{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T08:54:28Z","timestamp":1784796868087,"version":"3.55.0"},"reference-count":27,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"unspecified","delay-in-days":257,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007192","name":"Rijksinstituut voor Volksgezondheid en Milieu","doi-asserted-by":"publisher","award":["325911"],"award-info":[{"award-number":["325911"]}],"id":[{"id":"10.13039\/501100007192","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003221","name":"Agentschap NL","doi-asserted-by":"publisher","award":["DGNR-RRE\/14191181"],"award-info":[{"award-number":["DGNR-RRE\/14191181"]}],"id":[{"id":"10.13039\/501100003221","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>The global prevalence and spread of multidrug-resistant organisms (MDROs) represent an emerging public health threat. Day care centre (DCC) attendance is a risk factor for MDRO carriage in children and their environment. This study aimed to map the epidemiology of carriage and potential transmission of these organisms within 18 Flemish DDCs (Belgium). An MDRO prevalence survey was organised between November 2018 and February 2019 among children attending the centres. Selective chromogenic culture media were used for the detection of extended-spectrum beta-lactamase-producing <jats:italic>Enterobacterales<\/jats:italic> (ESBL-E), carbapenemase-producing <jats:italic>Enterobacterales<\/jats:italic> (CPE), and vancomycin-resistant Enterococci (VRE) in faecal swabs obtained from diapers or jars (n\u00a0=\u00a0448). All isolated MDROs were subjected to resistance gene sequencing. A total of 71 of 448 samples (15.8%) yielded isolates of ESBL-E with a predominance of <jats:italic>Escherichia coli<\/jats:italic> (92.2% of ESBL-E) and ESBL resistance gene bla<jats:sub>CTX-M-15<\/jats:sub> (50.7% of ESBL coding genes in <jats:italic>E. coli<\/jats:italic>). ESBL-E prevalence varied between DCCs, ranging from 0 to 50%. Transmission, based on the clonal relatedness of ESBL-E strains, was observed. CPE was identified in only one child carrying an <jats:italic>E. coli<\/jats:italic> with an OXA-244 gene. VRE was absent from all samples. The observed prevalence of ESBL-E in Flemish DCCs is high compared with previous studies, and our findings re-emphasise the need for rigorous hygiene measures within such centres to control the further spread of MDROs in the community.<\/jats:p>","DOI":"10.1017\/s0950268823001528","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T07:05:36Z","timestamp":1694761536000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":5,"title":["Epidemiology and molecular typing of multidrug-resistant bacteria in day care centres in Flanders, Belgium"],"prefix":"10.1017","volume":"151","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9500-3674","authenticated-orcid":false,"given":"Stefanie","family":"van Kleef \u2013 van Koeveringe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2137-2068","authenticated-orcid":false,"given":"Veerle","family":"Matheeussen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilde","family":"Jansens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natascha","family":"Perales Selva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0685-7553","authenticated-orcid":false,"given":"Dieter","family":"De Coninck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7105-3001","authenticated-orcid":false,"given":"Katrien","family":"De Bruyne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9859-8589","authenticated-orcid":false,"given":"Klaas","family":"Mensaert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6576-6408","authenticated-orcid":false,"given":"Marjolein","family":"Kluytmans - van den Bergh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Kluytmans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman","family":"Goossens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter","family":"Dhaeze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the i-4-1-Health Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"S0950268823001528_r13","doi-asserted-by":"publisher","DOI":"10.20944\/preprints201912.0216.v1"},{"key":"S0950268823001528_r12","first-page":"93","article-title":"Prevalence and risk factors for colonization with extended-spectrum cephalosporin-resistant Escherichia coli in children attending daycare centers: A cohort study in the Netherlands","volume":"4","author":"Koningstein","year":"2015","journal-title":"Journal of the Pediatric Infectious Diseases Society"},{"key":"S0950268823001528_r9","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00016-17"},{"key":"S0950268823001528_r1","doi-asserted-by":"publisher","DOI":"10.2900\/93403"},{"key":"S0950268823001528_r2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw443"},{"key":"S0950268823001528_r17","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btx106"},{"key":"S0950268823001528_r20","doi-asserted-by":"publisher","DOI":"10.3201\/eid2011.131845"},{"key":"S0950268823001528_r21","unstructured":"[21] Latour, K (2018) Surveillance of antimicrobial resistant bacteria in Belgian hospitals. Brussels. https:\/\/www.sciensano.be\/en\/biblio\/surveillance-antimicrobial-resistant-bacteria-belgian-hospitals-report-2018"},{"key":"S0950268823001528_r15","unstructured":"[15] Martinez, L and Simonsen, GS (2017) EUCAST detection of resistance mechanisms 170711, pp. 1\u201343. http:\/\/www.eucast.org\/clinical_breakpoints\/."},{"key":"S0950268823001528_r23","unstructured":"[23] European Centre for Disease Prevention and Control (2020) Increase in OXA-244-producing Escherichia coli in the European Union\/European Economic Area and the UK since 2013. Published online. https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/RRA-E-coli-OXA-244-producing-E-coli-EU-EEA-UK-since-2013.pdf"},{"key":"S0950268823001528_r25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2020.106157"},{"key":"S0950268823001528_r5","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.154.2.180"},{"key":"S0950268823001528_r4","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.epirev.a017913"},{"key":"S0950268823001528_r3","doi-asserted-by":"publisher","DOI":"10.2223\/JPED.1649"},{"key":"S0950268823001528_r8","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00262-14"},{"key":"S0950268823001528_r10","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro3093"},{"key":"S0950268823001528_r7","first-page":"1","article-title":"Typing methods used in the molecular epidemiology of microbial pathogens: A how-to guide","volume":"37","author":"Ranjbar","year":"2014","journal-title":"New Microbiologica"},{"key":"S0950268823001528_r16","doi-asserted-by":"publisher","DOI":"10.1099\/mgen.0.000567"},{"key":"S0950268823001528_r19","doi-asserted-by":"publisher","DOI":"10.1186\/s12864-018-4976-3"},{"key":"S0950268823001528_r22","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00818-17"},{"key":"S0950268823001528_r18","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2016.12.035"},{"key":"S0950268823001528_r26","first-page":"e00102","article-title":"The global ascendency of OXA-48-type carbapenemases","volume":"33","author":"Pitout","year":"2020","journal-title":"Clinical Microbiology Reviews"},{"key":"S0950268823001528_r14","unstructured":"[14] EUCAST (2018) European committee on antimicrobial susceptibility testing breakpoint tables for interpretation of MICs and zone diameters. 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Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e156"}}