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 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 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 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

scholarly journals Multidrug-Resistant, Including Extended-Spectrum Beta Lactamase-Producing and Quinolone-Resistant, Escherichia coli Isolated from Poultry and Domestic Pigs in Dar es Salaam, Tanzania

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 406
Author(s):  
Zuhura I. Kimera ◽  
Fauster X. Mgaya ◽  
Gerald Misinzo ◽  
Stephen E. Mshana ◽  
Nyambura Moremi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Multidrug Resistant ◽  
Antibiotics Resistance ◽  
Beta Lactamase ◽  
Domestic Pigs ◽  
Extended Spectrum Beta Lactamase ◽  
Phenotypic Profile ◽  
E Coli ◽  
Extended Spectrum ◽  
Esbl Producers

We determined the phenotypic profile of multidrug-resistant (MDR) Escherichia coli isolated from 698 samples (390 and 308 from poultry and domestic pigs, respectively). In total, 562 Enterobacteria were isolated. About 80.5% of the isolates were E. coli. Occurrence of E. coli was significantly higher among domestic pigs (73.1%) than in poultry (60.5%) (p = 0.000). In both poultry and domestic pigs, E. coli isolates were highly resistant to tetracycline (63.5%), nalidixic acid (53.7%), ampicillin (52.3%), and trimethoprim/sulfamethoxazole (50.9%). About 51.6%, 65.3%, and 53.7% of E. coli were MDR, extended-spectrum beta lactamase-producing enterobacteriaceae (ESBL-PE), and quinolone-resistant, respectively. A total of 68% of the extended-spectrum beta lactamase (ESBL) producers were also resistant to quinolones. For all tested antibiotics, resistance was significantly higher in ESBL-producing and quinolone-resistant isolates than the non-ESBL producers and non-quinolone-resistant E. coli. Eight isolates were resistant to eight classes of antimicrobials. We compared phenotypic with genotypic results of 20 MDR E. coli isolates, ESBL producers, and quinolone-resistant strains and found 80% harbored blaCTX-M, 15% aac(6)-lb-cr, 10% qnrB, and 5% qepA. None harbored TEM, SHV, qnrA, qnrS, qnrC, or qnrD. The observed pattern and level of resistance render this portfolio of antibiotics ineffective for their intended use.

scholarly journals Evaluation of extended spectrum beta lactamase enzymes prevalence in clinical isolates of Escherichia coli

2011 ◽  
Vol 2 (1) ◽  
pp. 8
Author(s):  
Ronak Bakhtiari ◽  
Jalil Fallah Mehrabadi ◽  
Hedroosha Molla Agamirzaei ◽  
Ailar Sabbaghi ◽  
Mohammad Mehdi Soltan Dallal
Keyword(s):  
Escherichia Coli ◽  
Disk Diffusion ◽  
Confirmatory Test ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Beta Lactamase ◽  
Disk Diffusion Method ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum

Resistance to b-lactam antibiotics by gramnegative bacteria, especially <em>Escherichia coli (E. coli)</em>, is a major public health issue worldwide. The predominant resistance mechanism in gram negative bacteria particularly <em>E. coli </em>is via the production of extended spectrum beta lactamase (ESBLs) enzymes. In recent years, the prevalence of b-lactamase producing organisms is increased and identification of these isolates by using disk diffusion method and no-one else is not satisfactory. So, this investigation focused on evaluating the prevalence of ESBL enzymes by disk diffusion method and confirmatory test (Combined Disk). Five hundred clinical samples were collected and 200 <em>E. coli </em>isolates were detected by standard biochemical tests. To performing initial screening of ESBLs was used from Disk diffusion method on <em>E. coli </em>isolates. A confirmation test (Combined Disk method) was performed on isolates of resistant to cephalosporin's indicators. Up to 70% isolates exhibited the Multi Drug Resistance phenotype. In Disk diffusion method, 128(64%) <em>E. coli </em>isolates which resistant to ceftazidime and cefotaxime while in Combined Disk, among 128 screened isolates, 115 (89.8%) isolates were detected as ESBLs producers. This survey indicate beta lactamase enzymes are playing a significant role in antibiotic resistance and correct detection of them in phenotypic test by using disk diffusion and combined Disk is essential for accurate recognition of ESBLs.

scholarly journals Extended Spectrum Beta-Lactamase Escherichia coli in River Waters Collected from Two Cities in Ghana, 2018–2020

2021 ◽  
Vol 6 (2) ◽  
pp. 105
Author(s):  
Regina Ama Banu ◽  
Jorge Matheu Alvarez ◽  
Anthony J. Reid ◽  
Wendemagegn Enbiale ◽  
Appiah-Korang Labi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
River Waters ◽  
E Coli ◽  
Extended Spectrum ◽  
Two Cities ◽  
Animal Wastewater ◽  
Sources Of Contamination

Infections by Extended-Spectrum Beta-Lactamase producing Escherichia coli (ESBL-Ec) are on the increase in Ghana, but the level of environmental contamination with this organism, which may contribute to growing Antimicrobial Resistance (AMR), is unknown. Using the WHO OneHealth Tricycle Protocol, we investigated the contamination of E. coli (Ec) and ESBL-Ec in two rivers in Ghana (Odaw in Accra and Okurudu in Kasoa) that receive effluents from human and animal wastewater hotspots over a 12-month period. Concentrations of Ec, ESBL-Ec and percent ESBL-Ec/Ec were determined per 100 mL sample. Of 96 samples, 94 (98%) were positive for ESBL-Ec. concentrations per 100 mL (MCs100) of ESBL-Ec and %ESBL-Ec from both rivers were 4.2 × 104 (IQR, 3.1 × 103–2.3 × 105) and 2.79 (IQR, 0.96–6.03), respectively. MCs100 were significantly lower in upstream waters: 1.8 × 104 (IQR, 9.0 × 103–3.9 × 104) as compared to downstream waters: 1.9 × 106 (IQR, 3.7 × 105–5.4 × 106). Both human and animal wastewater effluents contributed to the increased contamination downstream. This study revealed high levels of ESBL-Ec in rivers flowing through two cities in Ghana. There is a need to manage the sources of contamination as they may contribute to the acquisition and spread of ESBL-Ec in humans and animals, thereby contributing to AMR.

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