Carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae among unaccompanied minor migrants during their first visit to the Angers University Hospital

Introduction - The prevalence of carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-producing Enterobacteriaceae) is high among refugees and asylum seekers arriving in Europe. Our objective was to study the carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae and highly antibiotic-resistant and emerging bacteria (HAREB) among unaccompanied minor migrants (UAMs) upon their arrival in Angers, as well as to identify possible clusters among these bacteria. Materials and Methods - An observational study was conducted over an 18-month period and included all UCMs arriving in Angers. Stool samples were inoculated onto selective agar media directly and after enrichment using antibiotic-supplemented broths. Resistance mechanisms were identified using various methods: combination discs, immunochromatography, and PCR. Isolates were compared using pulsed-field gel electrophoresis. Clinical and administrative data regarding the UAMs were collected. Results - A total of 139 UAMs were included in the study. Most of them (74.1%) were from Africa. The main points of arrival in Europe were the Balkans (20.1%), Italy (28.1%), and the Iberian Peninsula (38.1%). The prevalence of EBLSE was 25.7% (confidence interval: 95% CI: [18.4%–33.0%]). No BHRe was isolated. Analysis of Escherichia coli isolates by pulsed-field gel electrophoresis identified 4 clusters. Within these clusters, consideration of data regarding the travel routes of each unaccompanied minor suggested the hypothesis of EBLSE transmission after their arrival in Angers. Discussion and Conclusion - The possibility of contamination of unaccompanied minors in the first weeks following their arrival could lead to a review of the housing conditions offered to them at the start of their stay.

Author(s): Lemoine Jean-Philippe, Pasquier Charlotte, Rabier Valérie, Binder Anne-Marie, Auffray Yseult, de Gentile Ludovic, Éveillard Matthieu

Publishing year: 2022

Pages: 271-277

Weekly Epidemiological Bulletin, 2022, n° 15, p. 271-277

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