Factors that impact on the burden of Escherichia coli bacteraemia: multivariable regression analysis of 2011–2015 data from West London

Blandy, Oliver; Honeyford, Kate; Gharbi, Myriam; Thomas, Anthony J.; Ramzan, Farzan; Ellington, M.J.; Hope, Russell; Holmes, Alison; Johnson, Alan P.; Aylin, Paul; Woodford, Neil; Sriskandan, Shiranee

doi:10.1016/j.jhin.2018.10.024

Cited by 33 publications

(46 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…England reports a relatively high incidence of 50e60 cases per 100 000 population [80,81]. More than three-quarters were community-onset disease with somehow unexpected increasing tendency over time [81,82]. A population-based study from Australia found an incidence of 52 per 100 000 in the period between 2005 and 2011 [83].…”

Section: Escherichia Coli and Klebsiella Bsi And Third-generation Cepmentioning

confidence: 99%

Burden of bacterial bloodstream infection—a brief update on epidemiology and significance of multidrug-resistant pathogens

Kern

Rieg

2020

Clinical Microbiology and Infection

207

182

View full text Add to dashboard Cite

Background: Bloodstream infections comprise a wide variety of pathogens and clinical syndromes with considerable overlap with similar syndromes of non-bacteraemic infections and diverse risk factors, therapeutic implications and outcomes. Yet, this heterogeneous 'entity' has the advantage to be pathogen-defined compared with the broad and even more heterogeneous entity 'sepsis', and so has become helpful for clinicians and epidemiologists for research and surveillance purposes. The increasing availability of population-based and large multicentre well-defined cohort studies should allow us to assess with much confidence and in detail its burden, the significance of antimicrobial resistance, and areas of uncertainty regarding further epidemiological evolution and optimized treatment regimens. Aim: To review key aspects of bloodstream infection epidemiology and burden, and summarize recent news and questions concerning critical developments. Sources: Peer-reviewed articles based on the search terms 'bloodstream infection' and 'bacteremia' combined with the terms 'epidemiology' and 'burden'. The emphasis was on new information from studies in adult patients and on the added burden due to pathogen resistance to firstand second-line antimicrobial agents. Content: Topics covered include recent developments in the epidemiology of bloodstream infection due to key pathogens and published information about the relevance of resistance for patient outcomes. Implications: Despite the availability of population-based studies and an increasing number of large well-defined multicentre cohort studies, more surveillance and systematic data on bloodstream infection epidemiology at regional level and in resource-limited settings may be needed to better design new methods for prevention and define the need for and further develop optimized therapeutic strategies.

show abstract

Section: Escherichia Coli and Klebsiella Bsi And Third-generation Cepmentioning

confidence: 99%

Burden of bacterial bloodstream infection—a brief update on epidemiology and significance of multidrug-resistant pathogens

Kern

Rieg

2020

Clinical Microbiology and Infection

207

182

View full text Add to dashboard Cite

show abstract

“…Enterobacteriaceae have relatively open pan-genomes and are able to rapidly adapt to changing selection pressures (including antibiotic usage) 6,7 . Multidrug resistance (MDR)-associated STs have been linked with prolonged hospital stay and adverse outcomes 8 . Whilst infections caused by relatively susceptible isolates still represent the majority of cases, the potential for rapid proliferation of AMR-associated clones and the dissemination of AMR genes on mobile genetic elements between lineages and species is a major concern 9 .…”

Section: Introductionmentioning

confidence: 99%

Molecular epidemiology of Escherichia coli and Klebsiella species bloodstream infections in Oxfordshire (UK) 2008-2018

Lipworth

Vihta

Chau

et al. 2021

Preprint

View full text Add to dashboard Cite

The incidence of Gram-negative bloodstream infections (BSIs), predominantly caused by Escherichia coli and Klebsiella species, continues to increase; however the causes of this are unclear and effective interventions are therefore hard to design. In this study we sequenced 3468 sequential, unselected isolates over a decade in Oxfordshire, UK. We demonstrate that the observed increases in E. coli incidence were not driven by clonal expansion; instead, four major sequence types (STs) continue to dominate a stable population structure, with no evidence of adaptation to hospital/community settings. Conversely in Klebsiella spp. most infections are caused by sporadic STs with the exception of a local drug-resistant outbreak strain (ST490). Virulence elements are highly structured by ST in E. coli but not Klebsiella spp. where they occur in a diverse spectrum of STs and equally across healthcare and community settings. Most clinically hypervirulent (i.e. community-onset) Klebsiella BSIs have no known acquired virulence loci. Finally we demonstrate a diverse but largely genus-restricted mobilome with close associations between antimicrobial resistance (AMR) genes and insertion sequences but not typically specific plasmid replicon types; consistent with the dissemination of AMR genes being highly contingent on smaller mobile genetic elements (MGEs). Our large genomic study highlights distinct differences in the molecular epidemiology of E. coli and Klebsiella BSIs, and suggests that no single specific pathogen genetic factors are likely contributing to the increasing incidence of BSI overall, that association with AMR genes in E. coli is a contributor to the increasing number of E. coli BSIs, and that more attention should be given to AMR gene associations with non-plasmid MGEs to try and understand horizontal gene transfer networks.

show abstract

“…Some studies have suggested the importance of the prevention of community-acquired infections in order to reduce the cases of E.coli bacteremia, which are mainly related to underlying UTI. Indeed, prompt adequate treatment of UTI could reduce the prevalence of community-acquired E.coli bacteremia, since a high proportion of these bacterial bloodstream infections are due to treatment failure in UTIs [26]. Single-dose fosfomycin is recommended for the treatment of UTIs in pregnant women, and in this study, the levels of resistance to fosfomycin were 44%.…”

Section: Discussionmentioning

confidence: 63%

Multidrug resistance and its association with Enterobacteriales and age among pregnant Peruvian women with- bacteremia

Quispe

Soza

Pons

2020

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: This study aimed to assess the prevalence of multidrug resistance (MDR) and its associated factors among pregnant Peruvian women with bacteremia. Methodology: In an 18-month cross-sectional study, all pregnant women were routinely tested with a presumptive diagnosis of sepsis admitted to the largest reference maternity hospital (Instituto Nacional Materno Perinatal) in Lima, Peru for bacteremia. Every isolate was tested for antimicrobial susceptibility as defined by the Institute of Clinical and Laboratory Standards (CLSI). Additionally, associated factors were assessed with MDR and the number of resistant antimicrobial categories using robust Poisson regression models with link log, especially focused on its association with age and bacterial families or species. Results: A total of 236 blood cultures of pregnant women (33.4 ± 11.4 years old) was analyzed. The prevalence of MDR was 70% (95% confidence interval [CI]: 64%–76%). The main etiological agent was Escherichia coli (65%), showing an MDR rate of 74% (68%–81%). Overall, we observed that the MDR rate was associated with Enterobacteriales (adjusted prevalence rate, (aPR) = 1.29; 95% CI: 1.03–1.61) and age 35 or older (PR = 1.18; 95% CI: 1.01–1.39). However, the number of resistant antimicrobial categories was associated with Enterobacteriales (aPR = 1.44; 95% CI: 1.25–1.67) and hospital-acquired infections (PR = 0.81; 95% CI: 1.01–1.39). Conclusions: The prevalence of MDR among pregnant women with sepsis was alarmingly high, being even higher among women age 35 or older and among those with hospital-acquired infections.

show abstract

Factors that impact on the burden of Escherichia coli bacteraemia: multivariable regression analysis of 2011–2015 data from West London

Cited by 33 publications

References 26 publications

Burden of bacterial bloodstream infection—a brief update on epidemiology and significance of multidrug-resistant pathogens

Burden of bacterial bloodstream infection—a brief update on epidemiology and significance of multidrug-resistant pathogens

Molecular epidemiology of Escherichia coli and Klebsiella species bloodstream infections in Oxfordshire (UK) 2008-2018

Multidrug resistance and its association with Enterobacteriales and age among pregnant Peruvian women with- bacteremia

Contact Info

Product

Resources

About