<i>In Vitro</i>
            Activities of 21 Antimicrobial Agents Alone and in Combination with Aminoglycosides or Fluoroquinolones against Extended-Spectrum-β-Lactamase-Producing Escherichia coli Isolates Causing Bacteremia

Kyeong, Min; Kang, Cheol-In; Kim, So Hyun; Cho, Sun Young; Ha, Young Eun; Wi, Yu Mi; Chung, Doo Ryeon; Peck, Kyong Ran; Song, Jae-Hoon

doi:10.1128/aac.01121-15

Cited by 18 publications

(19 citation statements)

References 16 publications

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“…[ 25 ] The proportion of multidrug resistance E coli varies due to the underlying diseases and regional differences (range 31–92%). [ 26 – 30 ] In our study, 85.6% stains isolated were MDR and 2.4% were XDR. Regarding ESBL-EC, nearly all (98.6%) were MDR.…”

Section: Discussionmentioning

confidence: 48%

Antimicrobial resistance patterns, clinical features, and risk factors for septic shock and death of nosocomial E coli bacteremia in adult patients with hematological disease

Li²,

Liu³

et al. 2017

Medicine

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The aim of this retrospective analysis was to evaluate the antimicrobial resistance, clinical features, and risk factors for septic shock and death of nosocomial E coli bacteremia in adult patients in a single hematological center in China. A retrospective case-control study of 157 adult hematological patients with 168 episodes of E coli bacteremia was initiated from April 2012 to July 2015. Antimicrobial susceptibility as well as antimicrobial co-resistance rates were analyzed. Clinical features and outcomes were also studied. In addition, risk factors for septic shock and death were investigated. Among the 553 positive blood isolates during the study period, the prevalence of E coli was 33.3% and ESBL production strains represented 61.9% of those examined. In all the E coli strains isolated, 85.6% were multidrug-resistance (MDR), 2.4% were extensive drug resistance (XDR), and 6.0% were resistant to carbapenems. More MDR phenotype was noted in ESBL-EC strains (98.6% vs 62.8%, P<.001) and isolates from neutropenic patients (98.6% vs 62.8%, P < .001). In the antimicrobial susceptibility test, carbapenems and amikacin exhibited not only higher in vitro activity against E coli (94.0% and 92.0%, respectively), but lower co-resistance rates to other antibiotics. Carbapenem resistant strains retained full sensitivity to tigecycline and 60% to amikacin. Piperacillin/tazobatam was the third sensitive drug to both ESBL-EC (77.1%) and non-ESBL-EC (86.0%). In our series, 81.6% episodes received appropriate initial antibiotic treatment and no significant decrease in it was found in bacteremia due to ESBL E coli and patients with neutropenia, septic shock. Septic shock was noted in 15.5% patients and the overall 30-day mortality rate was 21.7%. Multivariate analysis revealed that induction chemotherapy (OR 2.126; 95% CI 1.624–11.332; P = .003) and polymicrobial infection (OR 3.628; 95% CI 1.065–21.219; P = .041) were risk factors for septic shock, whereas male (OR 2.223; 95% CI 1.132–12.022; P < .01) and septic shock (OR 52.359; 95% CI 19.951–292.690; P = .030) were risk factors for death.In the hematology department, ESBL-producing and MDR are widely prevalent in E coli bacteremia which is still a major life-threatening problem, especially for patients with septic shock. For empirical antimicrobial therapy, combination based on aminoglycoside, especially amikacin, will be helpful to increase the antimicrobial coverage against ESBL-EC while combining tigecycline with aminoglycoside should be considered for seriously carbapenem-resistant infectious patients.

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Section: Discussionmentioning

confidence: 48%

Antimicrobial resistance patterns, clinical features, and risk factors for septic shock and death of nosocomial E coli bacteremia in adult patients with hematological disease

Li²,

Liu³

et al. 2017

Medicine

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“…Piperacillin‐tazobactam is a possible choice but covers only 80% of the Enterobacteriaceae and 94% of the E. coli . Adding in amikacin increases the coverage, but clinicians remain concerned about the risk of aminoglycoside nephrotoxicity. In one study, 5 of 20 carbapenem‐resistant K. pneumoniae bacteriuria cases were treated with an aminoglycoside‐containing regimen, and none of them developed nephrotoxicity vs 4 patients of 13 treated with non‐aminoglycoside‐containing regimens and developed nephrotoxicity.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and impact of bloodstream infections among kidney transplant recipients: A retrospective single‐center experience

Shendi

Wallis

Painter

et al. 2018

Transplant Infectious Dis

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Urinary tract infection remains the commonest source of systemic infection among kidney transplant recipients and resistance to commonly used frontline antibiotics is common; thus, prevention and early detection are paramount. The appropriate choice of initial empirical antibiotic is vital to improve the outcome. Each unit needs to understand the epidemiology of organisms causing BSI in their transplant patients and their antibiotic susceptibilities.

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“…The interpretation of this data is limited by the retrospective design of the study and only randomized trials could address a possible role of quinolones, also in severe infections. However, their use should be carefully evaluated considering the high rates of resistance reported, especially in area with an increased consumption of these antibiotics [36][37].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Predictors of outcome in patients with severe sepsis or septic shock due to extended-spectrum β-lactamase-producing Enterobacteriaceae

Russo

Falcone

Gutiérrez‐Gutiérrez

et al. 2018

International Journal of Antimicrobial Agents

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In Vitro Activities of 21 Antimicrobial Agents Alone and in Combination with Aminoglycosides or Fluoroquinolones against Extended-Spectrum-β-Lactamase-Producing Escherichia coli Isolates Causing Bacteremia

Cited by 18 publications

References 16 publications

Antimicrobial resistance patterns, clinical features, and risk factors for septic shock and death of nosocomial E coli bacteremia in adult patients with hematological disease

Antimicrobial resistance patterns, clinical features, and risk factors for septic shock and death of nosocomial E coli bacteremia in adult patients with hematological disease

Epidemiology and impact of bloodstream infections among kidney transplant recipients: A retrospective single‐center experience

Predictors of outcome in patients with severe sepsis or septic shock due to extended-spectrum β-lactamase-producing Enterobacteriaceae

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