Carriage prevalence of antimicrobial resistance in Hong Kong: a longitudinal study (abridged secondary publication)
KO Kwok1; EYY Chan1; S Riley2; B Cowling3; M Ip4
1 Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong
2 MRC Centre for Outbreak Analysis and Modelling, Department for Infectious Disease Epidemiology, Imperial College London
3 World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong
4 Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong
1. The decreasing point prevalence of extended-spectrum beta-lactamase-producing Entero-bacteriaceae (ESBL-E) in the general population from 54.8% (July 2018 to April 2019) to 43.4% (July 2019 to January 2020) suggests that the government’s population-wide effort to combat antimicrobial resistance has been effective.
2. The high proportion (29.6%) of individuals who were colonised persistently (for a mean of 42.0 weeks) with ESBL-E is worrying. This suggests potential outbreaks of infections caused by ESBL-E. More understanding on the transient nature of ESBL-E colonisation enables better implementation of prevention strategies.
3. As an additional household member increased the odds of one carrying ESBL-E persistently by 16%; future study of household transmission of ESBL-E is warranted.
4. Owing to the continual presence of methicillin-resistant Staphylococcus aureus and carbapenem-producing Enterobacteriaceae in the community, an alert system should be in place to identify carriers discharged from healthcare settings, especially when the prevalence in the community remains low.