Clinical outcomes of spontaneous bacterial peritonitis due to extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiellaspecies: A retrospective matched case-control study

Abstract Background The role of therapeutic intervention, particularly antibiotics, for Shiga toxin-producing Escherichia coli (STEC) related infection is controversial. Methods We performed a population based matched case-control study to assess the association between treatment (antibiotics, antidiarrheal agents and probiotics) for STEC related infections and HUS development. We identified all STEC HUS patients as cases and matched five non-HUS patients as controls using the data from the National Epidemiological Surveillance of Infectious Diseases (NESID) between January 1, 2017, and December 31, 2018. Further medical information was obtained by standardized questionnaires answered by physicians who registered each patient. We used multivariate conditional logistic regression model to evaluate the association between exposures (use of antibiotics, use of antidiarrheal agents, days between disease onset and fosfomycin administration [within two or three days]) and the development of HUS, by matched odds ratios (OR) and 95% confidence intervals (CI). Covariates we used were sex, age group, area code, presence of diarrhea and other factors. We also performed subgroup analyses using age (adults and children) as a stratification factor. Results 7,760 STEC related patients were registered in the NESID. We selected patients who had a record of HUS diagnosis (n=182) and matched controls without HUS (n=910). After collecting standardized paper-based questionnaires, we enrolled 90 HUS patients and 371 non-HUS patients for analysis. In the main analysis, matched OR of fosfomycin was 0.75(0.47-1.20) in all ages, 1.41(0.51-3.88) in adults and 0.58(0.34-1.01) in children. Matched OR of antidiarrheal agents was 2.07(1.07-4.03) in all ages, 1.84(0.32-10.53) in adults, 2.65(1.21-5.82) in children. Matched OR of probiotics was 0.86(0.46-1.61) in all ages, 0.76(0.21-2.71) in adults, 1.00(0.48-2.09) in children. There was no significant association between the timing of fosfomycin use in the first two or five days of illness and HUS development in any age group. Conclusion Our results suggest that fosfomycin might decrease the risk of HUS in children younger than 15 years of age with STEC confirmed bacterial gastroenteritis. Disclosures All Authors: No reported disclosures

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Bacteremia Caused by Escherichia coli producing Extended-spectrum Beta-lactamase: a Case-control Study of Risk Factors and Outcomes

Scandinavian Journal of Infectious Diseases ◽

10.1080/00365540210147516 ◽

2002 ◽

Vol 34 (8) ◽

pp. 567-573 ◽

Cited By ~ 76

Author(s):

Pak-Leung Ho ◽

Wai-Ming Chan ◽

Samson S. Y. Wong ◽

Karl Young ◽

Kenneth W. T. Tsang

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Case Control Study ◽

Case Control ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum ◽

Control Study

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Escherichia coli O157:H7 outbreak linked to salami, British Columbia, Canada, 1999

Epidemiology and Infection ◽

10.1017/s0950268803001651 ◽

2004 ◽

Vol 132 (2) ◽

pp. 283-289 ◽

Cited By ~ 55

Author(s):

D. M. MacDONALD ◽

M. FYFE ◽

A. PACCAGNELLA ◽

A. TRINIDAD ◽

K. LOUIE ◽

...

Keyword(s):

Escherichia Coli ◽

Case Control Study ◽

Meat Products ◽

Case Control ◽

Pfge Pattern ◽

Escherichia Coli O157 ◽

E Coli ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

An outbreak of E. coli O157:H7 infections was identified in November 1999 with a fivefold increase in the occurrence of laboratory-confirmed cases of E. coli O157:H7 infection. A matched case-control study was conducted. Samples of food from cases and from retailers were analysed for the presence of E. coli O157:H7. A total of 143 cases were identified over a 12-week period with the same pulsed-field gel electrophoresis (PFGE) pattern. The case-control study found that Company A salami was significantly associated with illness (Mantel–Haenszel matched odds ratio 10·0, 95% CI 1·4–434, P=0·01). Company A salami tested positive for E. coli O157:H7 and isolates had the same PFGE pattern as case isolates. An immediate voluntary national recall of Company A dry fermented meat products took place. Findings from the investigation of this outbreak suggest that the hold-and-test option may not be adequate to prevent shiga-toxigenic Escherichia coli (STEC) infection in salami consumers.

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Worrisome high frequency of extended-spectrum beta-lactamase-producing Escherichia coli in community-acquired urinary tract infections: a case–control study

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2016.12.007 ◽

2017 ◽

Vol 55 ◽

pp. 16-19 ◽

Cited By ~ 9

Author(s):

Franco Castillo-Tokumori ◽

Claudia Irey-Salgado ◽

Germán Málaga

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Urinary Tract Infections ◽

High Frequency ◽

Case Control Study ◽

Case Control ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

Tract Infections ◽

Control Study

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Urinary Tract Infections and Preeclampsia among Pregnant Women Attending Two Hospitals in Mwanza City, Tanzania: A 1:2 Matched Case-Control Study

BioMed Research International ◽

10.1155/2019/3937812 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8

Author(s):

Joshua Kaduma ◽

Jeremiah Seni ◽

Clotilda Chuma ◽

Richard Kirita ◽

Fridolin Mujuni ◽

...

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Pregnant Women ◽

Case Control Study ◽

Case Control ◽

Neonatal Outcomes ◽

Significant Bacteriuria ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

Urinary tract infection (UTI) and preeclampsia are common among pregnant women and are associated with adverse maternal-fetal and neonatal outcomes. Despite this, limited information exists on the association between UTIs and preeclampsia in Tanzania to guide specific management and thereby averting the adverse outcomes. A 1:2 matched case-control study (by age and gravidity) involving 131 pregnant women with preeclampsia (cases) and 262 without preeclampsia (controls) was conducted. Sociodemographic and clinical information was collected using a questionnaire. Midstream urine samples were collected during admission for culture and antimicrobial susceptibility testing (AST). Out of 393 pregnant women enrolled, 110 (28.0%), 95% CI: 23.8%-32.7%, had significant bacteriuria [cases: 50.4% (66/131) and control: 16.8% (44/262)]. Pregnant women with preeclampsia had 7.7 odds of having significant bacteriuria than those without preeclampsia [OR=7.7, 95% CI (4.11-14.49); p-value <0.001]. Escherichia coli, 50 (45.5%), and Klebsiella spp., 25 (23.6%), predominated, and resistance to gentamicin, ceftriaxone, and piperacillin-tazobactam ranged from 9.0% to 29.0% in these dominant species. Extended spectrum beta lactamases (ESBL) production in Escherichia coli and Klebsiella spp. was 18.0% (9/50) and 15.4% (4/26), respectively. Routine urine culture and AST among pregnant women with preeclampsia should be introduced in the antenatal clinics to ensure prompt management. Delineation of maternal-fetal and neonatal outcomes among pregnant women with preeclampsia and UTIs would be of interest in future studies.

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