scholarly journals Increasing Incidence of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae (ESBL) and the Relation to Consumption of Broad-Spectrum Antimicrobial Agents 2003-2011 in a Large Area of Copenhagen, Denmark

2015 ◽  
Vol 05 (01) ◽  
pp. 28-42 ◽  
Author(s):  
Lene Nielsen ◽  
Anne Kjerulf ◽  
Magnus Arpi
Keyword(s):  
Broad Spectrum ◽  
Antimicrobial Agents ◽  
Beta Lactamase ◽  
Large Area ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

scholarly journals Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Meningitis and Cerebral Abscess in a Neonate: Therapeutic Challenge

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Surasak Puvabanditsin ◽  
Marianne Jacob ◽  
Maaz Jalil ◽  
Samhita Bhattarai ◽  
Qaiser Patel ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Agents ◽  
Cerebral Abscess ◽  
Term Neonate ◽  
Resistant Bacteria ◽  
Beta Lactamase ◽  
Therapeutic Challenge ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum

We report a case of a 12-day-old term neonate with extended-spectrum beta-lactamase (ESBL) producing Escherichia coli (E. coli) meningitis and cerebral abscess. The patient received a 7-day course of antibiotics just few days prior to the infection. The incidence of infections from ESBL-producing E. coli is increasingly emerging. Antimicrobial agents must be vigilantly utilized to prevent the new highly resistant bacteria.

scholarly journals Efficacies of piperacillin-tazobactam and cefepime in rats with experimental intra-abdominal abscesses due to an extended-spectrum beta-lactamase-producing strain of Klebsiella pneumoniae.

1997 ◽  
Vol 41 (5) ◽  
pp. 1053-1057 ◽  
Author(s):  
C Thauvin-Eliopoulos ◽  
M F Tripodi ◽  
R C Moellering ◽  
G M Eliopoulos
Keyword(s):  
Klebsiella Pneumoniae ◽  
Antimicrobial Agents ◽  
Total Duration ◽  
Viable Cell ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Abdominal Abscesses ◽  
Cell Counts ◽  
Extended Spectrum

The in vivo activities of piperacillin-tazobactam and cefepime were compared with those of ticarcillin-clavulanate, ceftazidime, cefotaxime, and imipenem in a rat model of intra-abdominal abscess with a strain of Klebsiella pneumoniae elaborating an extended-spectrum beta-lactamase (TEM-26). With the exception of ceftazidime, all of the antimicrobial agents significantly reduced bacterial counts within abscesses at the end of therapy compared with those in untreated controls. Residual viable cell counts (mean +/- standard deviation in log10 CFU/gram) were as follows: control, 8.76 +/- 0.97; ceftazidime, 8.00 +/- 0.76; piperacillin-tazobactam, 3.87 +/- 1.72; ticarcillin-clavulanate, 3.74 +/- 1.34; cefepime, 3.15 +/- 1.19; cefotaxime, 2.61 +/- 0.77; imipenem, 2.41 +/- 0.93. Imipenem was more effective than either of the inhibitor combinations (P < 0.05). Cefotaxime was unexpectedly effective given its poor in vivo activity against this organism in our earlier studies, which used a different dose and total duration of therapy (L. B. Rice, J. D. C. Yao, K. Klimm, G. M. Eliopoulos, and R. C. Moellering, Jr., Antimicrob. Agents Chemother. 35:1243-1244, 1991). These observations suggest that the effectiveness of cephalosporins in the treatment of experimental infections caused by extended-spectrum beta-lactamase-producing K. pneumoniae may be highly dependent on dosing regimens, even for a specific organism and site of infection.

scholarly journals Impact of a restrictive antibiotic policy on the acquisition of extended-spectrum beta-lactamase-producing Enterobacteriaceae in an endemic region: a before-and-after, propensity-matched cohort study in a Caribbean intensive care unit

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Christophe Le Terrier ◽  
Marco Vinetti ◽  
Paul Bonjean ◽  
Régine Richard ◽  
Bruno Jarrige ◽  
...  
Keyword(s):  
Propensity Score ◽  
Median Time ◽  
Broad Spectrum ◽  
Hazard Ratio ◽  
Beta Lactamase ◽  
Icu Mortality ◽  
Antibiotic Policy ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Before And After

Abstract Background High-level antibiotic consumption plays a critical role in the selection and spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) in the ICU. Implementation of a stewardship program including a restrictive antibiotic policy was evaluated with respect to ESBL-E acquisition (carriage and infection). Methods We implemented a 2-year, before-and-after intervention study including all consecutive adult patients admitted for > 48 h in the medical-surgical 26-bed ICU of Guadeloupe University Hospital (French West Indies). A conventional strategy period (CSP) including a broad-spectrum antibiotic as initial empirical treatment, followed by de-escalation (period before), was compared to a restrictive strategy period (RSP) limiting broad-spectrum antibiotics and shortening their duration. Antibiotic therapy was delayed and initiated only after microbiological identification, except for septic shock, severe acute respiratory distress syndrome and meningitis (period after). A multivariate Cox proportional hazard regression model adjusted on propensity score values was performed. The main outcome was the median time of being ESBL-E-free in the ICU. Secondary outcome included all-cause ICU mortality. Results The study included 1541 patients: 738 in the CSP and 803 in the RSP. During the RSP, less patients were treated with antibiotics (46.8% vs. 57.9%; p < 0.01), treatment duration was shorter (5 vs. 6 days; p < 0.01), and administration of antibiotics targeting anaerobic pathogens significantly decreased (65.3% vs. 33.5%; p < 0.01) compared to the CSP. The incidence of ICU-acquired ESBL-E was lower (12.1% vs. 19%; p < 0.01) during the RSP. The median time of being ESBL-E-free was 22 days (95% CI 16-NA) in the RSP and 18 days (95% CI 16–21) in the CSP. After propensity score weighting and adjusted analysis, the median time of being ESBL-E-free was independently associated with the RSP (hazard ratio, 0.746 [95% CI 0.575–0.968]; p = 0.02, and hazard ratio 0.751 [95% CI 0.578–0.977]; p = 0.03, respectively). All-cause ICU mortality was lower in the RSP than in the CSP (22.5% vs. 28.6%; p < 0.01). Conclusions Implementation of a program including a restrictive antibiotic strategy is feasible and is associated with less ESBL-E acquisition in the ICU without any worsening of patient outcome.

scholarly journals Occurrence of extended-spectrum beta-lactamase producing E. coli in broiler farm workers and the farm environment in Chiang Mai-Lamphun, Thailand

2020 ◽  
Vol 19 (1) ◽  
pp. 23-35
Author(s):  
Jutamart Rodroo ◽  
◽  
Montira Intanon ◽  
Khwanchai Kreausukon ◽  
Aphisek Kongkaew ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
Close Contact ◽  
Farm Workers ◽  
Beta Lactamase ◽  
Global Public Health ◽  
Chiang Mai ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum

Antimicrobial resistance has become a major global public health threat. Extended-spectrum beta-lactamase (ESBL) producing E. coli appears as an emergence cause of treatment failure and increase mortality due to limited available effective antimicrobial agents. This study was conducted to determine the occurrence and antimicrobial resistance of ESBL producing E. coli in broilers, farm workers and environment in broiler farms in Chiang Mai-Lamphun, Thailand. The prevalence of ESBL producing E. coli in the broiler farms was 60.4% (29/48). The prevalence of ESBL producing E. coli from boot swabs, farm worker’s rectal swabs, feed and water samples were 43.8%, 55.7%, 12.5% and 2.1%, respectively. All isolates showed susceptible to imipenem and, in contrast, resistant to ampicillin. The results demonstrated high antimicrobial resistant rate to streptomycin (94.3%), gentamicin (86.8%), tetracycline (77.4%), chloramphenicol (66.0%), nalidixic acid (58.5%), and sulfamethoxazole/trimethoprim (56.6%). High percentage (96.2%) of isolates was classified as multidrug resistance (MDR). Thirty-five antimicrobial resistance profiles were identified with AMP-GEN-SXT-NAL-TET-CHL-STR, AMP-GEN-SXT-TET-CHL-STR (14.3%) as the 2 most prevalent profiles. The common resistance profiles between farm workers and broilers was demonstrated. These findings are suggestive for possible transmission between poultry and humans in broiler farms, most likely via close contact. Antimicrobial usage should be strictly controlled together with increase awareness on hygiene practices in broiler farms.

Surveillance in Taiwan Using Molecular Epidemiology for Extended-Spectrum Beta-Lactamase-ProducingKlebsiella pneumoniae

2004 ◽  
Vol 25 (10) ◽  
pp. 812-818 ◽  
Author(s):  
Wen-Liang Yu ◽  
Patricia L. Winokur ◽  
Ronald N. Jones ◽  
Hélio S. Sader
Keyword(s):  
Isoelectric Focusing ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Beta Lactamase ◽  
University Hospitals ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Central Regions ◽  
Typing Methods ◽  
Computer Based

AbstractObjective:To evaluate intrahospital and interhospital clonal dissemination of extended-spectrum beta-lactamase (ESBL)-producing strains ofKlebsiella pneumoniae.Setting:Eight tertiary-care university hospitals and 16 regional hospitals in Taiwan.Methods:Two hundred eleven confirmed ESBL-producing isolates ofK. pneumoniaewere collected from January 1998 to June 2000. The isolates were characterized by various typing methods, including antibiogram (9 antimicrobial agents), computer-based ribotyping, pulsed-field gel electrophoresis (PFGE), and isoelectric focusing of beta-lactamase.Results:Ribotyping identified 70 distinct ribogroups among 200 isolates evaluated. Forty-three of these ribogroups were unique. Eleven ribogroups, comprising 115 isolates, were detected in more than one hospital (interhospital dissemination), whereas 16 groups (42 isolates) were detected in more than one patient within a hospital (intrahospital dissemination). The combination of ribotyping and PFGE identified two large epidemic clones, which were called 691.5/PFGE-G and 595.7/PFGE-A. These epidemic clones were detected mainly in the hospitals located in the northern and central regions of Taiwan. However, variation of the profiles of antibiograms and isoelectric focusing was apparent within each clone. In addition, isolates with the same isoelectric focusing profile (isoelectric points 7.9, 8.2, and 8.4) and antibiogram (resistance to 9 compounds evaluated) were present among different molecular-typed clones.Conclusions:Our results showed that clonal dissemination (both interhospital and intrahospital dissemination) is occurring in several regions of Taiwan. Rapid computer-based ribotyping associated with PFGE demonstrated multiple epidemic clones of ESBL-producingK. pneumoniaein Taiwan. The combination of phenotypic and molecular methods has proved useful to characterize these epidemic clones.

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