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Risk Factors for Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Community-Onset Bloodstream Infection: Impact on Long-Term Care Hospitals in Korea

BACKGROUND: The prevalence of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) in the community has increased worldwide due to multifactorial reasons. ESBL-EC bloodstream infection (BSI) complicates the decision for proper antimicrobial administration. In this multicenter study, we...

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Autores principales: Baek, Yae Jee, Kim, Young Ah, Kim, Dokyun, Shin, Jong Hee, Uh, Young, Shin, Kyeong Seob, Shin, Jeong Hwan, Jeong, Seok Hoon, Lee, Geun Woo, Lee, Eun Ji, Kim, Dong-Sook, Park, Yoon Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society for Laboratory Medicine 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8041596/
https://www.ncbi.nlm.nih.gov/pubmed/33824233
http://dx.doi.org/10.3343/alm.2021.41.5.455
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author Baek, Yae Jee
Kim, Young Ah
Kim, Dokyun
Shin, Jong Hee
Uh, Young
Shin, Kyeong Seob
Shin, Jeong Hwan
Jeong, Seok Hoon
Lee, Geun Woo
Lee, Eun Ji
Kim, Dong-Sook
Park, Yoon Soo
author_facet Baek, Yae Jee
Kim, Young Ah
Kim, Dokyun
Shin, Jong Hee
Uh, Young
Shin, Kyeong Seob
Shin, Jeong Hwan
Jeong, Seok Hoon
Lee, Geun Woo
Lee, Eun Ji
Kim, Dong-Sook
Park, Yoon Soo
author_sort Baek, Yae Jee
collection PubMed
description BACKGROUND: The prevalence of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) in the community has increased worldwide due to multifactorial reasons. ESBL-EC bloodstream infection (BSI) complicates the decision for proper antimicrobial administration. In this multicenter study, we investigated the prevalence, risk factors, and molecular background of community-onset (CO) ESBL-EC BSI. METHODS: We included data for all episodes of ESBL-EC BSI of community origin from May 2016 to April 2017 obtained from the Korean national antimicrobial resistance surveillance system, which comprises six sentinel hospitals. Data, including previous history of admission and use of antimicrobials and medical devices before BSI, were collected, along with microbiological analysis results. RESULTS: Among 1,189 patients with CO BSI caused by E. coli, 316 (27%) were identified as ESBL producers. History of admission, especially to a long-term care hospital (LTCH), and previous use of β-lactams/β-lactamase inhibitors, carbapenem, lincosamide, aminoglycoside, and extended-spectrum cephalosporin were independent risk factors for CO ESBL-EC BSI; admission to an LTCH showed the highest odds ratio (3.8, 95% confidence interval 2.3-6.1). The most common genotype was CTX-M-15 (N=131, 41%), followed by CTX-M-14 (N=86, 27%). ST131 was the most common sequence type among ESBL-EC groups (57%). CONCLUSIONS: In Korea, 27% of CO E. coli BSI were caused by ESBL producers. From perspectives of empirical treatment and infection control, history of admission to an LTCH and antimicrobial use should be noted.
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spelling pubmed-80415962021-09-01 Risk Factors for Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Community-Onset Bloodstream Infection: Impact on Long-Term Care Hospitals in Korea Baek, Yae Jee Kim, Young Ah Kim, Dokyun Shin, Jong Hee Uh, Young Shin, Kyeong Seob Shin, Jeong Hwan Jeong, Seok Hoon Lee, Geun Woo Lee, Eun Ji Kim, Dong-Sook Park, Yoon Soo Ann Lab Med Original Article BACKGROUND: The prevalence of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) in the community has increased worldwide due to multifactorial reasons. ESBL-EC bloodstream infection (BSI) complicates the decision for proper antimicrobial administration. In this multicenter study, we investigated the prevalence, risk factors, and molecular background of community-onset (CO) ESBL-EC BSI. METHODS: We included data for all episodes of ESBL-EC BSI of community origin from May 2016 to April 2017 obtained from the Korean national antimicrobial resistance surveillance system, which comprises six sentinel hospitals. Data, including previous history of admission and use of antimicrobials and medical devices before BSI, were collected, along with microbiological analysis results. RESULTS: Among 1,189 patients with CO BSI caused by E. coli, 316 (27%) were identified as ESBL producers. History of admission, especially to a long-term care hospital (LTCH), and previous use of β-lactams/β-lactamase inhibitors, carbapenem, lincosamide, aminoglycoside, and extended-spectrum cephalosporin were independent risk factors for CO ESBL-EC BSI; admission to an LTCH showed the highest odds ratio (3.8, 95% confidence interval 2.3-6.1). The most common genotype was CTX-M-15 (N=131, 41%), followed by CTX-M-14 (N=86, 27%). ST131 was the most common sequence type among ESBL-EC groups (57%). CONCLUSIONS: In Korea, 27% of CO E. coli BSI were caused by ESBL producers. From perspectives of empirical treatment and infection control, history of admission to an LTCH and antimicrobial use should be noted. Korean Society for Laboratory Medicine 2021-09-01 2021-09-01 /pmc/articles/PMC8041596/ /pubmed/33824233 http://dx.doi.org/10.3343/alm.2021.41.5.455 Text en © Korean Society for Laboratory Medicine https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Baek, Yae Jee
Kim, Young Ah
Kim, Dokyun
Shin, Jong Hee
Uh, Young
Shin, Kyeong Seob
Shin, Jeong Hwan
Jeong, Seok Hoon
Lee, Geun Woo
Lee, Eun Ji
Kim, Dong-Sook
Park, Yoon Soo
Risk Factors for Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Community-Onset Bloodstream Infection: Impact on Long-Term Care Hospitals in Korea
title Risk Factors for Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Community-Onset Bloodstream Infection: Impact on Long-Term Care Hospitals in Korea
title_full Risk Factors for Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Community-Onset Bloodstream Infection: Impact on Long-Term Care Hospitals in Korea
title_fullStr Risk Factors for Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Community-Onset Bloodstream Infection: Impact on Long-Term Care Hospitals in Korea
title_full_unstemmed Risk Factors for Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Community-Onset Bloodstream Infection: Impact on Long-Term Care Hospitals in Korea
title_short Risk Factors for Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Community-Onset Bloodstream Infection: Impact on Long-Term Care Hospitals in Korea
title_sort risk factors for extended-spectrum-β-lactamase-producing escherichia coli in community-onset bloodstream infection: impact on long-term care hospitals in korea
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8041596/
https://www.ncbi.nlm.nih.gov/pubmed/33824233
http://dx.doi.org/10.3343/alm.2021.41.5.455
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