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Changing epidemiology of infections due to extended spectrum beta-lactamase producing bacteria.

Kassakian SZ, Mermel LA - Antimicrob Resist Infect Control (2014)

Bottom Line: Fifty-eight cases (18%) were community-acquired, 170 (53%) were healthcare-associated, and 93 (29%) were hospital-acquired.For ESBL-producing E. coli isolates, resistance to both ciprofloxacin and trimethoprim-sulfamethoxazole was 95% and 65%, respectively but 94% of isolates were susceptible to nitrofurantoin.Most isolates are resistant to oral antibiotics commonly used to treat urinary tract infections.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA. lmermel@lifespan.org.

ABSTRACT

Background: Community-associated infections caused by extended-spectrum beta-lactamase (ESBL) producing bacteria are a growing concern.

Methods: Retrospective cohort study of clinical infections due to ESBL-producing bacteria requiring admission from 2006-2011 at a tertiary care academic medical center in Providence, RI.

Results: A total of 321 infections due to ESBL-producing bacteria occurred during the study period. Fifty-eight cases (18%) were community-acquired, 170 (53%) were healthcare-associated, and 93 (29%) were hospital-acquired. The incidence of ESBL infections per 10,000 discharges increased during the study period for both healthcare-associated infections, 1.9 per year (95% CI 1-2.8), and for community-acquired infections, 0.85 per year (95% CI 0.3-1.4) but the rate remained unchanged for hospital-acquired infections. For ESBL-producing E. coli isolates, resistance to both ciprofloxacin and trimethoprim-sulfamethoxazole was 95% and 65%, respectively but 94% of isolates were susceptible to nitrofurantoin.

Conclusions: Community-acquired and healthcare-associated infections due to ESBL-producing bacteria are increasing in our community, particularly urinary tract infections due to ESBL-producing E. coli. Most isolates are resistant to oral antibiotics commonly used to treat urinary tract infections. Thus, our findings have important implications for outpatient management of such infections.

No MeSH data available.


Related in: MedlinePlus

ESBL-producing bacteria. ESBL-producing bacteria identified during the study period.
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Figure 2: ESBL-producing bacteria. ESBL-producing bacteria identified during the study period.

Mentions: Urinary tract infection predominated (80%), followed by bloodstream infection (10%), skin and soft-tissue infection (5%), pneumonia (3%) and intra-abdominal infection (2%). There was a marked shift in the predominant organism in all three acquisition types from K. pneumoniae to E. coli (FigureĀ 2). For the entire study period, E. coli accounted for 78%, 66% and 65% of the community, healthcare-associated, and hospital-acquired groups, respectively.


Changing epidemiology of infections due to extended spectrum beta-lactamase producing bacteria.

Kassakian SZ, Mermel LA - Antimicrob Resist Infect Control (2014)

ESBL-producing bacteria. ESBL-producing bacteria identified during the study period.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230027&req=5

Figure 2: ESBL-producing bacteria. ESBL-producing bacteria identified during the study period.
Mentions: Urinary tract infection predominated (80%), followed by bloodstream infection (10%), skin and soft-tissue infection (5%), pneumonia (3%) and intra-abdominal infection (2%). There was a marked shift in the predominant organism in all three acquisition types from K. pneumoniae to E. coli (FigureĀ 2). For the entire study period, E. coli accounted for 78%, 66% and 65% of the community, healthcare-associated, and hospital-acquired groups, respectively.

Bottom Line: Fifty-eight cases (18%) were community-acquired, 170 (53%) were healthcare-associated, and 93 (29%) were hospital-acquired.For ESBL-producing E. coli isolates, resistance to both ciprofloxacin and trimethoprim-sulfamethoxazole was 95% and 65%, respectively but 94% of isolates were susceptible to nitrofurantoin.Most isolates are resistant to oral antibiotics commonly used to treat urinary tract infections.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA. lmermel@lifespan.org.

ABSTRACT

Background: Community-associated infections caused by extended-spectrum beta-lactamase (ESBL) producing bacteria are a growing concern.

Methods: Retrospective cohort study of clinical infections due to ESBL-producing bacteria requiring admission from 2006-2011 at a tertiary care academic medical center in Providence, RI.

Results: A total of 321 infections due to ESBL-producing bacteria occurred during the study period. Fifty-eight cases (18%) were community-acquired, 170 (53%) were healthcare-associated, and 93 (29%) were hospital-acquired. The incidence of ESBL infections per 10,000 discharges increased during the study period for both healthcare-associated infections, 1.9 per year (95% CI 1-2.8), and for community-acquired infections, 0.85 per year (95% CI 0.3-1.4) but the rate remained unchanged for hospital-acquired infections. For ESBL-producing E. coli isolates, resistance to both ciprofloxacin and trimethoprim-sulfamethoxazole was 95% and 65%, respectively but 94% of isolates were susceptible to nitrofurantoin.

Conclusions: Community-acquired and healthcare-associated infections due to ESBL-producing bacteria are increasing in our community, particularly urinary tract infections due to ESBL-producing E. coli. Most isolates are resistant to oral antibiotics commonly used to treat urinary tract infections. Thus, our findings have important implications for outpatient management of such infections.

No MeSH data available.


Related in: MedlinePlus