Measures used to assess the burden of ESBL-producing Escherichia coli infections in humans: a scoping review

Abstract

Background ESBL-producing bacteria pose a serious challenge to both clinical care and public health. There is no standard measure of the burden of illness (BOI) of ESBL-producing Escherichia coli (ESBL-EC) in the published literature, indicating a need to synthesize available BOI data to provide an overall understanding of the impact of ESBL-EC infections on human health. Objectives To summarize the characteristics of BOI reporting in the ESBL-EC literature to (i) describe how BOI associated with antimicrobial resistance (AMR) is measured and reported; (ii) summarize differences in other aspects of reporting between studies; and (iii) highlight the common themes in research objectives and their relation to ESBL-EC BOI. Methods and results Two literature searches, run in 2013 and 2018, were conducted to capture published studies evaluating the BOI associated with ESBL-EC infections in humans. These searches identified 1723 potentially relevant titles and abstracts. After relevance screening of titles and abstracts and review of full texts, 27 studies were included for qualitative data synthesis. This review identified variability in the reporting and use of BOI measures, study characteristics, definitions and laboratory methods for identifying ESBL-EC infections. Conclusions Decision makers often require BOI data to make science-based decisions for the implementation of surveillance activities or risk reduction policies. Similarly, AMR BOI measures are important components of risk analyses and economic evaluations of AMR. This review highlights many limitations to current ESBL-EC BOI reporting, which, if improved upon, will ensure data accessibility and usefulness for ESBL-EC BOI researchers, decision makers and clinicians.

ESBL‐producing Enterobacteriaceae in a rural Rwandan community: Carriage among community members, livestock, farm products and environment

“…Antimicrobial resistance poses a serious threat to Global Health [1, 27], and WHO classifies ESBL‐PE as the highest priority status pathogens [28]. In the present study from a rural community in southern Rwanda, 14.8% of all the samples collected in various One Health domains contained ESBL‐PE, with the highest figures for human rectal carriage (38%) and lowest for water specimens (<1%).…”

Study of the Membrane Activity of the Synthetic Peptide ∆M3 against Extended-Spectrum β-Lactamase Escherichia coli Isolates

“…coli is a bacterium that belongs to the Enterobacteriaceae family and is part of the natural intestinal microbiota of humans and animals. However, when it spreads to other areas of the body, it causes serious infections in the upper respiratory tract, urinary tract, surgical wounds, blood, and gastroenteritis (23,33). The WHO in their report on antimicrobial resistance for the year 2022, emphasized the alarming growth of resistant E. coli isolates due to the presence of extended-spectrum b-lactamases (1).…”

Building an International One Health Strain Level Database to Characterise the Epidemiology of AMR Threats: ESBL—AmpC Producing E. coli as An Example—Challenges and Perspectives

“…In general, the presence of ESBLs/AmpC is a complicating factor for the treatment of patients with serious infections, since ESBL-producing bacteria are frequently MDR, often including resistance to fluoroquinolones [ 22 ]. It is clear that ESBL and AmpC producing E. coli (from here on called extended spectrum cephalosporin resistant E. coli or ESC-EC) infections place a burden on health-care systems, but there are inconsistencies in the method for defining the burden of illness of ESC-EC and other Enterobacterales in hospital settings [ 23 ]. Intestinal colonisation by ESC-EC and its association with community acquired MDR infections is of great concern; an increasing prevalence of ESBLs has been observed in the human gut microbiota in both healthy and diseased members of the community, and a recent study estimated a global eight-fold increase in the intestinal carriage rate of ESC-EC in the community over the past two decades [ 24 ].…”