TY - JOUR
T1 - High carriage of ESBL-producing Enterobacteriaceae associated with sexual activity among men who have sex with men
AU - van Bilsen, Ward P. H.
AU - van Dulm, Eline
AU - Matser, Amy
AU - Linde, Ineke
AU - van Duijnhoven, Yvonne T. H. P.
AU - Prins, Jan M.
AU - Prins, Maria
AU - Boyd, Anders
AU - van Dam, Alje P.
N1 - Funding Information: The authors gratefully acknowledge the ACS on HIV Infection and AIDS, a collaboration between the Public Health Service of Amsterdam, the Amsterdam UMC Location AMC, Sanquin Blood Supply Foundation, Medical Centre Jan van Goyen and the HIV Focus Centre of the DC Clinics. It is part of the Netherlands HIV Monitoring Foundation and supported financially by the Centre for Infectious Disease Control of the Netherlands National Institute for Public Health and the Environment. The authors wish to thank all ACS participants for their contribution, as well as the ACS study nurses (Leeann Storey and Samantha de Graaf), data managers and laboratory technicians. Funding: None. Competing interests: None declared. Ethical approval: The Medical Ethical Committee of the Amsterdam UMC approved the ACS (NL49748.018.14). Participation is voluntary and each participant gave written informed consent at study enrollment. Funding Information: The authors gratefully acknowledge the ACS on HIV Infection and AIDS, a collaboration between the Public Health Service of Amsterdam, the Amsterdam UMC Location AMC, Sanquin Blood Supply Foundation, Medical Centre Jan van Goyen and the HIV Focus Centre of the DC Clinics. It is part of the Netherlands HIV Monitoring Foundation and supported financially by the Centre for Infectious Disease Control of the Netherlands National Institute for Public Health and the Environment. The authors wish to thank all ACS participants for their contribution, as well as the ACS study nurses (Leeann Storey and Samantha de Graaf), data managers and laboratory technicians. Publisher Copyright: © 2021 Elsevier Ltd Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/3
Y1 - 2021/3
N2 - Background: Extended-spectrum β-lactamase Enterobacteriaceae (ESBL-E) may be sexually transmitted. Men who have sex with men (MSM) have different sexual behaviour than the general population, and thus may be at risk for ESBL-E carriage. This study determined the prevalence of ESBL-E carriage and its association with sexual behaviour among MSM in Amsterdam, The Netherlands. Materials and methods: In total, 583 HIV-positive and HIV-negative MSM from the Amsterdam Cohort Study were screened for rectal ESBL-E carriage between April and December 2018. Participants completed a self-administered questionnaire on (sexual) behaviour and risk factors for antimicrobial resistance. The proportion of the study population with ESBL-E carriage was compared by number of sexual partners using logistic regression, and across clusters of sexual behaviours with steady and casual partners, separately, using latent class analyses; all results were adjusted for recent use of antibiotics, travel and hospitalization. Results: Overall, 16.3% [95% confidence interval (CI) 13.4–19.5] of the study population tested positive for ESBL-E. The odds of ESBL-E carriage increased as number of sexual partners increased [adjusted odds ratio per ln(partner+1), 1.57, 95% CI 1.26–1.94; P<0.001]. There was no association between ESBL-E carriage and sexual behaviour with steady partner(s). Compared with participants in the ‘no sex with casual partner(s)’ cluster, adjusted odds of being ESBL-E positive were 2.95-fold higher (95% CI 1.52–5.80) for participants in the ‘rimming and frottage’ cluster (P=0.001) and 2.28-fold higher (95% CI 0.98–5.31) for participants in the ‘toy use and fisting’ cluster (P=0.056). Conclusions: The prevalence of ESBL-E in MSM is higher compared with the overall Dutch population, likely due to sexual transmission with casual partners. This implies that sexually active MSM should be considered a risk group for ESBL-E carriage.
AB - Background: Extended-spectrum β-lactamase Enterobacteriaceae (ESBL-E) may be sexually transmitted. Men who have sex with men (MSM) have different sexual behaviour than the general population, and thus may be at risk for ESBL-E carriage. This study determined the prevalence of ESBL-E carriage and its association with sexual behaviour among MSM in Amsterdam, The Netherlands. Materials and methods: In total, 583 HIV-positive and HIV-negative MSM from the Amsterdam Cohort Study were screened for rectal ESBL-E carriage between April and December 2018. Participants completed a self-administered questionnaire on (sexual) behaviour and risk factors for antimicrobial resistance. The proportion of the study population with ESBL-E carriage was compared by number of sexual partners using logistic regression, and across clusters of sexual behaviours with steady and casual partners, separately, using latent class analyses; all results were adjusted for recent use of antibiotics, travel and hospitalization. Results: Overall, 16.3% [95% confidence interval (CI) 13.4–19.5] of the study population tested positive for ESBL-E. The odds of ESBL-E carriage increased as number of sexual partners increased [adjusted odds ratio per ln(partner+1), 1.57, 95% CI 1.26–1.94; P<0.001]. There was no association between ESBL-E carriage and sexual behaviour with steady partner(s). Compared with participants in the ‘no sex with casual partner(s)’ cluster, adjusted odds of being ESBL-E positive were 2.95-fold higher (95% CI 1.52–5.80) for participants in the ‘rimming and frottage’ cluster (P=0.001) and 2.28-fold higher (95% CI 0.98–5.31) for participants in the ‘toy use and fisting’ cluster (P=0.056). Conclusions: The prevalence of ESBL-E in MSM is higher compared with the overall Dutch population, likely due to sexual transmission with casual partners. This implies that sexually active MSM should be considered a risk group for ESBL-E carriage.
KW - Antimicrobial resistance
KW - ESBL
KW - Men who have sex with men
KW - Sexual activity
KW - Transmission
UR - http://www.scopus.com/inward/record.url?scp=85100693145&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ijantimicag.2021.106276
DO - https://doi.org/10.1016/j.ijantimicag.2021.106276
M3 - Article
C2 - 33434675
SN - 0924-8579
VL - 57
JO - International Journal of Antimicrobial Agents
JF - International Journal of Antimicrobial Agents
IS - 3
M1 - 106276
ER -