Risk Factors for Community-Acquired Extended-Spectrum Beta-Lactamase–Producing Enterobacteriaceae Infections—A Retrospective Study of Symptomatic Urinary Tract Infections

Goyal, Dheeraj; Dean, Nathan C.; Neill, Sarah; Jones, Peter; Dascomb, Kristin

doi:10.1093/ofid/ofy357

Cited by 56 publications

(45 citation statements)

References 27 publications

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“…4 Escherichia coli and K. pneumoniae are the most common ESBL-producing bacteria; indwelling catheterization, history of recurrent urinary tract infection and use of antibiotics within 3 months are risk factors for ESBL production. 5 The detection rates are higher in Latin America, Asia, and the Middle East but lower in the South Pacific, Europe, and North America, 6,7 considering the abuse and non-standard use of antibiotics in developing countries. It has been reported that from 2000 to 2009, the detection rate of ESBL-producing E.coli increased from 3.3% to 8% and that of K. pneumoniae increased from 9.1% to 18.6%.…”

Section: Methods the Drug Susceptibility Results Of Hospitalized Chimentioning

confidence: 99%

Analysis of drug resistance of extended-spectrum beta-lactamases-producing Escherichia coli and Klebsiella pneumoniae in children with urinary tract infection

Xiao

et al. 2019

SMJ

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Objectives: To investigate the drug resistance of extendedspectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) in children with urinary tract infection (UTI) and to provide the rationale for clinical use of antibiotics. Methods: This is a retrospective analysis of drug susceptibility in children with E. coli or K. pneumoniae-positive urine culture between August 2013 and August 2017, Shenzhen Children's Hospital, Shenzhen, China. Drug resistance was statistically assessed using Fisher exact test and χ 2 test. Results: A total of 698 cases of E. coli, 426 of which were confirmed ESBL-producing strains, and 217 cases of K. pneumoniae, including 111 ESBL-producing strains, were detected, and the difference in proportion of positive ESBL-producing strains (61.03% versus 51.15%) was statistically significant (p=0.010). The average drug resistance rates of E. coli and K. pneumoniae to piperacillin/tazobactam, meropenem, ertapenem, imipenem, and amikacin were <15%. The average resistance rates of ESBL-producing E. coli and K. pneumoniae to cefpodoxime, cefixime, cefazolin, and ceftriaxone was >98%, while average resistance rates for non-ESBL-producing bacteria to the above 4 drugs was <20%. Conclusion: In southern China, the proportion of ESBL-producing strains and the drug resistance rates of E. coli and K. pneumoniae in UTI in children was high, but their resistance rates to carbapenems and β-lactamase inhibitor complexes containing tazobactam were low. Carbapenems are the most effective antibacterial drugs for the treatment of ESBL-producing bacteria.

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Section: Methods the Drug Susceptibility Results Of Hospitalized Chimentioning

confidence: 99%

Analysis of drug resistance of extended-spectrum beta-lactamases-producing Escherichia coli and Klebsiella pneumoniae in children with urinary tract infection

Xiao

et al. 2019

SMJ

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“…It is known that patients with comorbid conditions have frequent encounters at healthcare settings; lathering the way for ESBL colonization and recurrent infection [23]. It is assumed that vulnerability of patients with urological condition to acquire resistant bacterial strains is enhanced, as the host's immune system is weakened [24][25][26][27][28]. Many previous studies showed that urinary instrumentation and/or a history of frequent UTIs were both linked to a higher hazard of ESBL-UTIs [25][26][27][28].…”

Section: Plos Onementioning

confidence: 99%

Predictive utility of prior positive urine culture of extended- spectrum β -lactamase producing strains

et al. 2020

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Rising incidence of extended- spectrum beta-lactamase (ESBL) induced urinary tract infections (UTIs) is an increasing concern worldwide. Thus, it is of paramount importance to investigate novel approaches that can facilitate the identification and guide empiric antibiotic therapy in such episodes. The study aimed to evaluate the usability of antecedent ESBL-positive urine culture to predict the pathogenic identity of future ones. Moreover, the study evaluated the accuracy of selected empiric therapy in index episodes. This was a retrospective study that included 693 cases with paired UTI episodes, linked to two separate hospital admissions within 12 month-period, and a conditional previous ESBL positive episode. Pertinent information was obtained by reviewing patients’ medical records and computerized laboratory results. Multivariate analysis showed that shorter interval between index and previous episodes was significantly associated with increased chance of ESBL-positive results in current culture (OR = 0.912, 95CI% = 0.863–0.963, p = 0.001). Additionally, cases with ESBL-positive results in current culture were more likely to have underlying urological/surgical condition (OR = 1.416, 95CI% = 1.018–1.969, p = 0.039). Investigations of the accuracy of current empirical therapy revealed that male patients were less accurately treated compared to female patients (OR = 0.528, 95CI% = 0.289–0.963, p = 0.037). Furthermore, surgical patients were treated less accurately compared to those treated in internal ward (OR = 0.451, 95CI% = 0.234–0.870, p = 0.018). Selecting an agent concordant with previous microbiologic data significantly increased the accuracy of ESBL-UTIs therapy (p<0.001). A quick survey of the previous ESBL urine culture results can guide practitioners in the selection of empiric therapy for the pending current culture and thus improve treatment accuracy.

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“…The prevalence of nosocomial and community-acquired infections of Extended Spectrum β-Lactamase (ESBL) producing Enterobacteriaceae (ESBL-E), especially Escherichia coli (ESBL-EC) and Klebsiella pneumoniae (ESBL-KP), is increasing worldwide (1)(2)(3)(4)(5). A study in the three tertiary referral hospitals in East and Central Java, Indonesia, found that ESBL-EC and ESBL-KP were the most frequently isolated ESBL-E, followed by ESBL-Enterobacter (6).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Carriage of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Among Pregnant Women in the Primary Health Care Center and Hospital Setting in Indonesia

Oktaviani¹,

Hasanah²,

Setyarini³

et al. 2020

Preprint

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Abstract Background: The incidence of healthy individuals carrying Extended-Spectrum Beta-Lactamase producing Enterobacteriaceae (ESBL-E), especially E. coli (ESBL-EC) and Klebsiella pneumoniae (ESBL-KP), is increasing worldwide. ESBL-E causes early or late onset of neonatal sepsis, resulting in increased morbidity and mortality rates. Although maternal-neonatal transmissions of ESBL-E have been reported in several countries, the prevalence of ESBL-E carriage among pregnant women in Indonesia is not clear. In the present study, we compared the prevalence of carriage of ESBL-E among pregnant women in a primary health care center (PHC) versus two hospitals in Indonesia and identified the phenotypic and genotypic characteristics of the isolated ESBL-E strains. Methods: We collected rectal swab samples from 200 pregnant women who visited a PHC (101 women) or were admitted to Dr. Soetomo Referral Hospital or Airlangga University Hospital (99 women) in Surabaya, Indonesia from July to October 2018. The samples were cultivated on MacConkey Agar plates supplemented with cefotaxime 2 mg/L, at 37oC overnight. The isolated strains were identified by Bruker MALDI BiotyperÒ System, phenotypic detection of ESBL was performed by the combination disk method, and antibiotic susceptibility was tested by the disk diffusion method. In addition, ESBL gene was identified by PCR and DNA sequencing and molecular epidemiological studies were performed by PFGE. Results: ESBL-E strains were isolated from 25 (rate of fecal carriage; 24.8%) pregnant women who visited the PHC and 49 (49.5%) pregnant women who were admitted to the hospitals. The rate of ESBL-E carriage of pregnant women in the hospitals was significantly higher than that in the PHC. Among the 74 isolated ESBL-E strains, ESBL-EC was most frequently isolated (62 strains), followed by ESBL-KP (12 strains). In addition, blaCTX-M15 was the most frequent ESBL gene type of the isolated ESBL-E strains. Conclusion: Our results revealed the high prevalence of ESBL-E carriage in pregnant women, especially those who were admitted to the hospitals. CTX-M15 ESBL-EC was the most frequent type of ESBL-E in the pregnant women in our study. Continuous surveillance for ESBL-E carriage in pregnant women is strongly recommended to reduce the incidence of neonatal sepsis in Indonesia.

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Risk Factors for Community-Acquired Extended-Spectrum Beta-Lactamase–Producing Enterobacteriaceae Infections—A Retrospective Study of Symptomatic Urinary Tract Infections

Cited by 56 publications

References 27 publications

Analysis of drug resistance of extended-spectrum beta-lactamases-producing Escherichia coli and Klebsiella pneumoniae in children with urinary tract infection

Analysis of drug resistance of extended-spectrum beta-lactamases-producing Escherichia coli and Klebsiella pneumoniae in children with urinary tract infection

Predictive utility of prior positive urine culture of extended- spectrum β -lactamase producing strains

Prevalence of Carriage of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Among Pregnant Women in the Primary Health Care Center and Hospital Setting in Indonesia

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