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1675. Epidemiology of Urinary Tract Infections in the United States, 2009 - 2018

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1853 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S823-S823

Author(s):

Kendra Foster ◽

Linnea A Polgreen ◽

Brett Faine ◽

Philip M Polgreen

Keyword(s):

United States ◽

Urinary Tract ◽

Klebsiella Pneumoniae ◽

Urinary Tract Infections ◽

Proteus Mirabilis ◽

Antibiotic Use ◽

The United States ◽

Drug Resistant ◽

E Coli ◽

Tract Infections

Abstract Background Urinary tract infections (UTIs) are one of the most common bacterial infections. There is a lack of large epidemiologic studies evaluating the etiologies of UTIs in the United States. This study aimed to determine the prevalence of different UTI-causing organisms and their antimicrobial susceptibility profiles among patients being treated in a hospital setting. Methods We used the Premier Healthcare Database. Patients with a primary diagnosis code of cystitis, pyelonephritis, or urinary tract infection and had a urine culture from 2009- 2018 were included in the study. Both inpatients and patients who were only treated in the emergency department (ED) were included. We calculated descriptive statistics for uropathogens and their susceptibilities. Multi-drug-resistant pathogens are defined as pathogens resistant to 3 or more antibiotics. Resistance patterns are also described for specific drug classes, like resistance to fluoroquinolones. We also evaluated antibiotic use in this patient population and how antibiotic use varied during the hospitalization. Results There were 640,285 individuals who met the inclusion criteria. Females make up 82% of the study population and 45% were age 65 or older. The most common uropathogen was Escherichia Coli (64.9%) followed by Klebsiella pneumoniae (8.3%), and Proteus mirabilis (5.7%). 22.2% of patients were infected with a multi-drug-resistant pathogen. We found that E. Coli was multi-drug resistant 23.8% of the time; Klebsiella pneumoniae was multi-drug resistant 7.4%; and Proteus mirabilis was multi-drug resistant 2.8%. The most common antibiotics prescribed were ceftriaxone, levofloxacin, and ciprofloxacin. Among patients that were prescribed ceftriaxone, 31.7% of them switched to a different antibiotic during their hospitalization. Patients that were prescribed levofloxacin and ciprofloxacin switched to a different antibiotic 42.8% and 41.5% of the time, respectively. Conclusion E. Coli showed significant multidrug resistance in this population of UTI patients that were hospitalized or treated within the ED, and antibiotic switching is common. Disclosures All Authors: No reported disclosures

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Epidemiologic and Microbiologic Characteristics of 28 Hospitalized Patients Cocolonized With Multiple Carbapenem-Resistant Enterobacteriaceae (CRE) in the United States

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.547 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s62-s62

Author(s):

Timileyin Adediran ◽

Anthony Harris ◽

J. Kristie Johnson ◽

David Calfee ◽

Loren Miller ◽

...

Keyword(s):

United States ◽

Secondary Analysis ◽

Positive Culture ◽

The United States ◽

Healthcare Personnel ◽

Surveillance Culture ◽

E Coli ◽

Carbapenem Resistant ◽

Multicenter Prospective Cohort Study ◽

Epidemiological Significance

Background: As carbapenem-resistant Enterobacteriaceae (CRE) prevalence increases in the United States, the risk of cocolonization with multiple CRE may also be increasing, with unknown clinical and epidemiological significance. In this study, we aimed to describe the epidemiologic and microbiologic characteristics of inpatients cocolonized with multiple CRE. Methods: We conducted a secondary analysis of a large, multicenter prospective cohort study evaluating risk factors for CRE transmission to healthcare personnel gown and gloves. Patients were identified between January 2016 and June 2019 from 4 states. Patients enrolled in the study had a clinical or surveillance culture positive for CRE within 7 days of enrollment. We collected and cultured samples from the following sites from each CRE-colonized patient: stool, perianal area, and skin. A modified carbapenem inactivation method (mCIM) was used to detect the presence or absence of carbapenemase(s). EDTA-modified CIM (eCIM) was used to differentiate between serine and metal-dependent carbapenemases. Results: Of the 313 CRE-colonized patients enrolled in the study, 28 (8.9%) were cocolonized with at least 2 different CRE. Additionally, 3 patients were cocolonized with >2 different CRE (1.0%). Of the 28 patients, 19 (67.6%) were enrolled with positive clinical cultures. Table 1 summarizes the demographic and clinical characteristics of these patients. The most frequently used antibiotic prior to positive culture was vancomycin (n = 33, 18.3%). Among the 62 isolates from 59 samples from 28 patients cocolonized patients, the most common CRE species were Klebsiella pneumoniae (n = 18, 29.0%), Escherichia coli (n = 10, 16.1%), and Enterobacter cloacae (n = 9, 14.5%). Of the 62 isolates, 38 (61.3%) were mCIM positive and 8 (12.9%) were eCIM positive. Of the 38 mCIM-positive isolates, 33 (86.8%) were KPC positive, 4 (10.5%) were NDM positive, and 1 (2.6%) was negative for both KPC and NDM. Also, 2 E. coli, 1 K. pneumoniae, and 1 E. cloacae were NDM-producing CRE. Conclusion: Cocolonization with multiple CRE occurs frequently in the acute-care setting. Characterizing patients with CRE cocolonization may be important to informing infection control practices and interventions to limit the spread of these organisms, but further study is needed.Funding: NoneDisclosures: None

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Functionalized Chitosan Nanomaterials: A Jammer for Quorum Sensing

Polymers ◽

10.3390/polym13152533 ◽

2021 ◽

Vol 13 (15) ◽

pp. 2533

Author(s):

Moupriya Nag ◽

Dibyajit Lahiri ◽

Dipro Mukherjee ◽

Ritwik Banerjee ◽

Sayantani Garai ◽

...

Keyword(s):

Drug Resistance ◽

Quorum Sensing ◽

Targeted Delivery ◽

Direct Interaction ◽

Orthodontic Appliances ◽

Chronic Infections ◽

Functionalized Nanomaterials ◽

Low Toxicity ◽

Novel Target ◽

Positively Charged

The biggest challenge in the present-day healthcare scenario is the rapid emergence and spread of antimicrobial resistance due to the rampant use of antibiotics in daily therapeutics. Such drug resistance is associated with the enhancement of microbial virulence and the acquisition of the ability to evade the host’s immune response under the shelter of a biofilm. Quorum sensing (QS) is the mechanism by which the microbial colonies in a biofilm modulate and intercept communication without direct interaction. Hence, the eradication of biofilms through hindering this communication will lead to the successful management of drug resistance and may be a novel target for antimicrobial chemotherapy. Chitosan shows microbicidal activities by acting electrostatically with its positively charged amino groups, which interact with anionic moieties on microbial species, causing enhanced membrane permeability and eventual cell death. Therefore, nanoparticles (NPs) prepared with chitosan possess a positive surface charge and mucoadhesive properties that can adhere to microbial mucus membranes and release their drug load in a constant release manner. As the success in therapeutics depends on the targeted delivery of drugs, chitosan nanomaterial, which displays low toxicity, can be safely used for eradicating a biofilm through attenuating the quorum sensing (QS). Since the anti-biofilm potential of chitosan and its nano-derivatives are reported for various microorganisms, these can be used as attractive tools for combating chronic infections and for the preparation of functionalized nanomaterials for different medical devices, such as orthodontic appliances. This mini-review focuses on the mechanism of the downregulation of quorum sensing using functionalized chitosan nanomaterials and the future prospects of its applications.

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Molecular Mechanisms of Drug Resistance in Glioblastoma

International Journal of Molecular Sciences ◽

10.3390/ijms22126385 ◽

2021 ◽

Vol 22 (12) ◽

pp. 6385

Author(s):

Maya A. Dymova ◽

Elena V. Kuligina ◽

Vladimir A. Richter

Keyword(s):

Drug Resistance ◽

Brain Tumor ◽

Molecular Mechanisms ◽

Primary Brain Tumor ◽

Therapeutic Resistance ◽

Molecular Characteristics ◽

Blood Brain ◽

Conventional Radiation ◽

The Brain ◽

Made In

Glioblastoma multiforme (GBM) is the most common and fatal primary brain tumor, is highly resistant to conventional radiation and chemotherapy, and is not amenable to effective surgical resection. The present review summarizes recent advances in our understanding of the molecular mechanisms of therapeutic resistance of GBM to already known drugs, the molecular characteristics of glioblastoma cells, and the barriers in the brain that underlie drug resistance. We also discuss the progress that has been made in the development of new targeted drugs for glioblastoma, as well as advances in drug delivery across the blood–brain barrier (BBB) and blood–brain tumor barrier (BBTB).

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Underreporting of Vestibular Schwannoma Incidence Within National Brain Tumor and Cancer Registries in the United States

Otology & Neurotology ◽

10.1097/mao.0000000000003049 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

John P. Marinelli ◽

Ashley M. Nassiri ◽

Elizabeth B. Habermann ◽

Christine M. Lohse ◽

Sara J. Holton ◽

...

Keyword(s):

United States ◽

Brain Tumor ◽

Vestibular Schwannoma ◽

Cancer Registries ◽

The United States

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Preliminary Estimates of Costs of Foodborne Disease in the United States

Journal of Food Protection ◽

10.4315/0362-028x-52.8.595 ◽

1989 ◽

Vol 52 (8) ◽

pp. 595-601 ◽

Cited By ~ 139

Author(s):

EWEN C. D. TODD

Keyword(s):

United States ◽

Food Industry ◽

The United States ◽

Control Measures ◽

Effective Control ◽

Foodborne Diseases ◽

Hemorrhagic Colitis ◽

E Coli ◽

The Cost ◽

Total Impact

Although the full economic impact of foodborne diseases has yet to be measured, preliminary studies show that the cost of illness, death, and business lost is high indeed. This impact is probably greatest in developing countries, but few facts are known. For the United States, preliminary estimates are 12.6 million cases costing $8.4 billion. These may seem excessive but other authors have postulated even higher case and dollar figures. Microbiological diseases (bacterial and viral) represent 84% of the United States' costs, with salmonellosis and staphylococcal intoxication being the most economically important diseases (annually $4.0 billion and $1.5 billion, respectively). Other costly types of illnesses are toxoplasmosis ($445 million), listeriosis ($313 million), campylobacteriosis ($156 million), trichinosis ($144 million), Clostridium perfringens enteritis ($123 million), and E. coli infections including hemorrhagic colitis ($223 million). Botulism has a high cost per case ($322,200), but its total impact is only $87 million because relatively few cases occur (270). This is because the food industry has been able to introduce effective control measures. Salmonellosis, however, is much more widespread (2.9 million cases) and affects all sectors of the food industry.

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Hospitalizations due to selected infections caused by opportunistic premise plumbing pathogens (OPPP) and reported drug resistance in the United States older adult population in 1991–2006

Journal of Public Health Policy ◽

10.1057/s41271-016-0038-8 ◽

2016 ◽

Vol 37 (4) ◽

pp. 500-513 ◽

Cited By ~ 11

Author(s):

Elena N. Naumova ◽

Alexander Liss ◽

Jyotsna S. Jagai ◽

Irmgard Behlau ◽

Jeffrey K. Griffiths

Keyword(s):

United States ◽

Drug Resistance ◽

Older Adult ◽

Adult Population ◽

The United States ◽

Premise Plumbing ◽

Older Adult Population

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Prehospital delay in patients hospitalized with heart attack symptoms in the United States: The REACT trial

American Heart Journal ◽

10.1016/s0002-8703(99)70069-4 ◽

1999 ◽

Vol 138 (6) ◽

pp. 1046-1057 ◽

Cited By ~ 132

Author(s):

David C. Goff ◽

Henry A. Feldman ◽

Paul G. McGovern ◽

Robert J. Goldberg ◽

Denise G. Simons-Morton ◽

...

Keyword(s):

United States ◽

Heart Attack ◽

The United States ◽

Prehospital Delay

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Phylogeographic Analysis Reveals Multiple International transmission Events Have Driven the Global Emergence of Escherichia coli O157:H7

Clinical Infectious Diseases ◽

10.1093/cid/ciy919 ◽

2018 ◽

Vol 69 (3) ◽

pp. 428-437 ◽

Cited By ~ 8

Author(s):

Eelco Franz ◽

Ovidiu Rotariu ◽

Bruno S Lopes ◽

Marion MacRae ◽

James L Bono ◽

...

Keyword(s):

United States ◽

Disease Outbreaks ◽

The United States ◽

Human Case ◽

Whole Genome Sequencing Data ◽

Nucleotide Polymorphisms ◽

Sequencing Data ◽

E Coli ◽

Phylogeographic Analysis ◽

International Distribution

AbstractBackgroundShiga toxin–producing Escherchia coli (STEC) O157:H7 is a zoonotic pathogen that causes numerous food and waterborne disease outbreaks. It is globally distributed, but its origin and the temporal sequence of its geographical spread are unknown.MethodsWe analyzed whole-genome sequencing data of 757 isolates from 4 continents, and performed a pan-genome analysis to identify the core genome and, from this, extracted single-nucleotide polymorphisms. A timed phylogeographic analysis was performed on a subset of the isolates to investigate its worldwide spread.ResultsThe common ancestor of this set of isolates occurred around 1890 (1845–1925) and originated from the Netherlands. Phylogeographic analysis identified 34 major transmission events. The earliest were predominantly intercontinental, moving from Europe to Australia around 1937 (1909–1958), to the United States in 1941 (1921–1962), to Canada in 1960 (1943–1979), and from Australia to New Zealand in 1966 (1943–1982). This pre-dates the first reported human case of E. coli O157:H7, which was in 1975 from the United States.ConclusionsInter- and intra-continental transmission events have resulted in the current international distribution of E. coli O157:H7, and it is likely that these events were facilitated by animal movements (eg, Holstein Friesian cattle). These findings will inform policy on action that is crucial to reduce the further spread of E. coli O157:H7 and other (emerging) STEC strains globally.

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