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Background The best strategy to control ESBL-producing Escherichia coli (ESBL-EC) spread in the community is lacking.
Methods We developed an individual-based transmission model to evaluate the impact of hand hygiene (HH) improvement and reduction in antibiotic use on the within-household transmission of ESBL-EC. We used data from the literature and incorporated key elements of ESBL-EC transmission such as the frequency and nature of contacts among household members, antibiotic use in the community and hand hygiene behaviour. We introduced in a household a single ESBL-EC colonised person and simulated the transmission dynamics of ESBL-EC over a one-year time horizon.
Results The probability of ESBL-EC transmission depended on the household composition and the profile of the initial carrier. In the two-person household, the probability of ESBL-EC transmission was 5.3% (95% CI 5.0-5.6) or 6.6% (6.3-6.9) when the index person was a woman or a man, respectively. In a four-person household, the probability of transmission varied from 61.4% (60.9-62.0) to 68.8% (68.3- 69.3) and was the highest when the index patient was the baby. Improving HH by 50% reduced the probability of transmission by 33-62%. Antibiotic restriction by 50% reduced the transmission by 2-6%.
Conclusions The transmission of ESBL-EC is frequent in households and especially those with a baby. Antibiotic reduction had little impact on ESBL-EC. Improvement of hygiene in the community could help prevent transmission of ESBL-EC.
Keywords
extended-spectrum β-lactamase-producing E. coli, household, control, mathematical model
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View the published article at Antimicrobial Resistance and Infection Control.
Version 2
Posted 28 Jul, 2020
No community comments so far
Review #2 received
Received 10 Aug, 2020
Editorial decision: Accept
On 10 Aug, 2020
Reviewer #2 agreed
On 27 Jul, 2020
Editor assigned
On 23 Jul, 2020
Reviewers invited
Invitations sent on 23 Jul, 2020
Reviewer #1 agreed
On 23 Jul, 2020
Review #1 received
Received 23 Jul, 2020
Submission checks complete
On 22 Jul, 2020
Editor invited
On 22 Jul, 2020
No comments provided
Review #2 received
Received 15 Jun, 2020
Editorial decision: Major revision
On 15 Jun, 2020
Reviewer #2 agreed
On 08 Jun, 2020
Review #1 received
Received 08 Jun, 2020
Reviewer #1 agreed
On 27 May, 2020
Editor assigned
On 26 May, 2020
Reviewers invited
Invitations sent on 26 May, 2020
Editor invited
On 25 May, 2020
Submission checks complete
On 15 May, 2020
First submitted
On 13 May, 2020
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See the published version of this preprint at Antimicrobial Resistance and Infection Control.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Antimicrobial Resistance and Infection Control.
Version 2
Posted 28 Jul, 2020
No community comments so far
Review #2 received
Received 10 Aug, 2020
Editorial decision: Accept
On 10 Aug, 2020
Reviewer #2 agreed
On 27 Jul, 2020
Editor assigned
On 23 Jul, 2020
Reviewers invited
Invitations sent on 23 Jul, 2020
Reviewer #1 agreed
On 23 Jul, 2020
Review #1 received
Received 23 Jul, 2020
Submission checks complete
On 22 Jul, 2020
Editor invited
On 22 Jul, 2020
No comments provided
Review #2 received
Received 15 Jun, 2020
Editorial decision: Major revision
On 15 Jun, 2020
Reviewer #2 agreed
On 08 Jun, 2020
Review #1 received
Received 08 Jun, 2020
Reviewer #1 agreed
On 27 May, 2020
Editor assigned
On 26 May, 2020
Reviewers invited
Invitations sent on 26 May, 2020
Editor invited
On 25 May, 2020
Submission checks complete
On 15 May, 2020
First submitted
On 13 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Antimicrobial Resistance and Infection Control.
Background The best strategy to control ESBL-producing Escherichia coli (ESBL-EC) spread in the community is lacking.
Methods We developed an individual-based transmission model to evaluate the impact of hand hygiene (HH) improvement and reduction in antibiotic use on the within-household transmission of ESBL-EC. We used data from the literature and incorporated key elements of ESBL-EC transmission such as the frequency and nature of contacts among household members, antibiotic use in the community and hand hygiene behaviour. We introduced in a household a single ESBL-EC colonised person and simulated the transmission dynamics of ESBL-EC over a one-year time horizon.
Results The probability of ESBL-EC transmission depended on the household composition and the profile of the initial carrier. In the two-person household, the probability of ESBL-EC transmission was 5.3% (95% CI 5.0-5.6) or 6.6% (6.3-6.9) when the index person was a woman or a man, respectively. In a four-person household, the probability of transmission varied from 61.4% (60.9-62.0) to 68.8% (68.3- 69.3) and was the highest when the index patient was the baby. Improving HH by 50% reduced the probability of transmission by 33-62%. Antibiotic restriction by 50% reduced the transmission by 2-6%.
Conclusions The transmission of ESBL-EC is frequent in households and especially those with a baby. Antibiotic reduction had little impact on ESBL-EC. Improvement of hygiene in the community could help prevent transmission of ESBL-EC.
Figure 1
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