scholarly journals Trends in prevalence of extended-spectrum beta-lactamase-producing Escherichia coli isolated from patients with community- and healthcare-associated bacteriuria: results from 2014 to 2020 in an urban safety-net healthcare system

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Eva Raphael ◽  
M. Maria Glymour ◽  
Henry F. Chambers
Keyword(s):  
Risk Factors ◽  
Safety Net ◽  
Male Gender ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
The Past ◽  
Race Ethnicity ◽  
Healthcare Associated ◽  
Community Onset

Abstract Background The prevalence of infections caused by extended-spectrum beta-lactamase producing Escherichia coli (ESBL-E. coli) is increasing worldwide, but the setting in which this increase is occurring is not well defined. We compared trends and risk factors for ESBL-E. coli bacteriuria in community vs healthcare settings. Methods We collected electronic health record data on all patients with E. coli isolated from urine cultures in a safety-net public healthcare system from January 2014 to March 2020. All analyses were stratified by healthcare-onset/associated (bacteriuria diagnosed > 48 h after hospital admission or in an individual hospitalized in the past 90 days or in a skilled nursing facility resident, N = 1277) or community-onset bacteriuria (bacteriuria diagnosed < 48 h after hospital admission or in an individual seen in outpatient clinical settings without a hospitalization in the past 90 days, N = 7751). We estimated marginal trends from logistic regressions to evaluate annual change in prevalence of ESBL-E. coli bacteriuria among all bacteriuria. We evaluated risk factors using logistic regression models. Results ESBL-E. coli prevalence increased in both community-onset (0.91% per year, 95% CI 0.56%, 1.26%) and healthcare-onset/associated (2.31% per year, CI 1.01%, 3.62%) bacteriuria. In multivariate analyses, age > 65 (RR 1.88, CI 1.17, 3.05), male gender (RR 2.12, CI 1.65, 2.73), and Latinx race/ethnicity (RR 1.52, CI 0.99, 2.33) were associated with community-onset ESBL-E. coli. Only male gender (RR 1.53, CI 1.03, 2.26) was associated with healthcare-onset/associated ESBL-E. coli. Conclusions ESBL-E. coli bacteriuria frequency increased at a faster rate in healthcare-associated settings than in the community between 2014 and 2020. Male gender was associated with ESBL-E. coli bacteriuria in both settings, but additional risks—age > 65 and Latinx race/ethnicity—were observed only in the community.

scholarly journals Trends in Prevalence of Extended-Spectrum Beta-Lactamase-Producing Escherichia Coli Isolated From Patients With Community- And Healthcare-Associated Bacteriuria: Results From 2014 To 2020 In An Urban Safety-Net Healthcare System

2021 ◽  
Author(s):  
Eva Raphael ◽  
Maria Glymour ◽  
Henry F Chambers
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Safety Net ◽  
Male Gender ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Race Ethnicity ◽  
Healthcare Associated ◽  
Community Onset

Abstract BackgroundThe prevalence of infections caused by extended-spectrum beta-lactamase producing Escherichia coli (ESBL-E. coli) is increasing worldwide, but the setting in which this increase is occurring is not well defined. We compared trends and risk factors for ESBL-E. coli bacteriuria in community vs healthcare settings.MethodsWe collected electronic health record data on all patients with E. coli isolated from urine cultures in a safety-net public healthcare system from January 2014 to March 2020. All analyses were stratified by healthcare-onset/associated (bacteriuria diagnosed > 48 hours after hospital admission or in an individual hospitalized in the past 90 days or in a skilled nursing facility resident, N=1,277) or community-onset bacteriuria (all other, N=7,751). We estimated marginal trends from logistic regressions to evaluate annual change in prevalence of ESBL-E. coli bacteriuria among all bacteriuria. We evaluated risk factors using logistic regression models.ResultsESBL-E. coli prevalence increased in both community-onset (0.91% per year, 95% CI: 0.56%, 1.26%) and healthcare-onset/associated (2.31% per year, CI: 1.01%, 3.62%) bacteriuria. In multivariate analyses, age >65 (RR 1.88, CI: 1.17, 3.05), male gender (RR 2.12, CI: 1.65, 2.73), and Latinx race/ethnicity (RR 1.52, CI: 0.99, 2.33) were associated with community-onset ESBL-E. coli. Only male gender (RR 1.53, CI: 1.03, 2.26) was associated with healthcare-onset/associated ESBL-E. coli.ConclusionsESBL-E. coli bacteriuria frequency increased at a faster rate in healthcare-associated settings than in the community between 2004 to 2020. Male gender was associated with ESBL-E. coli bacteriuria in both settings, but additional risks—age >65 and Latinx race/ethnicity—were observed only in the community.

scholarly journals Molecular detection and antibiotic resistance pattern of extended-spectrum beta-lactamase producing Escherichia coli in a Tertiary Hospital in Enugu, Nigeria

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Ifeyinwa N. Nwafia ◽  
Martin E. Ohanu ◽  
Samuel O. Ebede ◽  
Uchenna C. Ozumba
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Associated Risk Factors

Abstract Background The use of antibiotic agents in the treatment of infectious diseases has greatly contributed to the decrease in morbidity and mortality, but these great advances in treatment are being undermined by the rapidly increasing antimicrobial resistant organisms. Extended-spectrum beta-lactamases are enzymes hydrolyzing the beta lactam antibiotics, including third generation cephalosporins and monobactams but not cephamycins and carbapenems. They pose a serious global health threat and have become a challenge for health care providers. The aim of this research was to assess the prevalence of extended-spectrum beta-lactamase producing Escherichia coli in University of Nigeria Teaching Hospital Ituku-Ozalla Enugu and to detect the risk factors for acquisition of the resistant organism. To proffer advice on antibiotic stewardship in clinical practice and public health interventions, to curb the spread of the resistant organisms in the hospital. Results Out of the 200 E. coli isolates, 70 (35.00%) were confirmed positive for extended-spectrum beta-lactamase production. Fifty-three (75.7%) were from hospital acquired infections. All the isolates were resistant to ampicillin, tetracycline and chloramphenicol while 68 (97.14%) of the 70 isolates were susceptible to imipenem. BlaTEM, blaSHV and blaTEM were detected in 66 (94%) of the 70 isolates. The ESBL bla genes detected were blaCTX-M (n = 26; 37.14%), blaTEM (n = 7; 10.00%), blaSHV (n = 2; 2.86%), blaCTX-M/TEM (n = 7; 10.0%), blaCTX-M/SHV (n = 14; 20.0%) and blaCTX-M/TEM/SHV (n = 10; 14.29%). The three bla genes were not detected in 4 (5.71%) of the isolates. Recent surgery, previous antibiotic and intensive care unit admission were the associated risk factors to infections caused by extended-spectrum beta-lactamase producing E. coli. Conclusion There is a high rate of infections caused by extended-spectrum beta-lactamase producing E. coli. Recent surgery, previous antibiotic and intensive care unit admission were associated risk factors.

scholarly journals Occurrence and faecal shedding of extended-spectrum beta-lactamase-producing Escherichia coli in sows and their offspring

2020 ◽  
Vol 89 (3) ◽  
pp. 217-223
Author(s):  
Jan Vašek ◽  
Jonáš Vaňhara ◽  
Monika Dolejská ◽  
Martina Masaříková ◽  
Alois Čížek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Before And After ◽  
Long Time ◽  
History Of ◽  
Synergy Test ◽  
Esbl Producers

The aim of the present study was to monitor the presence of extended-spectrum beta-lactamase (ESBL) producing E. coli on farm A with the history of previous use of ceftiofur in suckling pigletsand to analyse the risk factors of selection and dissemination of ESBL producers in the production herd. In the year of 2014, a total of 411 samples (rectal swabs or faeces)from pigs of various age categories (sows, gilts and suckling piglets) were collected. The sampling was performed more than 24 months after the ban of ceftiofur on the farm.The sows and gilts were sampled repeatedly before and after farrowing. All collected samples were directly cultivated on MacConkey agar (MCA) containing cefotaxime (2 mg/l) and obtained sub-cultures were tested for ESBL production by double disc synergy test. According to our results, all gilts were negative for ESBL-producing E. coli in the introduction period, however, the excretion of ESBL-producing E. coli was observed before and after delivery. Most of the new-born piglets from positive sows and gilts shed ESBL-producing E. coli early after birth. All tested ESBL-producing isolates were resistant to multiple antimicrobials, suggesting that antibiotics from other groups used for therapy co-select for ESBL producers in pigs on the studied farm. Intestinal colonization of lactating sows and their offspring as well as survival of ESBL-producing E. coli in the farm environment should be recognised as important risk factors of circulation and long-time persistence of ESBL producers in the herd.

Risk Factors and Outcomes of Extended-Spectrum Beta-Lactamase-Producing E. Coli Peritonitis in Capd Patients

2006 ◽  
Vol 26 (2) ◽  
pp. 191-197 ◽  
Author(s):  
Terence Yip ◽  
Kai-Chung Tse ◽  
Man-Fai Lam ◽  
Sydney Tang ◽  
Fu-Keung Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Acid ◽  
Clinical Outcomes ◽  
Demographic Data ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Acid Inhibitor ◽  
Extended Spectrum ◽  
The Difference

Objective To determine the risk factors and outcomes of peritonitis caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in continuous ambulatory peritoneal dialysis (CAPD). Patients and Methods Episodes of E. coli CAPD peritonitis in our unit from October 1994 to August 2003 were reviewed. Demographic data, underlying medical conditions, recent use of gastric acid inhibitors (including H2 antagonist and proton pump inhibitor), recent antibiotic therapy, antibiotic regimen for peritonitis episodes, sensitivity test results of the E. coli isolated, and clinical outcomes were examined. Results Over a 10-year study period, 88 episodes of E. coli peritonitis were recorded; 11 of the 88 cases were caused by ESBL-producing E. coli. Recent use of cephalosporins and gastric acid inhibitor were associated with the development of ESBL-producing E. coli peritonitis. Compared with non-ESBL-producing E. coli peritonitis, more cases in the ESBL-producing E. coli group developed treatment failure (45.5% vs 13.0%, p = 0.02) and died of sepsis (27.3% vs 3.9%, p = 0.02). Peritoneal failure rate was higher in the ESBL-producing E. coli group, although the difference was not statistically significant (18.2% vs 3.9%, p = 0.12). Conclusion Peritonitis caused by ESBL-producing E. coli is associated with worse clinical outcomes. The use of cephalosporins and gastric acid inhibitors may contribute to its development. Further studies are warranted to investigate and determine the predisposing factors for ESBL-producing E. coli peritonitis.

Aminoglycoside-Induced Nephrotoxicity—A Focus on Monitoring

2014 ◽  
Vol 27 (6) ◽  
pp. 562-566 ◽  
Author(s):  
Christopher J. Destache
Keyword(s):  
Risk Factors ◽  
Nosocomial Infections ◽  
Multidrug Resistant ◽  
Beta Lactamase ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
The Past ◽  
Related Risk ◽  
Increased Risk ◽  
Level Monitoring

The use of aminoglycoside (AG) antibiotics has declined over the past 15 years primarily due to comparable potency of other antimicrobials and the nephrotoxicity potential of AG drugs. However, resurgence in the use of AG antimicrobials is occurring due to multidrug-resistant gram-negative nosocomial infections. Multidrug-resistant Pseudomonas and Acinetobacter isolates as well as extended-spectrum beta-lactamase–producing Enterobacteriaceae continue to force clinicians to consider AG therapy for nosocomial infections in hospitalized patients and enterococcal endocarditis. Additionally, AGs are still indicated in the treatment of pulmonary exacerbations of cystic fibrosis. Along with the use of AG antibiotics is the associated renal insufficiency complication. This review discusses the mechanism for AG-induced nephrotoxicity. Patient- and drug-related risk factors are discussed to help identify patients at increased risk. The issue of serum-level monitoring is discussed relative to the development of nephrotoxicity.

scholarly journals Risk factors for bacteremia due to extended-spectrum beta-lactamase-producing Escherichia coli in a Turkish hospital

2013 ◽  
Vol 7 (07) ◽  
pp. 507-512 ◽  
Author(s):  
Onur Kaya ◽  
Fusun Zeynep Akcam ◽  
Ibak Gonen ◽  
Onur Unal ◽  
Tennure Ceylan
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Tertiary Care ◽  
Beta Lactamase ◽  
Tertiary Care Centre ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
History Of ◽  
Independent Risk Factors

Introduction: Bloodstream infection caused by extended-spectrum beta-lactamase (ESBL)-producing pathogens has become a serious concern worldwide. The purpose of this study was to identify risk factors for bacteremia due to ESBL-producing Escherichia coli in a Turkish hospital. Methodology: We retrospectively reviewed the medical records of patients with E. coli bacteremia in a tertiary care centre from January 2007 to October 2011. Data from patients such as demographic features, underlying conditions, and antibiotic exposure were analysed. Results: A total of 113 patients with bacteremia due to E. coli were included and data from patients with ESBL-producing E. coli (case patients) were compared to those with non-ESBL-producing E. coli (control patients). The frequency of ESBL producers was 38.9% (44/113). Exposure to fluoroquinolones and cephalosporins, history of intra-abdominal surgery intervention, and presence of central venous catheteter and urinary catheteter were more frequently detected among case patients (P < 0.05). Independent risk factors for bacteremia due to ESBL-producing E. coli were exposure to fluoroquinolones (OR 13.39, 95% CI 1.28-140.03) and cephalosporins (OR 3.48, 95% CI 1.03-11.74). Conclusions: Previous use of fluoroquinolone and cephalosporin in patients with bacteremia caused by E. coli increased the risk for ESBL-producing strains.

scholarly journals Extended-Spectrum Beta-Lactamase Producing Escherichia coli and Klebsiella pneumoniae are Emerging as Major Pathogens Responsible for Urinary Tract Infection

2015 ◽  
Vol 3 (2) ◽  
pp. 49-52
Author(s):  
Sarwar Iqbal ◽  
Muhammad Abdur Rahim ◽  
Tabassum Samad ◽  
Mehruba Alam Ananna ◽  
Palash Mitra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Past History ◽  
Significant Risk ◽  
Beta Lactamase ◽  
Poor Control ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
History Of ◽  
Culture Positive

Background: Escherichia coli and Klebsiella pneumoniae are two common organisms responsible for urinary tract infection (UTI) world-wide. Extended-spectrum beta-lactamase (ESBL) producing E. coli and K. pneumoniae are increasingly being reported as urinary isolates.Objectives: This study was aimed to describe the frequency of ESBL positive E. coli and K. pneumoniae causing UTI, associated risk factors and antibiotic sensitivity pattern of these organisms.Methods: This prospective cross-sectional study was conducted in BIRDEM General Hospital from January 2014 to March 2014. One hundred consecutive culture positive UTI cases due to E. coli or K. pneumoniae infection, irrespective of ESBL positivity were purposively included in this study. UTI due to organisms other than E. coli and K. pneumoniae and culture negative cases were excluded from the study.Results: Total patients were 100, male were 21 and female 79. Mean age was 59.1 (range 19-81) years. Out of 100 patients, 96 were diabetic. Fever, vomiting, dysuria and increased urinary frequency were common symptoms. Among the 100 culture positive samples, E. coli were 84 and K. pneumoniae were 16. Forty eight (48/84, 57.1%) of E. coli and 10 (10/16, 62.5%) of K. pneumoniae were ESBL positive. Female patients, presence of diabetes mellitus (DM), long duration and poor control of DM, chronic kidney disease (CKD), renal stone and past history of UTI were significant risk factors for ESBL positivity. Amikacin, netilmycin and imipenem were among the most sensitive antibiotics.Conclusion: Two-thirds of the E. coli and K. pneumoniae in this study were ESBL positive. Female gender with poor control of DM, CKD and past history of UTI were significant risk factors for ESBL positivity. Aminoglycosides and carbapenems remain the drug of choice.Bangladesh Crit Care J September 2015; 3 (2): 49-52

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