scholarly journals Escherichia coli Antibiotic Susceptibility Patterns for Infants Admitted to NICUs Across the United States from 2009 to 2017

2020 ◽  
Vol 41 (S1) ◽  
pp. s34-s35
Author(s):  
Dustin Flannery ◽  
Ibukun Akinboyo ◽  
Sagori Mukhopadhyay ◽  
Alison Tribble ◽  
Lihai Song ◽  
...  
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
Antibiotic Susceptibility ◽  
Antibiotic Prescription ◽  
The United States ◽  
E Coli ◽  
Empiric Antibiotic ◽  
Antibiotic Susceptibility Patterns ◽  
Susceptibility Patterns ◽  
Over Time

Background:Escherichia coli (E. coli) is a leading cause of infections among term and preterm newborn infants. Continued surveillance of neonatal E. coli antibiotic susceptibility patterns is important to optimize empiric antibiotic prescription for infants at risk for infection, in light of evolving reports of multidrug-resistant gram-negative bacteria in all settings. Our objective was to determine E. coli epidemiology and antibiotic susceptibility patterns among a large sample of infants admitted to neonatal intensive care units (NICUs) across the United States from 2009 to 2017. Methods: Retrospective observational study using the Premier Database, including infants born from 2009 to 2017 and admitted to academic or community NICUs contributing microbiology data during the study period. We analyzed antibiotic susceptibilities for E. coli isolated from blood, cerebrospinal fluid, and urine. We focused on clinically relevant and priority susceptibility categories: (1) ampicillin nonsusceptible; (2) aminoglycoside nonsusceptible; (3) carbapenem nonsusceptible; and (4) extended-spectrum β-lactamase (ESBL; phenotypic definition). We determined the proportion of infants with nonsusceptible organisms in each category by year and tested for changes over time. Lastly, we assessed susceptibility patterns by specimen source, birthweight, and timing of infection. Results: Of the 117,484 included infants, 733 (0.6%) had at least 1 E. coli episode, of which 721 (98.4%) had available susceptibility results, from 69 centers. Patient and center characteristics of infants with E. coli are shown in Table 1. Most organisms were tested against ampicillin (99.9%), gentamicin (99.6%), and ceftriaxone (91.5%). Figure 1 shows nonsusceptibility rates for the categories of interest. Overall, ampicillin nonsusceptibility ranged from 63.3% to 68.6% per year (mean, 66.8%±1.5%); aminoglycoside nonsusceptibility ranged from 10.7% to 23.2% (mean, 16.8%±4.5%); carbapenem nonsusceptibility was 0% for all years; and ESBL ranged from 1.2% to 11.3% (mean, 5.1%±3.4%). We detected no statistically significant trends for any of the categories of interest over time (all P > .05), and susceptibility trends were consistent when repeated by specimen source, birthweight, and timing of infection. Conclusions: We found stable, yet concerning, patterns of E. coli antibiotic nonsusceptibility among infants admitted to NICUs across the United States from 2009 to 2017. Rates of ampicillin nonsusceptibility and aminoglycoside nonsusceptibility were higher than previous reports. ESBL E. coli rates were low but present among neonatal patients. No carbapenem nonsusceptible E. coli was identified. These findings can inform empiric antibiotic prescription for infants admitted to NICUs across the United States.Funding: NoneDisclosures: None

scholarly journals 1354. Nocardia bejingensis: A Novel Isolate Affecting Immunocompromised Patients in the United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S490-S490
Author(s):  
Shylah M Moore-Pardo ◽  
Johonna Asquith ◽  
Sadaf Aslam ◽  
Cynthia Mayer ◽  
John Greene ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Antibiotic Susceptibility ◽  
Case Series ◽  
The United States ◽  
Solid Organ ◽  
Nocardia Species ◽  
Antibiotic Susceptibility Patterns ◽  
Immunocompromised Hosts ◽  
Susceptibility Patterns

Abstract Background Nocardia species can cause localized or disseminated disease in humans. Infection results from direct inoculation or inhalation. In recent years, several new species have been identified via molecular methods. Further speciation is crucial as each organism has its own spectrum of disease and unique antibiotic susceptibility patterns. Immunosuppression, alcoholism, and certain lung diseases are well-established risk factors for nocardiosis. In fact, cases have incremented in association with increasing population of immunocompromised hosts as well as improved methods for detection and identification. Thus, Nocardia species may be considered opportunistic pathogens. Nocardia bejingensis was first isolated in 2001 by Wang et al from sewage soil in China. The first human infections were reported in Asia. Subsequently, cases were reported in Europe and a few cases have been described in the United States but it has been infrequently cited in the literature. Thus, not much is known about its spectrum of disease. Methods The primary objective of this study was to determine the risk factors and clinical manifestations of Nocardia bejingensis infection via retrospective chart review of 6 cases identified in Tampa General Hospital and Moffitt Cancer Center within a 5-year period. We aimed to evaluate the treatment used and the antibiotic susceptibility patterns of the isolates. Results All patients were immunocompromised (1/3 HIV/AIDS, 1/3 hematologic malignancy, 1/3 solid-organ transplant). Most were male (67%) and mean age of 48. The majority had lung involvement (67%). Thecal sac infection and femur osteomyelitis (OM) were atypical manifestations. Localized disease predominated. Combination therapy was preferred. Trimethoprim-sulfamethoxazole (TMP-SMX), Ceftriaxone, and carbapenems were mostly used. All isolates were susceptible to TMP-SMX. See Table 1. Conclusion This case series depicts clinical features, risk factors, and epidemiology of Nocardia bejingensis infections. Our observations suggest that it is a novel pathogen in the United States, affecting mainly immunocompromised hosts. Early detection, appropriate antibiotics, and surgery were keys in successful management. However, further studies are needed to further elucidate its pathogenesis. Disclosures All authors: No reported disclosures.

scholarly journals Prevalence of Escherichia coli O157:H7 in Organically and Naturally Raised Beef Cattle

2009 ◽  
Vol 75 (16) ◽  
pp. 5421-5423 ◽  
Author(s):  
S. Reinstein ◽  
J. T. Fox ◽  
X. Shi ◽  
M. J. Alam ◽  
D. G. Renter ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Beef Cattle ◽  
Antibiotic Susceptibility ◽  
Escherichia Coli O157 ◽  
E Coli ◽  
Antibiotic Susceptibility Patterns ◽  
Susceptibility Profiles ◽  
Susceptibility Patterns

ABSTRACT We determined the prevalence of Escherichia coli O157:H7 in organically and naturally raised beef cattle at slaughter and compared antibiotic susceptibility profiles of the isolates to those of isolates from conventionally raised beef cattle. The prevalences of E. coli O157:H7 were 14.8 and 14.2% for organically and naturally raised cattle, respectively. No major difference in antibiotic susceptibility patterns among the isolates was observed.

Disinfectant and Antibiotic Susceptibility Profiles of Escherichia coli O157:H7 Strains from Cattle Carcasses, Feces, and Hides and Ground Beef from the United States†

2013 ◽  
Vol 76 (1) ◽  
pp. 6-17 ◽  
Author(s):  
ROSS C. BEIER ◽  
TONI L. POOLE ◽  
DAYNA M. BRICHTA-HARHAY ◽  
ROBIN C. ANDERSON ◽  
KENNETH M. BISCHOFF ◽  
...  
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Antibiotic Susceptibility ◽  
Ground Beef ◽  
The United States ◽  
Escherichia Coli O157 ◽  
E Coli ◽  
Inducible Resistance ◽  
Susceptibility Profiles

The disinfectant and antibiotic susceptibility profiles of 344 Escherichia coli O157:H7 strains from cattle carcasses, feces, and hides and ground beef from the United States were determined. A low prevalence of antibiotic resistance was observed (14%). The highest prevalences of resistance were to sulfisoxazole (10.5%), tetracycline (9.9%), streptomycin (7%), and chloramphenicol (4.9%). Four strains were resistant to eight antibiotics (two strains from ground beef and one strain each from hide and preevisceration carcass swabs of cull cattle at harvest). Pulsed-field gel electrophoresis analysis of the E. coli O157:H7 strains revealed two major groups (designated 1 and 2) composed of 17 and 20 clusters, respectively. Clusters 1A, 1B, 1C, and 1G.1 were associated with multidrug-resistant strains. There was no observed correlation between disinfectant resistance and antibiotic resistance. Sixty-nine (20%) of the 344 strains were resistant to chlorhexidine or benzalkonium chloride or the MICs of benzyldimethyldodecylammonium chloride were elevated. Inducible resistance was observed at elevated concentrations of antibiotics (1.4%) and disinfectants (6.1%). The highest rate of disinfectant inducible resistance was to OdoBan, quaternary ammonium chlorides, and the surface disinfectants F25, FS512, and MG, which are used in dairies, restaurants, and food processing plants. High MICs (1,024 to 4,096 μg/ml) of acetic, lactic, and citric acids were found. The decreasing order of acid potency based on molar MICs (MICsmolar) was acetic, citric, and lactic acid. The correlation of the concentration of dissociated organic acids and MICsmolar strongly suggests that the observed inhibition of E. coli O157:H7 was primarily due to dissociated forms of the acids.

scholarly journals Comparison of the Reveal 20-Hour Method and the BAM Culture Method for the Detection of Escherichia coli O157:H7 in Selected Foods and Environmental Swabs: Collaborative Study

2001 ◽  
Vol 84 (3) ◽  
pp. 737-751 ◽  
Author(s):  
Charles B Bird ◽  
Rebecca J Hoerner ◽  
Lawrence Restaino ◽  
G Anderson ◽  
W Birbari ◽  
...  
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
Collaborative Study ◽  
Culture Method ◽  
The United States ◽  
Escherichia Coli O157 ◽  
Private Industry ◽  
E Coli ◽  
Different Levels

Abstract Four different food types along with environmental swabs were analyzed by the Reveal for E. coli O157:H7 test (Reveal) and the Bacteriological Analytical Manual (BAM) culture method for the presence of Escherichia coli O157:H7. Twenty-seven laboratories representing academia and private industry in the United States and Canada participated. Sample types were inoculated with E. coli O157:H7 at 2 different levels. Of the 1095 samples and controls analyzed and confirmed, 459 were positive and 557 were negative by both methods. No statistical differences (p <0.05) were observed between the Reveal and BAM methods.

Fecal Shedding of Escherichia coli O157:H7 in North Dakota Feedlot Cattle in the Fall and Spring

2006 ◽  
Vol 69 (5) ◽  
pp. 1154-1158 ◽  
Author(s):  
MARGARET L. KHAITSA ◽  
MARC L. BAUER ◽  
GREGORY P. LARDY ◽  
DAWN K. DOETKOTT ◽  
REDEMPTA B. KEGODE ◽  
...  
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
North Dakota ◽  
The United States ◽  
Extreme Weather ◽  
Early Spring ◽  
Feedlot Cattle ◽  
Escherichia Coli O157 ◽  
Fecal Shedding ◽  
E Coli

Cattle are an important reservoir of Escherichia coli O157:H7, which can lead to contamination of food and water, and subsequent human disease. E. coli O157:H7 shedding in cattle has been reported as seasonal, with more animals shedding during summer and early fall than during winter. North Dakota has relatively cold weather, especially in winter and early spring, compared with many other regions of the United States. The objective was to assess fecal shedding of E. coli O157: H7 in North Dakota feedlot cattle over the fall, winter, and early spring. One hundred forty-four steers were assigned randomly to 24 pens on arrival at the feedlot. Samples of rectal feces were obtained from each steer four times (October and November 2003, and March and April 2004) during finishing. On arrival (October 2003), 2 (1.4%) of 144 cattle were shedding E. coli O157:H7. The shedding increased significantly to 10 (6.9%) of 144 after 28 days (November 2003), to 76 (53%) of 143 at the third sampling (March 2004), and dropped significantly to 30 (21%) of 143 at the fourth (last) sampling (March 2004) before slaughter. Unfortunately, we were unable to sample the cattle during winter because of the extreme weather conditions. Sampling time significantly (P < 0.0001) influenced variability in E. coli O157:H7 shedding, whereas herd (P = 0.08) did not. The prevalence of E. coli O157:H7 shedding in North Dakota steers in fall and early spring was comparable to what has been reported in other parts of the United States with relatively warmer weather. Further research into E. coli O157:H7 shedding patterns during extreme weather such as North Dakota winters is warranted in order to fully assess the seasonal effect on the risk level of this organism.

scholarly journals Extraintestinal Pathogenic and Antimicrobial-Resistant Escherichia coli, Including Sequence Type 131 (ST131), from Retail Chicken Breasts in the United States in 2013

2017 ◽  
Vol 83 (6) ◽  
Author(s):  
James R. Johnson ◽  
Stephen B. Porter ◽  
Brian Johnston ◽  
Paul Thuras ◽  
Sarah Clock ◽  
...  
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
Virulence Genes ◽  
Meat Products ◽  
The United States ◽  
Sequence Type ◽  
The Other ◽  
Antibiotic Resistant ◽  
Content Type ◽  
E Coli

ABSTRACT Chicken meat products are hypothesized to be vehicles for transmitting antimicrobial-resistant and extraintestinal pathogenic Escherichia coli (ExPEC) to consumers. To reassess this hypothesis in the current era of heightened concerns about antimicrobial use in food animals, we analyzed 175 chicken-source E. coli isolates from a 2013 Consumer Reports national survey. Isolates were screened by PCR for ExPEC-defining virulence genes. The 25 ExPEC isolates (12% of 175) and a 2:1 randomly selected set of 50 non-ExPEC isolates were assessed for their phylogenetic/clonal backgrounds and virulence genotypes for comparison with their resistance profiles and the claims on the retail packaging label (“organic,” “no antibiotics,” and “natural”). Compared with the findings for non-ExPEC isolates, the group of ExPEC isolates had a higher prevalence of phylogroup B2 isolates (44% versus 4%; P < 0.001) and a lower prevalence of phylogroup A isolates (4% versus 30%; P = 0.001), a higher prevalence of multiple individual virulence genes, higher virulence scores (median, 11 [range, 4 to 16] versus 8 [range, 1 to 14]; P = 0.001), and higher resistance scores (median, 4 [range, 0 to 8] versus 3 [range, 0 to 10]; P < 0.001). All five isolates of sequence type 131 (ST131) were ExPEC (P = 0.003), were as extensively resistant as the other isolates tested, and had higher virulence scores than the other isolates tested (median, 12 [range, 11 to 13] versus 8 [range, 1 to 16]; P = 0.005). Organic labeling predicted lower resistance scores (median, 2 [range, 0 to 3] versus 4 [range, 0 to 10]; P = 0.008) but no difference in ExPEC status or virulence scores. These findings document a persisting reservoir of extensively antimicrobial-resistant ExPEC isolates, including isolates from ST131, in retail chicken products in the United States, suggesting a potential public health threat. IMPORTANCE We found that among Escherichia coli isolates from retail chicken meat products purchased across the United States in 2013 (many of these isolates being extensively antibiotic resistant), a minority had genetic profiles suggesting an ability to cause extraintestinal infections in humans, such as urinary tract infection, implying a risk of foodborne disease. Although isolates from products labeled “organic” were less extensively antibiotic resistant than other isolates, they did not appear to be less virulent. These findings suggest that retail chicken products in the United States, even if they are labeled “organic,” pose a potential health threat to consumers because they are contaminated with extensively antibiotic-resistant and, presumably, virulent E. coli isolates.

How Does Escherichia coli O157:H7 Testing in Meat Compare with What We Are Seeing Clinically?

2000 ◽  
Vol 63 (6) ◽  
pp. 819-821 ◽  
Author(s):  
DAVID W. K. ACHESON
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
Shiga Toxin ◽  
Food Supply ◽  
The United States ◽  
Escherichia Coli O157 ◽  
Current Policy ◽  
E Coli ◽  
Different Types ◽  
Uremic Syndrome

Escherichia coli O157:H7 is but one of a group of Shiga toxin-producing E. coli (STEC) that cause both intestinal disease such as bloody and nonbloody diarrhea and serious complications like hemolytic uremic syndrome (HUS). While E. coli O157: H7 is the most renowned STEC, over 200 different types of STEC have been documented in meat and animals, at least 60 of which have been linked with human disease. A number of studies have suggested that non-O157 STEC are associated with clinical disease, and non-O157 STEC are present in the food supply. Non-O157 STEC, such as O111 have caused large outbreaks and HUS in the United States and other countries. The current policy in the United States is to examine ground beef for O157:H7 only, but restricting the focus to O157 will miss other important human STEC pathogens.

Epidemiology of Escherichia coli O157 in Feedlot Cattle

1997 ◽  
Vol 60 (5) ◽  
pp. 462-465 ◽  
Author(s):  
DALE D. HANCOCK ◽  
DANIEL H. RICE ◽  
LEE ANN THOMAS ◽  
DAVID A. DARGATZ ◽  
THOMAS E. BESSER
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
The United States ◽  
Feedlot Cattle ◽  
Escherichia Coli O157 ◽  
Fecal Samples ◽  
E Coli ◽  
Geographical Regions ◽  
Flagellar Antigen ◽  
Low Prevalence

Fecal samples from cattle in 100 feedlots in 13 states were bacteriologically cultured for Escherichia coli O157 that did not ferment sorbitol, lacked beta-glucuronidase, and possessed genes coding for Shiga-like toxin. In each feedlot 30 fresh fecal-pat samples were collected from each of four pens: with the cattle shortest on feed, with cattle longest on feed, and with cattle in two randomly selected pens. E. coli O157 was isolated from 210 (1.8%) of 11,881 fecal samples. One or more samples were positive for E. coli O157 in 63 of the 100 feedlots tested. E. coli O157 was found at roughly equal prevalence in all the geographical regions sampled. The prevalence of E. coli O157 in the pens with cattle shortest on feed was approximately threefold higher than for randomly selected and longest on feed pens. Of the E. coli O157 isolates found in this study, 89.52% expressed the H7 flagellar antigen. E. coli O157 was found to be widely distributed among feedlot cattle, but at a low prevalence, in the United States.

scholarly journals Genetic Determinants of Resistance to Extended-Spectrum Cephalosporin and Fluoroquinolone in Escherichia coli Isolated from Diseased Pigs in the United States

mSphere ◽  
2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Shivdeep Singh Hayer ◽  
Seunghyun Lim ◽  
Samuel Hong ◽  
Ehud Elnekave ◽  
Timothy Johnson ◽  
...  
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
High Risk ◽  
The United States ◽  
Genetic Determinants ◽  
Content Type ◽  
E Coli ◽  
Extended Spectrum ◽  
Animal Populations ◽  
Swine Population

ABSTRACT Fluoroquinolones and cephalosporins are critically important antimicrobial classes for both human and veterinary medicine. We previously found a drastic increase in enrofloxacin resistance in clinical Escherichia coli isolates collected from diseased pigs from the United States over 10 years (2006 to 2016). However, the genetic determinants responsible for this increase have yet to be determined. The aim of the present study was to identify and characterize the genetic basis of resistance against fluoroquinolones (enrofloxacin) and extended-spectrum cephalosporins (ceftiofur) in swine E. coli isolates using whole-genome sequencing (WGS). blaCMY-2 (carried by IncA/C2, IncI1, and IncI2 plasmids), blaCTX-M (carried by IncF, IncHI2, and IncN plasmids), and blaSHV-12 (carried by IncHI2 plasmids) genes were present in 87 (82.1%), 19 (17.9%), and 3 (2.83%) of the 106 ceftiofur-resistant isolates, respectively. Of the 110 enrofloxacin-resistant isolates, 90 (81.8%) had chromosomal mutations in gyrA, gyrB, parA, and parC genes. Plasmid-mediated quinolone resistance genes [qnrB77, qnrB2, qnrS1, qnrS2, and aac-(6)-lb′-cr] borne on ColE, IncQ2, IncN, IncF, and IncHI2 plasmids were present in 24 (21.8%) of the enrofloxacin-resistant isolates. Virulent IncF plasmids present in swine E. coli isolates were highly similar to epidemic plasmids identified globally. High-risk E. coli clones, such as ST744, ST457, ST131, ST69, ST10, ST73, ST410, ST12, ST127, ST167, ST58, ST88, ST617, ST23, etc., were also found in the U.S. swine population. Additionally, the colistin resistance gene (mcr-9) was present in several isolates. This study adds valuable information regarding resistance to critical antimicrobials with implications for both animal and human health. IMPORTANCE Understanding the genetic mechanisms conferring resistance is critical to design informed control and preventive measures, particularly when involving critically important antimicrobial classes such as extended-spectrum cephalosporins and fluoroquinolones. The genetic determinants of extended-spectrum cephalosporin and fluoroquinolone resistance were highly diverse, with multiple plasmids, insertion sequences, and genes playing key roles in mediating resistance in swine Escherichia coli. Plasmids assembled in this study are known to be disseminated globally in both human and animal populations and environmental samples, and E. coli in pigs might be part of a global reservoir of key antimicrobial resistance (AMR) elements. Virulent plasmids found in this study have been shown to confer fitness advantages to pathogenic E. coli strains. The presence of international, high-risk zoonotic clones provides worrisome evidence that resistance in swine isolates may have indirect public health implications, and the swine population as a reservoir for these high-risk clones should be continuously monitored.

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