Kalisvar MarimuthuYin MoMoi Lin LingAnastasia Hernandez-KoutouchevaShannon N. FenlonDenis BertrandDavid Chien LyeBrenda Sze Peng AngEli PerencevichOon Tek NgBen S. CooperNiranjan NagarajanSwaine L. ChenTimothy BarkhamNational Centre for Infectious DiseasesFaculty of Tropical Medicine, Mahidol UniversityNational University HospitalA-Star, Genome Institute of SingaporeNUS Yong Loo Lin School of MedicineSingapore General HospitalUniversity of Iowa Carver College of MedicineNuffield Department of MedicineNanyang Technological UniversityTan Tock Seng Hospital2022-08-042022-08-042021-05-01Journal of Antimicrobial Chemotherapy. Vol.76, No.5 (2021), 1299-130214602091030574532-s2.0-85104900020https://repository.li.mahidol.ac.th/handle/20.500.14594/78249Objectives: To estimate the transmission rate of carbapenemase-producing Enterobacteriaceae (CPE) in households with recently hospitalized CPE carriers. Methods: We conducted a prospective case-ascertained cohort study. We identified the presence of CPE in stool samples from index subjects, household contacts and companion animals and environmental samples at regular intervals. Linked transmissions were identified by WGS. A Markov model was constructed to estimate the household transmission potential of CPE. Results: Ten recently hospitalized index patients and 14 household contacts were included. There were seven households with one contact, two households with two contacts, and one household with three contacts. Index patients were colonized with blaOXA-48-like (n=4), blaKPC-2 (n=3), blaIMP (n=2), and blaNDM-1 (n=1), distributed among divergent species of Enterobacteriaceae. After a cumulative follow-up time of 9.0 years, three family members (21.4%, 3/14) acquired four different types of CPE in the community (hazard rate of 0.22/year). The probability of CPE transmission from an index patient to a household contact was 10% (95% CI 4%-26%). Conclusions: We observed limited transmission of CPE from an index patient to household contacts. Larger studies are needed to understand the factors associated with household transmission of CPE and identify preventive strategies.Mahidol UniversityMedicinePharmacology, Toxicology and PharmaceuticsArticleSCOPUS10.1093/jac/dkaa561