Escherichia coli early-onset sepsis: trends over two decades

Mendoza-Palomar, Natàlia; Balasch-Carulla, Milena; Lauro, Sabina González-Di; Céspedes, Maria Concepció; Andreu, Antònia; Frick, Marie Antoinette; Linde, Maria Ángeles; Soler‐Palacín, Pere

doi:10.1007/s00431-017-2975-z

Cited by 49 publications

(44 citation statements)

References 28 publications

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“…They reported ampicillin resistance in 75% of isolates and gentamicin resistance in 12% overall, with considerable increase in resistance reported in the period 2010–2014. Cefotaxime resistance, however, was rarely found . In our nationwide study, we demonstrated significant gentamicin resistance among Gram‐negative isolates in general (16%) and specifically among Escherichia coli and Klebsiella isolates (17%).…”

Section: Discussionmentioning

confidence: 66%

“…Previous studies demonstrated low gentamicin resistance in Gram‐negative isolates, 2% in Australia and New Zealand and 0–4% in studies from the United States, leading to the conclusion that ampicillin plus gentamicin remains appropriate empiric regimen for EOS . However, an alarming increase in the antimicrobial resistance rates of Gram‐negative bacteria in neonates, including cefotaxime resistance as ESBL phenotype, and gentamicin resistance, has been reported in India and other countries . Indeed, a recent publication from Spain evaluated trends in clinical and microbiologic characteristics of Escherichia coli EOS in 1994–2014 in a single centre.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, in our study, dual gentamicin resistance and ESBL phenotype were found in 8% of Gram‐negative pathogens, thus limiting the therapeutic options available for neonates infected with these bacteria. Additional large‐scale studies from developed and developing countries are urgently needed to investigate the antimicrobial resistance in Gram‐negative EOS pathogens, with specific attention to aminoglycoside resistance and ESBL phenotype, as current data are limited .…”

Section: Discussionmentioning

confidence: 99%

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Nationwide epidemiology of early‐onset sepsis in Israel 2010‐2015, time to re‐evaluate empiric treatment

et al. 2019

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Aim: Early-onset neonatal sepsis (EOS) may lead to significant morbidity and mortality, yet the recommended antimicrobials have not changed for many years. We aimed to optimise EOS treatment by examining EOS pathogens, resistance rates and resistance risk factors.Methods: A retrospective, nationwide cohort study analysing 2010-2015 EOS data in Israel. Results:The 21 participating centres constitute 92% of the total birth cohort (around 180 000 live births/year). Of 549 EOS neonates (0.57/1000 live births), 306 (56%) and 243 (44%) were full-term and preterm, respectively (0.35 vs. 2.94 per/1000 live births). Gram-negative pathogens predominated, especially in preterms. Escherichia coli and Streptococcus agalactiae were most common pathogens (0.2 and 0.19 per 1000 live births, respectively). In 277 Gram-negatives, 16%, 14%, 8% and 3% were gentamicinresistant, extended-spectrum beta-lactamase (ESBL)-positive, gentamicin-resistant and ESBL-positive, and amikacin-resistant, respectively; preterms had higher resistance rates. No risk factors for antimicrobial resistance were identified. Mortality was reported in 21% of Gram-negative EOS versus 7% of Gram-positive EOS [OR 3.4 (95% CI 1.8-6.2), p < 0.01].Conclusion: In this nationwide study, EOS was caused predominantly by Gram-negatives, with high gentamicin resistance and ESBL phenotype rates, without identifiable resistance risk factors. As EOS is life-threatening, modification of empiric therapy for amikacin-based regimens should be considered, mainly in preterms.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Nationwide epidemiology of early‐onset sepsis in Israel 2010‐2015, time to re‐evaluate empiric treatment

et al. 2019

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“…Among febrile infants≤28 days-old, the prevalence of bacteremia and meningitis is high, E.coli is one of the most common bacterial pathogens [9] . The incidence of E. coli early-onset sepsis in very low birth weight infants was 10.4 cases per 1000 live births and mortality reached 35.3% [10] . A recent meta-analysis based on a systematic review of the published studies in Chinese literature demonstrates that in newborn infants hospitalized in Chinese NICUs, roughly 50% of all E. coli bloodstream isolates (regardless of early onset or late onset) are multi-drug resistant due to extended-spectrum beta-lactamase (ESBL) production [11][12] .…”

Section: Discussionmentioning

confidence: 99%

Emergence of high multidrug-resistant Escherichia coli isolates from neonates with infection

Wu¹,

Ding²,

Zhang³

et al. 2020

Preprint

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Background Escherichia coli (E.coli) rank one of the most common pathogens that can cause neonatal infections. The emergence of antibiotic-resistant bacteria is a major cause of treatment failure in newborn with infection. The purpose of this study was to describe the antibiotic resistance and multidrug-resistance of E.coli isolated from neonates with infection.Methods The antimicrobial susceptibility testing of the E. coli strains to selected antibiotics was assessed with the E-test technique on the Mueller-Hinton agar. The antimicrobials tests were included ceftazidime, cefuroxime, cefatriaxone, amoxicillin, amoxicillin-clavulanic acid, cefoperazone - sulbactam, meropenem, gentamicin, ciprofloxacin and sulfonamides. The minimal inhibitory concerntration (MIC) values of the antimicrobial agents selected for this study was determined by an agar dilution technique on Mueller-Hinton agar according to the Clinical and Laboratory Standards Institute recommendations. Results A total of 100 E. coli strains was isolated from phlegm (n = 78), blood (n = 10), cerebrospinal fluid (n = 5), and umbilical discharge (n = 7) of neonates hospitalized at Beijing Children’s Hospital. The highest resistance rate of E.coli was found in amoxicillin at 85%, followed by cefuroxime 65%, and cefatriaxone 60%, respectively. 6% and 5% of all isolates were resistant to amoxicillin/clavulanic acid and cefoperazone -sulbactam merely. The resistance rates to ceftazidime, gentamicin, ciprofloxacin and sulfonamides were 31%, 20%, 33%, 47%, respectively. All the isolates were susceptible to meropenem. Multidrug resistance was defined in E.coli as resistance to at least three antibiotic families. About 26% (26/100) of all the E.coli isolates were multidrug-resistant. The detection rate of ESBL-Producing E. coli was 55%. The rate in E. coli isolates from phlegm was higher than aseptic humoral. The difference was statistically significant (P < 0.05). It is worth noting that the majority of the isolates were also resistant to non-β-lactam antimicrobial agents, but the resistant rates were significantly lower than extended-spectrum β-lactamases.Conclusions: Multi-drug-resistant E.coli has become a thorny problem in clinical treatment. It is necessary to monitor E. coli resistance.

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“…However, an increase in the incidence of early-onset Escherichia coli sepsis has occurred during the same time period (4). Several studies have found that the incidence of early-onset E. coli sepsis has continued to increase over the last decades, and this has manifested itself as increased disease severity and risk of newborn death (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Pathogens Responsible for Early-Onset Sepsis in Suzhou, China

Pan

et al. 2020

Jpn J Infect Dis

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Escherichia coli early-onset sepsis: trends over two decades

Cited by 49 publications

References 28 publications

Nationwide epidemiology of early‐onset sepsis in Israel 2010‐2015, time to re‐evaluate empiric treatment

Nationwide epidemiology of early‐onset sepsis in Israel 2010‐2015, time to re‐evaluate empiric treatment

Emergence of high multidrug-resistant Escherichia coli isolates from neonates with infection

Pathogens Responsible for Early-Onset Sepsis in Suzhou, China

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