). Extended-spectrum cephalosporin-resistant E coli was less common in DCCs where stricter hygiene protocols were enforced, eg, not allowing ill children to enter the DCC (odds ratio [OR], 0.34; 95% confidence interval [CI], 0.14–0.84), performing extra checks on handwashing of ill children (OR, 0.42; 95% CI, 0.20–0.87), and reporting suspected outbreaks to local health authorities (OR, 0.27; 95% CI, 0.11–0.69). Conclusions The distribution of ESC-R E coli types in DCCs differs from that of the general population. Extended-spectrum cephalosporin-resistant E coli carriage in DCC-attending children is associated with the hygiene policies enforced in the DCC. Although our results are not conclusive enough to change current DCC practice beyond ensuring compliance with standing policies, they generated hypotheses and defined the degree of ESC resistance among DCC attendees, which may influence empiric antibiotic therapy choices, and tracked the increasing trend in ESC resistance.
Campylobacteriosis in returning travellers and potential secondary transmission of exocit strains.
Mughini-Gras, L. ; Smid, J.H. ; Wagenaar, J.A. ; Boer, A. de; Havelaar, A.H. ; Friesema, I.H.M. ; French, N.P. ; Graziani, C. ; Busani, L. ; Pelt, W. van - \ 2014
Epidemiology and Infection 142 (2014)6. - ISSN 0950-2688 - p. 1277 - 1288.
risk-factors - household outbreaks - salad vegetables - jejuni - netherlands - coli - infection - epidemiology - disease - identification
Multilocus sequence types (STs) were determined for 232 and 737 Campylobacter jejuni/coli isolates from Dutch travellers and domestically acquired cases, respectively. Putative risk factors for travel-related campylobacteriosis, and for domestically acquired campylobacteriosis caused by exotic STs (putatively carried by returning travellers), were investigated. Travelling to Asia, Africa, Latin America and the Caribbean, and Southern Europe significantly increased the risk of acquiring campylobacteriosis compared to travelling within Western Europe. Besides eating chicken, using antacids, and having chronic enteropathies, we identified eating vegetable salad outside Europe, drinking bottled water in high-risk destinations, and handling/eating undercooked pork as possible risk factors for travel-related campylobacteriosis. Factors associated with domestically acquired campylobacteriosis caused by exotic STs involved predominantly person-to-person contacts around popular holiday periods. We concluded that putative determinants of travel-related campylobacteriosis differ from those of domestically acquired infections and that returning travellers may carry several exotic strains that might subsequently spread to domestic populations even through limited person-to-person transmission.
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