Epidemiology of extended-spectrum beta-lactamase (ESBL) producing Escherichia coli in Japan: Characteristics of community-associated versus healthcare-associated ESBL E. coli

Hayakawa, Kayoko; Nagamatsu, Maki; Mezaki, Kazuhisa; Sugiki, Yuko; Kutsuna, Satoshi; Takeshita, Nozomi; Yamamoto, Kei; Mawatari, Momoko; Fujiya, Yoshihiro; Ohmagari, Norio

doi:10.1016/j.jiac.2016.08.010

Cited by 16 publications

(9 citation statements)

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“…An increasing proportion of ESBL-producing E. coli among patients without any healthcare risk factors was observed in South Korea 24. In a report from Japan, 26.3% patients with ESBL-producing E. coli infection were considered to be community-associated because there were no discernible healthcare-associated risk factors 25. Community-associated infections caused by ESBL-producing E. coli have already raised public-health concerns and are gradually becoming a clinical challenge 26.…”

Section: Discussionmentioning

confidence: 99%

Multi-Drug Resistant Escherichia coli Causing Early-Onset Neonatal Sepsis – a Single Center Experience from China

Zhu¹,

Jin²,

Duan³

et al. 2019

IDR

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Background and objectiveInfections caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) have raised public-health concerns and are becoming a global health challenge. This study aimed to investigate changes in antimicrobial resistance of E. coli responsible for early-onset sepsis (EOS) in a perinatal center in eastern China.MethodsTwo periods, 2002 to 2008 and 2012 to 2018, were investigated. EOS was defined as the presence of a single potentially pathogenic bacterium grown from blood or cerebrospinal fluid in cultures drawn in any newborn infant within 72 hrs of birth. The changes in antimicrobial resistance of E. coli were analyzed.ResultsA total of 163 cases of EOS were identified, and E. coli continued to be the leading pathogen in our neonatal intensive care unit (NICU). Overall resistance of E. coli to third-generation cephalosporins increased from 14.3% in 2002–2008 to 46.7% in 2012–2018 (p<0.05). This resistance pattern closely parallels ESBL production. Compared to that from term infants, E. coli isolated from preterm infants had a significantly higher rate of resistance to ampicillin (93.3% vs 48.4%, p<0.01) and gentamicin (60.0% vs 9.4%, p<0.01), as well as a higher rate of ESBL production (66.7% vs 15.6%, p<0.01).ConclusionWe conclude that ESBL-producing multi-drug resistant E. coli has emerged as the major pathogen responsible for early-onset neonatal sepsis, particularly in preterm infants. Clinicians should consider this trend and attempt to select proper effective antibiotics as the empirical treatment for early-onset neonatal sepsis.

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Section: Discussionmentioning

confidence: 99%

Multi-Drug Resistant Escherichia coli Causing Early-Onset Neonatal Sepsis – a Single Center Experience from China

Zhu¹,

Jin²,

Duan³

et al. 2019

IDR

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“…The primary study objective was to evaluate the rates of antibiotic prescription changes within 2 days of rapid identification using the Verigene system. On the basis of a previous study [ 11 ], the possible rate of antibiotic changes after rapid identification by the Verigene system was estimated as 35%. Using EZR, (Saitama Medical Center, Jichi Medical University, Saitama, Japan), we calculated that a sample size of 179 cases would produce a two-sided 95% confidence interval with a width equal to 0.14 when the sample proportion is 0.35.…”

Section: Methodsmentioning

confidence: 99%

Impact of rapid identification of positive blood cultures using the Verigene system on antibiotic prescriptions: A prospective study of community-onset bacteremia in a tertiary hospital in Japan

et al. 2017

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BackgroundRapid identification of positive blood cultures is important for initiation of optimal treatment in septic patients. Effects of automated, microarray-based rapid identification systems on antibiotic prescription against community-onset bacteremia (COB) remain unclear.MethodsWe prospectively enrolled 177 patients with 185 COB episodes (occurring within 72 h of admission) over 17 months. Bacteremia episodes due to gram-positive bacteria (GP) and gram-negative bacteria (GN) in the same patient were counted separately. For GP bacteremia, patients with ≥2 sets of positive blood cultures were included. The primary study objective was evaluating the rates of antibiotic prescription changes within 2 days of rapid identification using the Verigene system.ResultsBacteremia due to GN and GP included 144/185 (77.8%) and 41/185 (22.2%) episodes, respectively. Antibiotic prescription changes occurred in 51/185 cases (27.6% [95%CI:21.3–34.6%]) after Verigene analysis and 70/185 cases (37.8% [30.8–45.2%]) after conventional identification and susceptibility testing. Prescription changes after Verigene identification were more frequent in GP (17/41[41.5%]) than in GN (34/144[23.5%]). Among bacteremia due to single pathogen targeted by Verigene test, bacterial identification agreement between the two tests was high (GP: 38/39[97.4%], GN: 116/116[100%]). The Verigene test correctly predicted targeted antimicrobial resistance. The durations between the initiation of incubation and reporting of the results for the Verigene system and conventional test was 28.3 h (IQR: 25.8–43.4 h) and 90.6 h (68.3–118.4 h), respectively. In only four of the seven episodes of COB in which two isolates were identified by conventional tests, the Verigene test correctly identified both organisms.ConclusionWe observed a high rate of antibiotic prescription changes after the Verigene test in a population with COB especially in GP. The Verigene test would be a useful tool in antimicrobial stewardship programs among patients with COB.

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“…This was a retrospective observational study, and most of the isolates included in this study were not available for further microbiological/molecular analysis. Although 8 out of 27 ESBL- E. coli isolates included in this study were found to be positive for different groups of CTX-M (4 isolates were positive for CTX-M group 9, 1 isolate was positive for CTX-M group 1 [other than CTX-M-15] [ 20 ], and 3 isolates were positive for CTX-M-15), it is possible that a closely related clonal strain might have caused some portion of the ESBLPE included in this study.…”

Section: Main Textmentioning

confidence: 99%

Bacteraemic urinary tract infections in a tertiary hospital in Japan: the epidemiology of community-acquired infections and the role of non-carbapenem therapy

et al. 2017

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ObjectivesThis study aimed to describe the epidemiology of bacteraemic urinary tract infections (UTIs), especially those that were community-acquired (i.e., with no discernible healthcare-associated exposure) and caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBLPE). We also evaluated and compared empirical antimicrobial treatments [carbapenem (CBP) vs. non-carbapenem beta-lactam (non-CBPBL)] for bacteraemic UTIs. Finally, we reviewed the published literature on the effectiveness of non-CBP compared to CBP treatments for UTIs caused by extended-spectrum beta-lactamase-producing organisms.ResultsA total of 339 bacteraemic UTI episodes were identified; 32 (9.4%) were caused by ESBLPE. In bacteraemic UTI episodes, ESBLPE accounted for 8.3% of hospital-acquired cases, 10.0% of community-acquired cases, and 8.2% of non-healthcare-associated cases. As effective empirical therapy for ESBLPE, 12 patients received CBP and 7 patients received non-CBPBL treatments [piperacillin/tazobactam (PT) or cefmetazole (CMZ)]. Age, sex, Pitt bacteraemia score, immunosuppressive status, and causative bacterial species were similar between groups; neither group experienced mortality within 14 days. The number of days to defervescence was similar between groups. No difference was noted in the rates of microbiological cure (58% vs. 57%, P = 1.0). Five of seven patients in the non-CBPBL group did not receive CBP during the treatment period, even as definitive therapy, but all experienced clinical cure.

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Epidemiology of extended-spectrum beta-lactamase (ESBL) producing Escherichia coli in Japan: Characteristics of community-associated versus healthcare-associated ESBL E. coli

Cited by 16 publications

References 10 publications

<p>Multi-Drug Resistant <em>Escherichia coli</em> Causing Early-Onset Neonatal Sepsis – a Single Center Experience from China</p>

<p>Multi-Drug Resistant <em>Escherichia coli</em> Causing Early-Onset Neonatal Sepsis – a Single Center Experience from China</p>

Impact of rapid identification of positive blood cultures using the Verigene system on antibiotic prescriptions: A prospective study of community-onset bacteremia in a tertiary hospital in Japan

Bacteraemic urinary tract infections in a tertiary hospital in Japan: the epidemiology of community-acquired infections and the role of non-carbapenem therapy

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