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@ARTICLE{Gpel:296166,
      author       = {S. Göpel and J. Guther and B. P. Gladstone and N.
                      Conzelmann and S. Bunk and T. Terzer$^*$ and T. D.
                      Verschuuren and D. Martak and E. Salamanca and I. B.
                      Autenrieth and S. Peter and J. A. J. W. Kluytmans and D.
                      Hocquet and J. Rodriguez-Baño and E. Tacconelli},
      collaboration = {M. W. s. group},
      othercontributors = {S. Eisenbeis and F. Hölzl and A. Pascual and R. Medina and
                          A. Fluit},
      title        = {{D}rivers of extended spectrum β-lactamase
                      ({ESBL})-producing {E}nterobacterales colonization among
                      residents of long-term health care facilities: a {E}uropean
                      multicentric prospective cohort study.},
      journal      = {The journal of hospital infection},
      volume       = {157},
      issn         = {0195-6701},
      address      = {Kidlington [u.a.]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2025-00093},
      pages        = {67-74},
      year         = {2025},
      note         = {2025 Jan 7:157:67-74},
      abstract     = {ESBL-producing Enterobacterales (ESBL-PE) are highly
                      prevalent in long-term healthcare (LTCF) settings. In order
                      to estimate the acquisition rate of ESBL-producing
                      Escherichia coli and Klebsiella pneumoniae in LTCF settings
                      and identify clinical and environmental risk factors, a
                      multicentric, prospective cohort study was conducted in six
                      LTCFs in Germany, France, Spain and the
                      Netherlands.Longitudinal screening of residents was
                      performed over 32 weeks, collecting epidemiological and
                      clinical data and environmental samples. The primary outcome
                      was rate of new acquisition of ESBL-PE among LTCF residents.
                      Molecular epidemiology was studied using whole genome
                      sequencing and risk factor analyses using logistic and
                      Poisson regression models.299 residents provided 1958
                      samples during follow-up. Prevalence of ESBL-PE colonization
                      at baseline was $16.4\%,$ incidence rate of acquisition was
                      0.79 per 1000 resident-days, both with high variability
                      among centres. Age ≥80 years, vascular disease, and
                      antibiotic consumption within one year were risk factors for
                      baseline colonization. Lack of hand sanitizers and low nurse
                      to resident ratio were associated with colonization.
                      Presence of medical devices was associated with risk of
                      acquisition. Vascular disease, hemiplegia, antibiotic
                      consumption, and non-availability of private bathrooms were
                      associated with multiple ST carriage. Prevalence of ESBL-PE
                      among environmental samples was $2\%,$ exclusively in
                      centres with high prevalence among residents. Genetic
                      analysis showed a high prevalence of ST10 E. coli and ST405
                      K. pneumoniae at two study sites.Infection prevention
                      including availability of hand sanitizers, the number of
                      nurses per resident, and antimicrobial stewardship
                      interventions constitute important measures to control
                      ESBL-PE in LTCFs. Genome-based surveillance could guide
                      targeted interventions.},
      keywords     = {ESBL producing Enterobacterales (Other) / acquisition
                      (Other) / colonization (Other) / long-term care facility
                      (Other) / molecular epidemiology (Other)},
      cin          = {C060},
      ddc          = {610},
      cid          = {I:(DE-He78)C060-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39788455},
      doi          = {10.1016/j.jhin.2024.12.010},
      url          = {https://inrepo02.dkfz.de/record/296166},
}