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dc.contributor.authorRaffelsberger, Niclas Peter
dc.contributor.authorBuczek, Dorota Julia
dc.contributor.authorSvendsen, Kristian
dc.contributor.authorSmåbrekke, Lars
dc.contributor.authorPöntinen, Anna Kaarina
dc.contributor.authorLöhr, Iren Høyland
dc.contributor.authorAndreassen, Lotte Leonore Eivindsdatter
dc.contributor.authorSimonsen, Gunnar Skov
dc.contributor.authorSundsfjord, Arnfinn Ståle
dc.contributor.authorGravningen, Kirsten
dc.contributor.authorSamuelsen, Ørjan
dc.date.accessioned2023-11-14T09:32:59Z
dc.date.available2023-11-14T09:32:59Z
dc.date.issued2023-06-12
dc.description.abstractThe global prevalence of infections caused by extended-spectrum βlactamase-producing Enterobacterales (ESBL-E) is increasing, and for Escherichia coli, observations indicate that this is partly driven by community-onset cases. The ESBL-E population structure in the community is scarcely described, and data on risk factors for carriage are conflicting. Here, we report the prevalence and population structure of fecal ESBL-producing E. coli and Klebsiella pneumoniae (ESBL-Ec/Kp) in a general adult population, examine risk factors, and compare carriage isolates with contemporary clinical isolates. Fecal samples obtained from 4,999 participants (54% women) ≥40 years in the seventh survey of the population-based Tromsø Study, Norway (2015, 2016), were screened for ESBL-Ec/Kp. In addition, we included 118 ESBL-Ec clinical isolates from the Norwegian surveillance program in 2014. All isolates were wholegenome sequenced. Risk factors associated with carriage were analyzed using multivariable logistic regression. ESBL-Ec gastrointestinal carriage prevalence was 3.3% [95% confidence interval (CI) 2.8%–3.9%, no sex difference] and 0.08% (0.02%–0.20%) for ESBL-Kp. For ESBL-Ec, travel to Asia was the only independent risk factor (adjusted odds ratio 3.46, 95% CI 2.18–5.49). E. coli ST131 was most prevalent in both collections. However, the ST131 proportion was significantly lower in carriage (24%) versus clinical isolates (58%, P < 0.001). Carriage isolates were genetically more diverse with a higher proportion of phylogroup A (26%) than clinical isolates (5%, P < 0.001), indicating that ESBL gene acquisition occurs in a variety of E. coli lineages colonizing the gut. STs commonly related to extraintestinal infections were more frequent in clinical isolates also carrying a higher prevalence of antimicrobial resistance, which could indicate clone-associated pathogenicity.en_US
dc.identifier.citationRaffelsberger, Buczek, Svendsen, Småbrekke, Pöntinen, Löhr, Andreassen, Simonsen, Sundsfjord, Gravningen, Samuelsen. Community carriage of ESBL-producing Escherichia coli and Klebsiella pneumoniae: a cross-sectional study of risk factors and comparative genomics of carriage and clinical isolates. mSphere. 2023;8(4)en_US
dc.identifier.cristinIDFRIDAID 2185863
dc.identifier.doi10.1128/msphere.00025-23
dc.identifier.issn2379-5042
dc.identifier.urihttps://hdl.handle.net/10037/31754
dc.language.isoengen_US
dc.publisherAmerican Society for Microbiologyen_US
dc.relation.journalmSphere
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleCommunity carriage of ESBL-producing Escherichia coli and Klebsiella pneumoniae: a cross-sectional study of risk factors and comparative genomics of carriage and clinical isolatesen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Med mindre det står noe annet, er denne innførselens lisens beskrevet som Attribution 4.0 International (CC BY 4.0)