Table 3 Assessment of risk factors of ESBL/pAmpC-producing E. coli/K. pneumoniae in veterinary healthcare workers
Determinant | ESBL-E/K prevalence | ESBL-E/K status n (%) | Univariable OR (95% CI) | Multivariable OR (95% CI) | |
|---|---|---|---|---|---|
Negative (n = 435) | Positive (n = 47) | ||||
% | n (%) | n (%) | |||
Sex | |||||
Male | 12.3 | 64 (14.7) | 9 (19.2) | 1.37 (0.63–2.98) | |
Female | 9.3 | 371 (85.3) | 38 (80.9) | Ref | |
Age, years (median; IQR) | – | 38 (31–48) | 35 (29–45) | 0.98 (0.96–1.01) | |
Born in the Netherlands | 9.6 | 426 (97.9) | 45 (95.7) | 0.48 (0.10–2.27) | |
Has children (< 4 years of age) attending day-care | 7.4 | 63 (14.5) | 5 (10.6) | 0.70 (0.27–1.85) | |
Urbanisation level | |||||
Very high (≥ 2500 Addresses/km2) | 17.5 | 47 (10.8) | 10 (21.3) | 2.31 (1.01–5.28)e | |
High/moderate (1000–2500 addresses/km2) | 8.6 | 181 (41.6) | 17 (36.2) | 1.02 (0.51–2.02) | |
Low/very low (< 1000 addresses/km2) | 8.4 | 206 (47.4) | 19 (40.4) | Ref | |
Season of participation | |||||
Spring | 10.6 | 59 (13.6) | 7 (14.9) | 1.56 (0.52–4.67) | |
Summer | 10.3 | 35 (8.1) | 4 (8.5) | 1.50 (0.41–5.45) | |
Autumn | 10.4 | 249 (57.2) | 29 (61.7) | 1.53 (0.65–3.62) | |
Winter | 7.1 | 92 (21.2) | 7 (14.9) | Ref | |
Occupational animal contact | |||||
Profession | |||||
Veterinarian | 11.5 | 200 (46.0) | 26 (55.3) | 1.55 (0.82–2.95)d | |
Veterinary techniciana | 7.7 | 203 (46.7) | 17 (36.2) | Ref | |
Veterinary assistantb | 11.1 | 32 (7.4) | 4 (8.5) | 1 49 (0.47–4.72) | |
No. of animal contact hours per week (median; IQR) | – | 20 (15–30) | 25 (15–30) | 1.00 (0.98–1.03) | |
Frequent contact with companion animalsc | 9.7 | 393 (90.3) | 42 (89.4) | 0.90 (0.34–2.39) | |
Frequent contact with livestockc | 10.9 | 98 (22.5) | 12 (25.5) | 1.18 (0.59–2.36) | |
Frequent contact equinesc | 7.7 | 72 (16.6) | 6 (12.8) | 0.74 (0.30–1.80) | |
Animal contact with (last 4 weeks) | |||||
Dogs | 9.8 | 377 (86.7) | 41 (87.2) | 1.05 (0.43–2.59) | |
Cats | 9.7 | 371 (85.3) | 40 (85.1) | 0.99 (0.42–2.30) | |
Rabbits/Guinea pigs/hamsters | 9.1 | 299 (68.7) | 30 (63.8) | 0.80 (0.43–1.51) | |
Rats/mice | 10.4 | 60 (13.8) | 7 (14.9) | 1.09 (0.47–2.55) | |
Birds | 7.6 | 110 (25.3) | 9 (19.2) | 0.70 (0.33–1.49) | |
Cattle | 11.1 | 72 (16.6) | 9 (19.2) | 1.19 (0.55–2.58) | |
Sheep | 8.8 | 62 (14.3) | 6 (12.8) | 0.88 (0.36–2.16) | |
Goats | 9.1 | 50 (11.5) | 5 (10.6) | 0.92 (0.35–2.43) | |
Chicken | 9.5 | 76 (17.5) | 8 (17.0) | 0.97 (0.44–2.16) | |
Other poultry | 8.3 | 11 (2.5) | 1 (2.1) | 0.84 (0.11–6.64) | |
Pigs | 9.4 | 29 (6.7) | 3 (6.4) | 0.96 (0.28–3.26) | |
Horses | 6.4 | 88 (20.2) | 6 (12.8) | 0.58 (0.24–1.40) | |
Reptiles | 12.5 | 7 (1.6) | 1 (2.1) | 1.33 (0.16–11.04) | |
Farm visits total (last 4 weeks) | 8.3 | 66 (15.2) | 6 (12.8) | 0.82 (0.33–2.00) | |
Cattle farms | 7.7 | 48 (11.0) | 4 (8.5) | 0.75 (0.26–2.18) | |
Poultry farms (including chicken) | 12.5 | 7 (1.6) | 1 (2.1) | 1.33 (0.16–11.04) | |
Pig farms | 4.8 | 20 (4.6) | 1 (2.1) | 0.45 (0.06–3.44) | |
Sheep farms | 5.6 | 34 (7.8) | 2 (4.3) | 0.52 (0.12–2.26) | |
Goat farms | 10.3 | 26 (6.0) | 3 (6.4) | 1.07 (0.31–3.69) | |
Hand washing frequency after patient contact | |||||
(Almost) always | 10.2 | 289 (66.4) | 33 (70.2) | Ref | |
Regularly/sometimes | 8.7 | 137 (31.5) | 13 (27.7) | 0.83 (0.42–1.63) | |
(Almost) never | 16.7 | 5 (1.2) | 1 (2.1) | 1.75 (0.20–15.45) | |
Occupation of household member | |||||
Profession with animal contact | 10.3 | 70 (16.1) | 8 (17.0) | 1.07 (0.48–2.39) | |
Farmer/farm employee | 9.1 | 10 (2.3) | 1 (2.1) | 0.92 (0.12–7.38) | |
Veterinarian | 7.5 | 37 (8.5) | 3 (6.4) | 0.73 (0.22–2.48) | |
Veterinary assistant/technician | 11.1 | 8 (1.8) | 1 (2.1) | 1.16 (0.14–9.49) | |
Healthcare professional | 9.4 | 29 (6.7) | 3 (6.4) | 0.96 (0.28–3.26) | |
Physician | 9.1 | 10 (2.3) | 1 (2.1) | 0.92 (0.12–7.38) | |
Nurse | 33.3 | 4 (0.9) | 2 (4.3) | 4.79 (0.85–26.88)d | |
Animal contact at home | |||||
Owning a pet or hobby farm animal | 10.1 | 275 (63.2) | 31 (66.0) | 1.13 (0.60–2.13) | |
Owning dog(s) | 7.4 | 163 (37.5) | 13 (27.7) | 0.64 (0.33–1.24)d | |
Owning cats(s) | 9.8 | 166 (38.2) | 18 (38.3) | 1.01 (0.54–1.87) | |
Owning rabbit(s)/Guinea pig(s)/hamster(s) | 5.1 | 75 (17.2) | 4 (8.5) | 0.45 (0.16–1.28)d | |
Owning rat(s)/mouse/mice | 14.3 | 6 (1.4) | 1 (2.1) | 1.55 (0.18–13.19) | |
Owning bird(s) | 8.8 | 31 (7.1) | 3 (6.4) | 0.89 (0.26–3.03) | |
Owning cow(s) | 14.3 | 6 (1.4) | 1 (2.1) | 1.55 (0.18–13.19) | |
Owning sheep | 9.1 | 20 (4.6) | 2 (4.3) | 0.92 (0.21–4.08) | |
Owning chicken | 9.1 | 70 (16.1) | 7 (14.9) | 0.91 (0.39–2.12) | |
Owning horse(s) | 9.5 | 57 (13.1) | 6 (12.8) | 0.97 (0.39–2.39) | |
Owns companion animal that eats raw meat | 6.3 | 30 (6.9) | 2 (4.3) | 0.56 (0.13–2.48) | |
Health and medication use | |||||
Hospitalized in Dutch hospital (last 6 months) | 12.5 | 14 (3.2) | 2 (4.3) | 1.34 (0.30–6.07) | |
Proton pump inhibitor use (last 6 months) | 14.1 | 55 (12.6) | 9 (19.2) | 1.64 (0.75–3.57) | |
Antibiotic use | |||||
Last 6 months | 11.5 | 77 (17.7) | 10 (21.3) | 1.26 (0.60–2.64) | |
Last 3 months | 5.6 | 51 (11.7) | 3 (6.4) | 0.51 (0.15–1.71) | |
Medication use (last 6 months) | |||||
ADHD medication | 40.0 | 3 (0.7) | 2 (4.3) | 6.39 (1.04–39.23)e | |
Oral contraceptives | 10.4 | 112 (25.8) | 13 (27.7) | 1.10 (0.56–2.16) | |
Antidepressants | 10.0 | 18 (4.1) | 2 (4.3) | 1.03 (0.23–4.57) | |
Sleeping pills/tranquilizers | 13.9 | 31 (7.1) | 5 (10.6) | 1.55 (0.57–4.19) | |
Antihypertensive agents | 13.6 | 19 (4.4) | 3 (6.4) | 1.49 (0.42–5.23) | |
Statins | 14.3 | 6 (1.4) | 1 (2.1) | 1.55 (0.18–13.16) | |
Laxatives | 10.0 | 9 (2.1) | 1 (2.1) | 1.03 (0.13–8.29) | |
Stomach and/or bowel disease | |||||
Acid reflux | 16.7 | 35 (8.1) | 7 (14.9) | 2.00 (0.83–4.79)d | |
Irritable bowel syndrome | 8.8 | 52 (12.0) | 5 (10.6) | 0.88 (0.33–2.32) | |
Crohn’s disease | 50.0 | 2 (0.5) | 2 (4.3) | 9.62 (1.32–69.96)e | |
Stomach and/or bowel complaints (last 4 weeks) | 14.4 | 161 (37.0) | 27 (57.5) | 2.30 (1.25–4.23)e | 2.18 (1.17–4.06) |
Leisure activities | |||||
Travel (last 6 months) | |||||
No travel, travel to Western/Northern Europe, North America, Australia or New Zeeland | 6.8 | 247 (56.8) | 18 (38.3) | Ref | Ref |
Travel to Southern/Eastern Europe | 8.1 | 137 (31.5) | 12 (25.5) | 1.20 (0.56–2.57) | 1.24 (0.58–2.66) |
Travel to Africa, Asia or Latin America | 25.0 | 51 (11.7) | 17 (36.2) | 4.57 (2.21–9.47)e | 4.41 (2.11–9.19) |
Swimming in fresh water (last 6 months) | 9.0 | 183 (42.1) | 18 (38.3) | 0.86 (0.46–1.59) | |
Swimming in salt water (last 6 months) | 13.7 | 170 (39.1) | 27 (57.5) | 2.10 (1.14–3.87)e | |
Used animal manure (last 6 months) | 9.1 | 80 (19.4) | 8 (19.5) | 0.99 (0.44–2.23) | |
Diet and hygiene | |||||
Diet | |||||
Vegetarian | 4.8 | 20 (4.6) | 1 (2.1) | 0.47 (0.06–3.58) | |
Non-vegetarian | 9.6 | 403 (92.6) | 43 (91.5) | Ref | |
Pescatarian | 20.0 | 12 (2.8) | 3 (6.4) | 2.34 (0.64–8.63) | |
Hand washing frequency before food preparation | |||||
(Almost) always | 10.2 | 229 (52.6) | 26 (55.3) | Ref | |
Regularly/sometimes | 8.7 | 179 (41.2) | 17 (36.2) | 0.84 (0.44–1.59) | |
(Almost) never | 12.9 | 27 (6.2) | 4 (8.5) | 1.31 (0.42–4.02) | |
Hand washing frequency after toilet use | |||||
(Almost) always | 10.4 | 250 (57.5) | 29 (61.7) | Ref | |
Regularly/sometimes | 8.6 | 170 (39.1) | 16 (34.0) | 0.81 (0.43–1.54) | |
(Almost) never | 11.8 | 15 (3.5) | 2 (4.3) | 1.15 (0.25–5.28) | |
Uses dishcloth/scourer for more than 1 day | 11.6 | 237 (54.5) | 31 (66.0) | 1.62 (0.86–3.05)d | |